Effectively Transition To Medicare Get Your Free Guidebook! We will pair you up with a local Medicare Insurance agent as well as help you get on the right plan before you turn 65. Remember, there is never a charge to sign up for Medicare, so we cannot charge you anything and your consultation is always going to be free because we get paid by the health plans, not by you.. Name* First Last Phone*Email* Zip CodeWe believe in localized help. Your Birth YearTo better determine your Medicare Eligibility.Your Rights* I agree to the privacy policy.By clicking submit on this form, you agree to having a sales agent call to discuss the types of products you selected above. Please note, the person who will discuss the products is either employed or contracted by a Medicare plan. They do not work directly for the Federal government. HRBC works with various Medicare health plans. Each one has a Medicare contract. Enrollment in a Plan depends on their contract renewal. This individual may also be paid based on your enrollment in a plan. Submitting this form does NOT obligate you to enroll in a plan, affect your current or future enrollment, or enroll you in a Medicare plan. AccountManagerBIZDEV1TypeTransTypeSeccodeIDdescaStageMKTSource1MKTSource2