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Medical Plan Quote Request

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Is spouse to be covered also?

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Are you now, or within the past 24 months have you been:
(a) confined to a hospital, nursing home or other medical institution; (b) receiving home healthcare services or didney dialysis;
(c) medically diagnosed as having
or are you receiving or been advised by a doctor to seek, care and/ or treatment for internal cancer, melanoma, Alzheimer's, systemic lupus, uncontrolled diabeties, conjestive heart failure or AIDS?

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