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Policy Change Request

The following form is provided to you for making changes or requests on your existing policies. By submitting this form you understand that no coverage or premium adjustment of any kind is bound until you receive written notice from us.

Policy Change Request

* indicates required fields

General Information

Name*

Company Name (If For a Business)

Email*

Phone*

Current Insurance Information

Insurance Company Name

Policy Number

Policy Expiration Date

Date You Would Like Changes to Take Effect

Describe Requested Changes

Phone

This field is for validation purposes and should be left unchanged.

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Customer Reviews

Contact

The M1 Agency

Phone: (248) 771-3161

Office Hours:

Mon-Thu: 9:00am-7:00pm
Fri: 9:00am-12:00pm
Sat-Sun: Weekends & After Hours By Appointment

The M1 Agency provides Social Security Planning, Medicare, Annuities, and Age-Specific Insurance Plans to all of Michigan, including Metropolitan Detroit.

We do not offer every available plan in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.