Request Your Free Critical Illness Insurance Quote

Request a FREE, No-Obligation Cost Quote from an Association Member.

Please fill in as much information as possible. If you are unaware of what to choose, simply
leave it blank. Pop-ups with helpful information will appear when you scroll over each area.


  1. Your Information
  2. Design Your Plan
  3. Your Quote

1. Your Information

All information gathered will be kept safe and secure and will be used only to prepare your quote.

Why an additional phone conversation is a smart next step.

How It Works - Why We Recommend A Phone Call

Once you submit your personal info, an instant message goes to the Association offices for review. We provide this private information only to a designated professional. We recommend they call you. By asking a few simple questions, they can clarify your information about health and see what discounts you may qualify for.

You just cannot get all the needed information via an online form to produce a meaningful price quote. But, if you prefer not to speak by phone, just say you'd like the information by mail or E-mail. You're never under any obligation.

If you have health conditions a phone conversation really is important. That's because each company sets different health underwriting standards. We understand sharing personal information with a stranger can be uncomfortable. But, our members are experts in this field. Let them work hard on your behalf to get you the best coverage for the best price.

Go ahead and submit your request now to get your free comparative rate quote.

Enter Your Personal Information

















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We recommend you briefly speak by phone with our designated Critical Illness Insurance professional who'll ask a few health questions and determine if you may qualify for applicable discounts. If you'd prefer information via E-mail, please check this box.

2. What Benefit Would You Like To Receive?

Use our Cost Calculator to get a sense of how much coverage you're interested in.

Your health history can affect your cost and is important. Your answers will help us get started.

Your Health Information Affects Your Cost

How Does Your Health Information Affect Your Cost?

How can this information reduce my cost?

Insurance companies will look at your health information prior to issuing your critical illness insurance policy.

We request the following information to help us determine if you can health qualify for critical illness insurance and to make certain that you get the best (lowest) costs.

Female  Male


   


 


Female  Male


   


 


How Much Coverage Do You Want? Hover over for more info

How Much Coverage Do You Want?

Critical illness insurance costs are based on the cash benefit amount you select, your age, sex and health. You can get a good sense of costs by looking at our Cost Calculator. Click here to see rates before indicating an amount.

Consider protection equal to 2 years of mortgage (or rent) payments. Imagine the peace of mind in knowing your mortgage is covered should a critical illness strike you. Remove that stress while you focus on recovering.

$10,000
$20,000
$30,000
$40,000
$50,000
Over $50,000

$10,000
$20,000
$30,000
$40,000
$50,000
Over $50,000

Yes
No

Yes
No

Yes
No

Yes
No

Immediate family members only which includes father, mother, sister or brother.  Critical illnesses include heart attack, cancer or stroke which occurred prior to them turning age 65.

Yes
No

Yes
No




I agree, by submitting this request, to this website's privacy policy and understand that I may receive my quotes via the phone number, email and or address provided.