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All the information you provide for this checkup will be kept confidential. We will not ask you for any information that can be used to contact you unless you request a quote.

First, let’s get some general information

Enter valid zip code.
Age should be in between 18-100 years.

Please select the health care coverage that applies:

  • I have group health insurance through my employer.
  • I have group health insurance through my spouse's employer.
  • I have an individual health policy directly with a health insurer.
  • I have Medicaid.
  • I have Medicare.
  • I have insurance: Other.
  • I do not have health insurance.
Select atleast one option.

This year, do you have a child turning 26 and aging out of your health insurance coverage?

Does your health plan pay for prescription medicine?

Do you have dental insurance?

Do you have coverage for eye exams?

All the information you provide for this checkup will be kept confidential.
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Health insurance
Did you know according to the National Safety Council the average cost of an accident with an injury in the U.S. easily exceeds state minimums at $25,600?