Contact Us: (719) 481-1616
Choice Enrollment
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  • Home
  • Quotes
    • Free Consultation
    • Fixed Indemnity
    • Health Insurance Quote
    • Gap Insurance Quote
    • Short Term Medical Quote
    • Accident Supplement Insurance Quote
    • Critical Illness Insurance Quote
    • Overseas Travel Health Insurance Quote
    • Dental Insurance Quote
    • Vision Insurance Quote
    • Life Insurance Quote
    • Medigap Quote
  • Service
    • Update Contact Info
    • Contact My Carrier
    • Healthcare Calculator
    • Free Consultation
    • Pre-Appointment Financial Worksheet
    • Renew/Non-Renew 2023 Health Insurance
  • Insurance
    • Health Insurance
    • Guarantee Acceptance Plans
    • Short Term Medical Insurance
    • Accident Supplement Insurance
    • Critical Illness Insurance
    • Overseas Travel Medical Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Medicare Supplement Coverage
  • About
    • Staff Directory
    • Insurance Carriers
    • Client Testimonials
    • Refer a Friend
    • Reviews
    • Helpful Links
    • Accessibility Statement
    • Videos
    • News
    • Blog
  • Contact
    • Schedule an Appointment

Pre-Appointment Financial Worksheet

Pre-Appointment Financial Worksheet

Contact Us

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    Dependents:

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    If your income falls between 138% - 400% the highlighted area, you may qualify for a subsidy to help pay your monthly premiums.  If you fall under 138%, then you may qualify for Medicaid.
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(719) 481-1616
5390 North Academy Blvd.
Suite 220
Colorado Springs, CO 80918​
Click Here to Email Us

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Choice Enrollment
5390 North Academy Blvd.
Suite 220
Colorado Springs, CO 80918
(719) 481-1616
Click Here to Email Us
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