M Media Medigap Contact Wizard
A free WordPress plugin for Medicare and Medigap insurance professionals.
Capture more leads with a guided 5-step wizard – self-hosted, no monthly fees, no third-party data storage.
Download Free on WordPress.org | Documentation | Support
The Problem With Generic Contact Forms
Most Medicare and Medigap websites use the same generic contact form every other site uses – name, email, phone, and a comment box. That form tells you almost nothing about the prospect, and it gives the prospect no reason to trust you with their information. The result is low completion rates, low-quality leads, and no context for the follow-up call.
The M Media Medigap Contact Wizard was built to solve exactly that problem. Instead of a blank form, visitors are guided through a structured, five-step conversation that collects everything a licensed agent needs to prepare a meaningful consultation: Medicare enrollment status, existing coverage, health conditions, prescription details, coverage priorities, and privacy consent. Every field is purposeful. Every step builds trust. And because it feels less like a form and more like a guided process, completion rates are dramatically higher than a traditional contact form.
A Five-Step Wizard Built for Medigap Lead Capture
The wizard is organized into five logical steps that mirror the natural conversation a licensed agent would have with a prospect. Visitors always know where they are in the process – a branded progress bar tracks their position from start to finish.
- Step 1 – Contact Information: Name, email, phone number, ZIP code, and state. The foundation of every lead record.
- Step 2 – Medicare Status: Current enrollment, which Medicare parts they hold, when they enrolled, and whether they already carry a Medigap or Medicare Advantage plan. Conditional fields surface only when relevant – the form never feels cluttered.
- Step 3 – Needs & Concerns: Multi-select chip buttons let prospects identify their coverage interests and timeline in seconds. No dropdowns, no tiny checkboxes – a clean, touch-friendly interface that works perfectly on mobile.
- Step 4 – Health Details: Existing conditions, preferred pharmacy, and an optional prescription list upload (PDF, image, or document). The file is stored securely in your WordPress media library and linked directly in the submission record.
- Step 5 – Preferences & Final Questions: Coverage priorities, how they found you, marketing preferences, and a required privacy consent checkbox. Everything needed for a compliant, context-rich lead record.
When the visitor submits, they see a fully customizable confirmation message – set in your admin settings with HTML support. Meanwhile, a notification email is already on its way to your inbox.
A Full Submissions Dashboard – Right in Your WordPress Admin
Every completed wizard submission is saved as a WordPress custom post type. That means you get the full power of WordPress’s native list view: sort by date, search by name or email, and instantly see how many leads have come in – without logging into any external system or third-party CRM.
Click any submission to open the full prospect record: all five steps worth of data on a single screen, including the uploaded prescription file if one was provided. Every field is labeled clearly so you can scan the record in seconds and walk into a follow-up call prepared.
Your data stays on your server. Always. There is no external database, no third-party storage, no subscription required to access your own leads.
Five Email Delivery Methods – Works With Any Setup
One of the most common failure points in contact form plugins is email delivery. The wizard ships with five distinct notification delivery methods so it works correctly regardless of your hosting environment, your email provider, or your existing WordPress configuration.