Schedule a Call

To schedule a call with a benefit advisor, enter your contact information and preferred time of day to be reached.

A benefit advisor will call you within two business days.

By entering my contact information and clicking "Submit" below, I consent to receive e-mails, telephone calls, text messages and artificial or pre-recorded messages from Extend Insurance Services, LLC licensed insurance agents or their affiliates and third-party partners, regarding health insurance products and services including Medicare Advantage Plans and/or Prescription Drug Plans, at the e-mail address and telephone number provided above, including my wireless number (if provided), using an automated telephone dialing system. I understand I can make a purchase or speak to a licensed insurance agent without granting this consent. I instead may call 1-855-803-2540, TTY 711 to speak to a licensed insurance agent. I agree to this website's privacy policy and terms & conditions.

Fields marked with an asterisk (*) are required.

Full Name

First and Last Name

Employer Name

If Via Benefits is provided by your employer, please provide the company name.

Phone Number

Please enter your phone number, area code first, as 10 digits without any characters.

In the event that we are unable to contact you at the number provided, please provide an email address where you can be reached.

State

Your state allows us to schedule your call based on your stated time of day preferences and time zone.

Preferred Time of Day

Indicate the best time of day to reach you in the next two business days.