Carl Levin - United States Senator for Michigan: Helping You

Medicare & Social Security

Medicare and Social Security Help

This section of my website - Medicare and Social Security Help - has two different pages that offer information and resources about these two federal programs.

If you need my office's assistance with a Medicare issue, please click on the Medicare link in the box on the left.

If you need my office's assistance with a Social Security issue, please click on the Social Security link in the box on the left.

From that page, you can find detailed information about each of these programs and access the specialized online form you can fill out and submit to my office. Please allow up to 30 days from the day we receive your release for my office to contact you.

Carl Levin

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Once you have reviewed your information on the next page, press the Print and Submit button. This will generate a PDF containing all of the information you have entered as well as a privacy release form. Please print the form, sign and date the last page, and return the form in its entirety to my Detroit office by fax or mail.

Although the information on your form will be submitted to my office electronically, we cannot open an inquiry on your behalf until we receive your signed form.

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This is a preview of your Request. Please confirm that all of the information below is correct before submitting. If you would like to make any changes to the information you have provided, please use the "Edit" button below. Using your browser's buttons to navigate will cause all form information to be lost.

Primary Contact Info - Preview

Salutation *

First Name *

Middle Name

Last Name *

Suffix

Street Address *

Street Address (2)

City *

State *

Zip Code *

Primary Phone *

Secondary Phone

e-mail

Federal Agency Information - Preview

Federal Agency Involved *

With which office is your claim pending?

Contacted another congressional office?*

Description of Request - Preview

Description
(please describe the problem in as much detail as necessary)

Preview and Send Request

Please review the information on this page. If you need to make any changes, click on the Edit button to return to the previous page.

To submit your request to my office, press the Print and Submit button. This will generate a PDF containing all of the information you have entered as well as a privacy release form. Please print the form, sign and date the last page, and return the form in its entirety to my Detroit office by fax or mail.

Although the information on your form will be submitted to my office electronically, we cannot open an inquiry on your behalf until we receive your signed form.

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Once we have received your signed authorization, my staff will begin assessing how we can help. Please allow up to 30 days from the day we receive your release for my office to contact you. Thank you.