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Request Pricing

Arrange your FREE and NO-OBLIGATION personalized price comparison, using multiple companies,rather than just one... The form below includes a partial list of questions asked on most LTCi applications, but the underwriting policies of the carrier you choose will apply in an actual application.  Proposals and price comparisons are for informational purposes only, and will not bind any party.  Response to this form with price comparison information will not imply a guarantee of insurability or of what your health rating will be in an actual application.   Face-to-face meetings will be needed for applications, and the actual pricing for your coverage may differ from the information generated here.    Intended for residents of New York State only

Your name                                                                       DOB  (mm/dd/yyyy)   Partner's name                                                                 DOB  (mm/dd/yyyy)   Your address, city, state, zip Your telephone(s)                                Your email address(es) Describe the coverage you're looking for (NYS Partnership; Benefit amount; etc.): List all prescription medications you or your partner are currently taking:   Your prescriptions:                          Prescribed for: Partner's prescriptions:                    Prescribed for: List any conditions for either of you that aren't covered above.  Include procedures performed in the past five years, and any procedures recommended by a health-care professional that have not yet been performed. What questions do you have about long-term care insurance? I/my partner presently have some LTCi coverage that we'd like reviewed. I/my partner have used tobacco products in the past five years. I/my partner have been rejected or rated by an LTCi company before. We represent a group that may be interested in having you as a speaker. Please tell us how you learned about our website?     Reminder:  Submitting this form does NOT constitute  an application for any insurance product.

To contact us about your case without sending the above information: info@plan4ltc.com Stephen Drew, CFP, CLTC POB 401 Henrietta, NY 14467 toll free:  877.800.3739