Your dashboard and resource to submit service requests and staying up to date on client-only information

Get Help With Your Policy!

Answer a few questions about how we can help and we will reach out to you at the phone number you provide!

Client Service Request: Step 1

Are you a current client?

Yes

No

DISCLAIMER: This form is a request for help and no action will be taken until you speak to a Husband and WIfe Agency team member by phone. We cannot accept policy cancellations by form or email, this must be done by phone at 435-757-1188.

Client Service Request: Step 2

How Can We Help

General Question

Help Me with a Medical Bill

Help Me File a Claim

Help Me Change My Plan

I'm not a current client, but I want to work with Husband and Wife Agency

DISCLAIMER: This form is a request for help and no action will be taken until you speak to a Husband and WIfe Agency team member by phone. We cannot accept policy cancellations by form or email, this must be done by phone at 435-757-1188.

*

Postal code

Date of birth

Phone *

Email *

The Husband and Wife Agency respects your privacy and will only use your information to recommend suitable healthcare plans based on your needs. You are agreeing to receive SMS marketing. Reply STOP to opt out. Learn more in our Privacy Policy.

The Husband and Wife Agency is committed to protecting the privacy of its visitors. We collect no personal information about you when you visit our website unless you choose to provide that information with us.

We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options.