PrimeTime Choices Medicare Supplement Insurance offered by AultCare Insurance Company
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  • Home
  • Area & Rates
  • About
  • Enroll Online
  • Silver&Fit
  • Forms and Documents
  • FAQ
  • Contact Us

Paper Application and Mail-in Option

Click the PDF PrimeTime Choices Enrollment Application 'Download File' link below the preview,  to save, print and complete. You may mail the completed application to:

PrimeTime Choices
PO Box 9975
Canton, OH 44710

A drop box for completed applications is available at our office location:

PrimeTime Choices
Morrow House Building
2600 6th St SW
Canton, OH 44710


* Coverage is contingent upon PrimeTime Choices approval of this application.

Review the application below, to preview the questions.  
Download the Enrollment Application
PrimeTime Choices EFT Form
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Click the Choosing a Medigap Policy cover to download the official guide from Medicare

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Location

PrimeTime Choices
AultCare Insurance Company
Morrow House
2600 Sixth St SW
Canton, Ohio 44710
(330) 363-4031
(877) 863-1791
​TTY: 711

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