Are you on Medicare or Medicaid?

What challenges do you feel are unique to someone who's on Medicare or Medicaid? We'd like to write more stories that dig deep into that topic. Help us figure out what those are. We may end up writing a story about you if you'd be up for it.

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First Name *

Last Name *

E-mail *

Phone *

City *

State or Province

Postal Code

How long have you had Medicare / Medicaid?

Are you in an HMO for Medicare / Medicaid or are you in a traditional fee-for-service model?

What challenges do you feel are unique to people on Medicare / Medicaid?

How would you rate your experience with the insurance so far?

Is there anything else you'd like to add? If so, tell us here.

Which county do you live in?

May we air your comments or publish them on our websites or newspapers and attribute them to you?
(They may be edited for length or clarity). *

In what year were you born?

What political party, if any, do you identify with most closely?

Here are a few questions that are designed to help us find out which articles or stories you'd be a good source for. This information is not shared beyond the newsroom. If you've answered them before, go ahead and skip them.

What do you do for work?

What race or ethnicity are you?

What faith tradition, if any, do you belong to?

What is your gender?

To what organizations do you belong?

Where did you hear about being a news source for The Miami Herald?

Your Information

We ask for some information about you so we can contact you if we have questions. We will not share your personal information outside Miami Herald/WLRN.

By filling out this form, you are giving Miami Herald/WLRN permission to contact you for help with current and future news coverage, and you become part of American Public Media's Public Insight Network.

Your answers are confidential. We will not quote you without first getting your explicit permission.

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About the Public Insight Network

Founded in 2003, American Public Media's Public Insight Network is a platform for connecting trusted journalists with knowledgeable sources and for fostering journalistic excellence, innovation and collaboration. Learn more »

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