WPS Health Insurance

Request a WPS Medicare Supplement Information Kit

Please note: This insurance plan is only available to Wisconsin residents.

Talk to a Licensed Agent!

Call 1-800-811-1670
711 TTY/TDD
Mon – Fri, 7 a.m. to 6 p.m.
Sat, 9 a.m. to 5 p.m.

To assure all your needs have been met, it is our practice to follow up by telephone with those who have requested information from us. By submitting this form you will be granting us permission to contact you via telephone in the future. Thank you for allowing us the opportunity to respond to your health insurance needs.

To receive your information kit, please complete the form below or call us at: 1-800-811-1670.

Name:

First:

Last:
E-mail Address:

Date of Birth:

Month

Day
 

Year

Phone Number:

( )  -

Address:

Number & Street:

City:
 

State:
 

Zip:

County:

Would you also like information about
our Medicare Prescription Drug (PDP) plans?
Yes
No
This is an advertisement for insurance. Neither WPS nor its agents are connected with the Federal Medicare program. 24873_021_1009
Wisconsin Physicians Service(WPS Health Insurance) is a Medicare approved Part D sponsor. [an error occurred while processing this directive] CMS Approved: pending . Last Updated: 10/1/2010