Long term care insurance policy illustration form 2025

1. Click ‘Get Form’ to open the Long-Term Care Insurance Policy Illustration Form in our platform.
2. Begin by filling in your personal information in Part I, including your full name, address, and Social Security number. Ensure all details are accurate.
3. If applicable, complete Part II for Spouse Information. Only fill this section if your spouse is also applying for coverage.
4. In Part IV, select one feature/benefit from each category. Make sure to choose only one option per category to avoid confusion.
5. Answer the eligibility questions in Part V honestly. A 'Yes' answer may disqualify you from coverage.
6. Complete the Health Statement in Part VI, providing detailed answers about your medical history and current health status.
7. In Part VII, provide your primary care physician's information and any medications you are currently taking.
8. Review all sections for completeness before submitting the form. Use our editor’s features to make corrections easily.

Start filling out your Long-Term Care Insurance Policy Illustration Form today on our platform for free!