Health Insurance
We provide Health Insurance to cover
Major Medical expenses,
Doctor visits, and Prescription drugs.

Heath Insurance

The high cost of Medical Expense has caused many Bankruptcies. A Major Medical policy will pay many of the cost's associated with a Hospital stay. The Premium for Medical Coverage can be reduced through the use of deductibles and co/pay options. For those unable to afford this coverage, there are accident policies and Hospital daily rate coverage's available.

Get a Health Insurance Proposal from Schuman Insurance Agency

HOW EASY!

STEP 1: Complete the form below.
About You
* First Name	* Last Name
* Email	* Email (retype)
Street Address	* State
* City	* Zip
* Phone (Day) Ext.	* Phone (Evening)
Fax	* Birth Date
* Occupation

* First Name	* Last Name
* Email	* Email (retype)
* Street Address	* State
* City	* Zip
* Phone (Day) Ext.	* Phone (Evening)
Fax	* Birth Date
* Driver's License #	* Occupation

Your Health Insurance Information Do you currently have health insurance? Yes No

Are you a Male Female *
* What is your birthdate?
* Your height
lbs. * Your weight

Are you, your spouse or any dependents now pregnant?	Yes No
Do you have any pre-existing medical conditions?	Yes No *

Do you currently take any medications?

Yes No


Optional Coverage
Include Spouse in quote? Yes No

Spouse is a Male Female		What is your spouse's birthdate?
Spouse's Height		lbs. Spouse's Weight
When did your spouse last use tobacco products?

Include Children in quote? Yes No

Additional Coverage? (check the ones you may want)
Health Insurance	Long Term Care
Prescription Card	Disability Insurance
Supplemental Accident	Life Insurance
Maternity
Details
Any Comments / Questions?

STEP 2: Our Agents will shop for the best rate and coverage!

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Child 1: Birthdate?			Child is a Male Female
Child 2: Birthdate?			Child is a Male Female
Child 3: Birthdate?			Child is a Male Female
Child 4: Birthdate?			Child is a Male Female
Child 5: Birthdate?			Child is a Male Female