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Long-Term Health Care Plan



LTC Insurance Quote

Name or initials:

Age
Weight:
Lbs.
 Height:
Ft. In.
Spouse or Other:

Age
Weight:
Lbs.
 Height:
Ft. In.

Because of health problems I have been declined or expect to be declined for a long term care insurance policy and want information on other long term care options that do not require health underwriting:
Yes No

List any medications and/or health problems:

Do you use tobacco? If quit, when?

City and State of residence:
(required - quotes are state specific)

E-mail:
(required to send quote)

I currently have a long term care insurance policy:
Yes No

I prefer to apply by :
Mail Phone Email In Person

If you can qualify when will you insure?

Phone: (entry required)
*home, work, cell or repeat email
Best days to contact you:
M-F Sat Sun
Best times to contact you: AM — PM

How did you find this website?


Call toll free 1-888-582-2464
or email us if you have any questions.

Are you ready to insure?

You cannot just buy this insurance you first must be approved.
After reviewing the quote contact us for an application.

The approval process (underwriting) takes 1-2 months.
If approved you can keep, change, or cancel the policy.

We have more experience selling policies on the Internet than anyone.
We can work with you the way you want: email, phone, postal mail, or arrange to have a local agent meet with you.

We offer policies from the largest and highest rated insurers such as
Mutual of Omaha, John Hancock, Prudential, Genworth, etc.

We provide the best policies, the best rates, and the best service.
Our customers rely on us, and so can you.

 

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