Medicare By Phone Payment Form

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Medicare By Phone Payment


Credit Cardholder understands that this is a RECURRING PAYMENT that will draft on the 5th of every month. Payments can only be canceled in writing. If for any reason, there is a balance due, it must be paid at the time of cancellation. NO REFUNDS, EXCHANGES, or REPLACEMENTS. Upon termination of this Agreement for any reason, Credit Cardholder shall not be entitled to any refund of any previously paid monthly fees, or any portion thereof.