Purpose-Built Medicare Lead Capture for WordPress
M Media Medicare Contact Wizard is a professional multi-step lead capture plugin for Medicare and Medigap insurance agents, built to collect the detailed prospect information you actually need — without requiring a CRM subscription, form builder, or third-party service.
The wizard walks visitors through five structured steps covering contact info, Medicare enrollment status, coverage needs, prescription details, and final preferences. Every submission is stored in your WordPress dashboard and delivered to your inbox. No monthly fees. No lead-sharing. Your leads stay yours.
Why M Media Medicare Contact Wizard Exists
Generic contact forms collect a name and email. That is not enough to have a productive first conversation with a Medicare prospect. You need to know what parts they have, when they want coverage to start, whether they take prescriptions, and what matters most to them.
M Media Medicare Contact Wizard solves this by design. It gives every prospect a guided, professional experience while giving you a complete intake record before you ever pick up the phone.
Five-Step Guided Intake
The wizard breaks a thorough qualification questionnaire into five short, focused steps so visitors are never overwhelmed.
- Step 1 — Contact info: Name, email, phone, ZIP, and state
- Step 2 — Medicare status: Enrollment, Medicare parts held, other insurance coverage
- Step 3 — Needs and concerns: Coverage priorities, turning 65 timeline, plan start window, number of people covered
- Step 4 — Health and prescriptions: Ongoing conditions, medication list, optional file upload, dental/vision/hearing needs
- Step 5 — Preferences and consent: Open-ended priorities, marketing opt-out, Privacy Policy agreement
Smart Conditional Logic
Follow-up questions appear only when relevant. A prospect who is not yet enrolled in Medicare sees different questions than one who already has Parts A and B. A prospect who takes prescriptions is offered a medication text field and an optional file upload. Fields that do not apply stay hidden, keeping the form clean and fast for every visitor.
Anti-Spam Protection Built In
Submissions are validated server-side before any notification is sent.
- Honeypot field traps automated form fillers invisibly
- Timing check rejects submissions completed too quickly to be human
- WordPress nonce verification on every POST request
- Server-side file validation with extension whitelist and size limits for prescription uploads
Flexible Email Notification
Choose how submission notifications are delivered to match your hosting environment.
- WordPress default mail (wp_mail)
- Built-in SMTP with TLS, SSL, or unencrypted connections
- Gmail via OAuth — connect your Gmail account directly without storing your password
- Email provider presets (Gmail app password, Outlook, and others)
- Send test emails from the dashboard to confirm delivery before going live
Submission Management in WordPress
Every completed form is saved as a custom post type entry in your WordPress admin.
- Browse, search, and review all leads from the dashboard
- Full field data stored per submission
- Prescription file attachments saved to your media library
- No external CRM required to view your leads
Customizable Without Touching Code
Agents and site owners can configure the wizard entirely from the admin panel.
- Toggle any optional field on or off per site
- Override field labels to match your brand voice
- Set a custom intro message and post-submission success message
- Primary color picker for brand-matched styling
Simple Shortcode Deployment
Add the wizard to any page, post, or widget area with a single shortcode.
- Shortcode:
[mmedia_medicare_wizard] - AJAX submission with no page reload
- Responsive, mobile-friendly layout
- Validation errors display inline without losing entered data
Who This Plugin Is For
- Independent Medicare and Medigap insurance agents
- Insurance agencies managing multiple agent sites
- Medicare lead generation sites that want qualified intake over raw volume
- WordPress users who want a professional lead form without SaaS lock-in
M Media Medicare Contact Wizard is not a bulk lead generation or list-building tool. It is built for agents who want better-qualified prospects and a cleaner first conversation.
Technical Requirements
- WordPress 6.2 or newer
- PHP 7.4 or newer
- A working email configuration (SMTP recommended for reliable delivery)
Licensing & Support
This product is licensed per site and includes access to updates and support for the duration of your license term. There are no per-lead fees, no submission limits, and no third-party data sharing.
If you need a professional Medicare intake form that works the first time and gives you real prospect data before the first call, M Media Medicare Contact Wizard was built for exactly that.
