When you submit our Pre-Screen form, we can determine which plans you may qualify for. After you submit it, we’ll reach out to schedule a meeting to discuss your options and which may best fit your situation.
Before You Submit This Form
Please review the Uninsurable Questions below. Unfortunately, if you can answer “Yes” to any of those questions, you will be uninsurable. If you have any questions or concerns, please contact our office.
Are you currently receiving home health care services, or are you confined in a rehabilitation facility, nursing facility, or assisted living facility?
Are you currently receiving assistance or supervision to perform activities of daily living (bathing, dressing, feeding, toileting, getting in and out of bed) or have bowel or bladder incontinence?
Are you currently being treated, or have you been diagnosed by a medical professional for Alzheimer’s, Parkinson’s, dementia or cognitive impairment?