Insurance for you

Protect What Matters Most

At the heart of what we do is a simple mission: helping individuals, families, and businesses protect what matters most. With expertise across Medicare, ACA health plans, final expense, life insurance, property and casualty, commercial coverage, and dental and vision plans, we provide tailored solutions designed to fit every stage of life and every unique need.

We understand that insurance can feel overwhelming, which is why we focus on making the process clear, straightforward, and personalized. Whether you're planning for retirement, safeguarding your family’s future, or protecting your business, our approach is built on education, transparency, and trust.

Our commitment goes beyond just finding a policy—we build long-term relationships by offering ongoing support, guidance, and advocacy when it matters most. Every client deserves confidence in their coverage and peace of mind in their future.

Medicare Made Simple

Find Medicare Coverage That Fits Your Life

Navigating Medicare can feel complicated, but understanding your options does not have to be. At Clear Choice Insurance, we provide personalized guidance to help you understand your Medicare coverage options and choose a plan that aligns with your healthcare needs, lifestyle, and budget.

Whether you are approaching Medicare eligibility, preparing for retirement, or reviewing your current coverage, we take the time to explain your options clearly and answer your questions. From Medicare Advantage and Medicare Supplement plans to prescription drug coverage, our goal is to help you make informed decisions with confidence.

With Clear Choice Insurance, you receive personal attention and ongoing support throughout your Medicare journey. We are committed to making the process straightforward, transparent, and easier to understand so you can focus on your health and enjoy the years ahead.

Start Medicare Quote Process

Complete SOA and questions below to get Medicare Quotes

Greg Diaz
Licensed Sales Agent

State Licenses-Texas

2319205

Hello, I'm Greg Diaz.

I have a couple of optional questions to help provide you with plan options. Upon completion of this short form, I’ll contact you to discuss plan options in your area!

By providing the information in this form, you are granting permission for a licensed insurance agent to contact you via phone, text, or email regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans. Providing permission does not impact eligibility to enroll or the provision of services.
Clear Choice Insurance Agency, LLC is a licensed health insurance agency and is not affiliated or endorsed by the government or Federal Medicare program. The submission data for this form is encrypted by AWS.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please visit Medicare.gov or call 1-800-MEDICARE to get information on all of your options.
Clear Choice Insurance Agency, LLC represents Medicare Advantage (HMO, PPO, PFFS) organizations and standalone PDP Prescription Drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal.

First Name *

Last Name *

Email *

Phone *

Date of birth *

Address

Street Address

State

City

Postal Code

County

What's your preferred pharmacy? ( You can add upto 3)

I use a mail order pharmacy

Let's take a look at your current prescriptions.

Please have your prescription bottles ready so we know exactly which medications you take. (Spelling, dosage and frequency are important!)

Do not include over-the-counter medications, vitamins, supplements.

Spelling is important!

Do you have any current prescribed medications? *

Please list your current prescription medications:

prescription medications Picture (if available)

Tell us about your Doctors and Hospitals.

To provide plan options in your area, We’ll need some info on your doctors and preferred hospital(s) to verify their network status.

What's your preferred hospital(s)?

Who are your physicians?

Do you have a Primary Care Physician *

List Primary Care Physician (Full Name) and ALL Physicians currently seeing

Is there any additional information that you feel is important?

Please share anything coverage or health related here (Chronic Conditions, Medicare Number and your Medicare Part A and B effective dates, Medicaid or LIS participant).

Let's wrap this up!

The Centers for Medicare and Medicaid Services requires agents to document the scope of a marketing appointment prior to any face-to-face sales meeting to ensure understanding of what will be discussed between the agent and the Medicare beneficiary (or their authorized representative). All information provided on this form is confidential and should be completed by each person with Medicare or his/her authorized representative.

Scope of Sales Appointment Confirmation Form

The Centers for Medicare and Medicaid Services requires agents to document the scope of a marketing appointment prior to any individual sales meeting to ensure understanding of what will be discussed between the agent and the Medicare beneficiary (or their authorized representative). All information provided on this form is confidential and should be completed by each person with Medicare or his/her authorized representative.

Please initial beside the type of product(s) you want the agent to discuss.

Stand-alone Medicare Prescription Drug Plans (Part D)

Medicare Prescription Drug Plan (PDP) - A stand-alone drug plan that adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans.

(Part D)Prescription Drug Plan (PDP) - Initial here

Medicare Advantage Plans (Part C) and Cost Plans

Medicare Health Maintenance Organization (HMO)- A Medicare Advantage Plan that provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. In most HMOs, you can only get your care from doctors or hospitals in the plan's network (except in emergencies).
Medicare Preferred Provider Organization (PPO) Plan- A Medicare Advantage Plan that provides all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug coverage. PPOs have network doctors and hospitals but you can also use out-of-network providers, usually at a higher cost.
Medicare Private Fee-For-Service (PFFS) Plan- A Medicare Advantage Plan in which you may go to any Medicare-approved doctor, hospital and provider that accepts the plan's payment, terms and conditions and agrees to treat you - not all providers will. If you join a PFFS Plan that has a network, you can see any of the network providers who have agreed to always treat plan members. You will usually pay more to see out-of-network providers
Medicare Special Needs Plan (SNP)- A Medicare Advantage Plan that has a benefit package designed for people with special health care needs. Examples of the specific groups served include people who have both Medicare and Medicaid, people who reside in nursing homes, and people who have certain chronic medical conditions.
Medicare Medical Savings Account (MSA) Plan- MSA Plans combine a high deductible health plan with a bank account. The plan deposits money from Medicare into the account. You can use it to pay your medical expenses until your deductible is met.
Medicare Cost Plan- In a Medicare Cost Plan, you can go to providers both in and out of network. If you get services outside of the plan's network, your Medicare-covered services will be paid for under Original Medicare but you will be responsible for Medicare coinsurance and deductibles.

(Part C)Medicare Advantage Plans - Initial here

Medicare Supplement Medigap Products

Plans offering a supplemental policy to fill “gaps" in Original Medicare coverage. A Medigap policy typically pays some or all of the deductible and coinsurance amounts applicable to Medicare-covered services, and sometimes covers items and services that are not covered by Medicare, such as care outside of the country. These plans are not affiliated or connected to Medicare.

Other Medicare Options Interested In

I am signing this as a POA for someone else

Please add a signuature below : *

Clear

Awesome! You're all set.

Greg from Clear Choice Insurance Agency, LLC will contact you soon!

By providing the information in this form, you are granting permission for a licensed insurance agent to contact you via phone, text, or email regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans. Providing permission does not impact eligibility to enroll or the provision of services.
Clear Choice Insurance Agency, LLC is a licensed health insurance agency and is not affiliated or endorsed by the government or Federal Medicare program. The submission data for this form is encrypted by AWS.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please visit Medicare.gov or call 1-800-MEDICARE to get information on all of your options.
Clear Choice Insurance Agency, LLC represents Medicare Advantage (HMO, PPO, PFFS) organizations, Supplemental and standalone PDP Prescription Drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal.