Long Term Care And Disability Health Insurance

Whether you need Long Term Care or Disability coverage, we’ll find an insurance policy that’s custom designed for your individual insurance needs.

Simply Fill out the form below or call us to find the most comprehensive and cost efficient individual insurance plans available. 

 

 

Long Term Care Insurance
What is Individual Long Term Care Insurance?
An insurance policy that helps provide for the cost of care for the disabled or chronically ill beyond a predetermined period.

Why is Individual Long Term Care Insurance important?
The rising cost of long term care and the shortage of caregivers have made finding quality, affordable long term care a challenge for countless Americans. This is especially true for those in their mid-forties to early sixties. We can help you find the right policy within your budget and insure your peace of mind when it comes to your future.

 

 

Individual Disability Insurance 

What is Individual Disability Insurance?
An insurance policy that pays benefits in the event that the individual policy holder becomes incapable of working.

 

Why is Individual Disability Insurance Important?
Income from disability insurance can help preserve one of life's most important responsibilities , earning a living. When you can't work, disability insurance can help you and your family survive and maintain your standard of living. We can help you find the right policy for your budget and insure your peace of mind in the event of becoming incapable of working.

Again, just fill out the form below or call us to find the individual insurance policy that's just right for you. It only takes a few minutes ...Let's get started.

LONG-TERM CARE INSURANCE INQUIRY

One of the most pressing needs for many people is the ability to provide caregiving should a spouse require on-going care. 
Long-term care is a reasonably priced solution. Taking care of a physically or mentally impaired spouse can be expensive and stressful to a spouse caregiver. 

These plans also provide protection of retirement income for the other spouse.  

First Name:		Last Name:
Evening Phone:		Day Time Phone:
Address:		City:
State:	Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code:
Who is this quote for?	Self Spouse Parent(s) Child(ren) Business Assoc. Other	E-mail:
Preferred time for us to contact you: Select One Call between 5:00pm and 8:00pm Call between 8:00am and 11:00am Call between 11:00am and 1:00pm Call between 1:00pm and 3:00pm Call between 3:00pm and 5:00pm Other (please note below)
Applicant:	Birth Date: Sex Male Female Married Single
Height: (feet-inches)		Weight: (pounds)
Currently enrolled in: Select One Medicare Plan A Medicare Plan B
Brief Health Survey
How do you classify your health?		Select One Best Average Below Average Poor
Diabetic? Yes No Insulin dependent? Yes No
Do you need assistance with everyday tasks? Yes No
Do you take any medication? Yes No
Please list any medications, health issues, concerns, or comments here.

INDIVIDUAL DISABILITY INSURANCE

Protect your family: Should you be unable to create income due to a disability.

First Name:		Last Name:
Home Phone:		Day Time Phone:
Address:		City:
State:	Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code:
Who is this quote for?	Self Spouse Parent(s) Child(ren) Business Assoc. Other	E-mail:
Applicant:	Birth Date: Sex Male Female Smoker Yes No Married Single
Current employment status:		Industry that best describes your occupation:
Select Full Time Part Time In Transition Retired Homemaker Student Other		Select One Computers --Graphics --Operator/Technician --Programmer Engineering --Aerospace --Chemical --Civil --Electrical --Mechanical --Nuclear --Other Construction --Contractor --Electrician --Installer --Mechanic --Painter --Plumber --Welder Education --Administration --College Professor --Professional Instructor --Teacher Healthcare --Administration --Dentist/Dental Technician --Lab Technician --Nurse/Paramedic --Pharmacist --Physician/Surgeon --Psychiatrist/Psychologist/Social Worker --Hospitality/Recreation/Travel --Airline Employee --Amusement Parks/Recreation Centers --Driving --Hotel Services --Restaurant Services --Travel Agent Manufacturing --Assembly --Machine Operator --Maintenance --Printing Professional --Accounting --Architecture --Art/ Photography --Entertainment/Performing --Financial Services --Insurance --Interior Design --Journalism --Law/Legal Services --Marketing & Sales --Membership Organizations --Real Estate --Sports/Fitness/Nutrition Private Sector --Child Care --Cleaning Services --Homemaker --Landscaping/Gardening --Personal Assistant Public Service --Civil Service --Economic Administration --Environmental Administration --Executive Legislative --Fire Fighter --Government Employee --Human Resources --International Affairs --Justice, Public Order and Safety --Military Officer --National Security --Police Department --Postal Service --Public Transportation --Social Worker Retail --Auto Dealer/Service Center --Consumer Services/Sales --Management --Merchandising --Product Sales --Security Other-Not Listed Retired Self Employed Student Unemployed Veteran
Has the applicant ever been declined or rated for disability insurance? Yes No
Do you currently have an individual disability policy? Yes No
	If yes, please enter:	Name of company:
		Monthly benefit:
Do you have a disability benefit through work? Yes No
	If yes, please enter:	Name of company:
		Weekly benefit:
Brief Health Survey
Do you take any medication? Yes No
Please list any medications, health issues, concerns, or comments here.