Alternative Coverage Options

You can request additional information about the alternative coverage options available.

Reference Number
    ZIPCODE

Please enter your reference number and click continue. Your reference number can be found on the announcement letter, fax cover sheet, or postcard you received.

Please include all digits and hyphens


How it Works

  1. Enter your reference number and zipcode
  2. Click continue to verify your record
  3. Complete the request form
  4. Submit your request for additional information