Kelsey Care Advantage Pre-Enrollment Kit

Pre-Enrollment Kit Request Form

The Broker Sales Kit Request Form allows brokers to order a Pre-Enrollment Kit to be mailed directly to a location when a digital kit is not preferred. This form helps brokers provide clients with important information about KelseyCare Advantage’s Medicare plans so they can make informed choices.

Simply fill out a simple form with the shipping information and kit preference (English or Spanish). Once submitted, the request is processed within 24 hours, and the kits are shipped directly to the address entered via United States Postal Service (USPS).