Short Term Health Insurance - Secure Lite Eligibility Questions

	Are you eligible for the Secure Lite short term health insurance plan?  To be eligible, you must be able to answer NO to the following questions.  Please Note: The eligibility questions may vary in some states. Secure Lite STM Eligibility Questions - Click Here to Get a Quote or Apply Will there be any other health insurance in force on the policy date? Is the proposed insured, spouse, or any dependent child now pregnant? Is any proposed insured currently eligible for Medicaid? Within the past 5 years have you or any person proposed for coverage been aware of, diagnosed, treated by a member of the medical profession, or taken medication for cancer or tumor, stroke, heart disease including heart attack, chest pain or had heart surgery, COPD (chronic obstructive pulmonary disease) or emphysema, liver disorder, degenerative disc disease or herniation/bulge, rheumatoid arthritis, degenerative joint disease of the knee, insulin-dependant diabetes (not applicable to DC residents) alcohol abuse or chemical dependency? Have you or any person proposed for coverage been diagnosed or treated for Acquired Immune Deficiency Syndrome (AIDS), AIDS related complex, or any other immune system disorder? Answer this question “no” if you have tested positive for HIV but have not developed symptoms of the disease AIDS Has any person proposed for coverage NOT been a legal resident of the United States for the last 12 consecutive months?
	Long Term Consumer Care, Inc. N27 W23960 Paul Road Suite 201 ~ Pewaukee, WI  53072 Toll Free: 1.800.544.9505  Fax: 1-262.523-1910