Paper Application and Mail-in Option

Click 'Download the Enrollment Application' below to save, print and complete your enrollment form.

Download the Enrollment Application

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

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 Sixth St. SW
Canton, OH 44710

Click the PrimeTime Choices Guide below to download the information found on this website.

Click the Choosing a Medigap Policy cover to download the official guide from Medicare

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