Med. Supp. lead card mailer.

1. Detach Here And Mail Today or
For Privacy Fold Card and Tape with Return Address Facing Out.
SIGNATURE:
DATE OF BIRTH:
/ / / /
( )
SPOUSE’S:
DATE OF BIRTH:
JEBAK006
q
For your free brochure, “New Government Changes in
Government Healthcare Benefits for Seniors” mail this
postage reply card today.
PHONE NUMBER:
EMAIL: (NEEDED FOR DELIVERY)
(PLEASE PRINT CLEARLY)
Presorted
FIRST CLASS MAIL
U.S.PostagePaid
FALLRIVER,MA
PERMITNO.6
2016
FORM MS17C
PERSONAL
BUSINESS MAIL
POSTMASTER:
If undeliverable as addressed
please refer to section 507.1.4
of the official DMM.
MS 2016

2. PLEASE VERIFY THE ADDRESS FOR THIS INFORMATION REQUEST. THIS INFORMATION IS NOT AFFILIATED WITH OR
ENDORSED BY GOVERNMENT AGENCIES. YOU MAY BE CONTACTED BY AN INSURANCE LICENSED REPRESENTATIVE.
GOVERNMENT HEALTHCARE
BENEFITS FOR SENIORS
New Changes for 2016
New legislation has been passed by Congress which
changes your benefits.
A new brochure, “New Changes in Government
Healthcare Benefits for Seniors” is now available. The
information includes explanations of Medicare changes and
benefits.
For your FREE COPY of the new brochure please mail the
attached postage paid reply card today.