Long Term Care Quotation from Gary Jones Insurance Agency in California

Long Term Care Insurance Long Term Care Insurance moving ball

For California residents only


	Coverage	Comprehensive
	Personal Care Advisor	X
	Home Care Services	X
	Respite Care	X
	Adult Day Care	X
	Hospice Care	X
	Nursing Facility	X
	Alternative Benefits	X
	Bed Reservations	X
	Residential Care Facility for Elderly	X

Click the SUBMIT button to receive your free quote. Remember should you wish to speak to a live person you can always phone us at 310-615-0940 (M-F 8:00 - 5:00).

Customer Information
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How would you like to receive your free Long Term Care Insurance quote?	U.S.Postal E-mail Fax

Gary Jones Insurance Agency	CA License #0E22842
508 Main Street	310-615-0940 Phone
El Segundo, CA 90245	310-615-0994 Fax

Coverage Amounts:
Your Birthdate (DOB):
Have you used any tobacco products in the last 12 months?	Yes No
Joint Application?	Yes No Explanation: Joint Application Discounts of up to 50% are available for any two people who live together in the same household and are applying at the same time (need not be married). Premiums are based on oldest insured. If so, enter Spouse's information below.
Spouse's Name:
Spouse's Birthdate (DOB):
Have they used any tobacco products in the last 12 months?	Yes No
Paid Up Survivor Benefit Rider?	Yes No Explanation: Paid Up Survivor Benefit Rider: joint policies will be paid up after both of the following occur: (1) The end of the 10th policy year (2) The death of either insured
Daily Benefit Amount:	$40 $80 $100 $150 $175 $200 $250 Other Explanation: Daily Benefit Amount is the maximum reimbursed by the insurance company for nursing home care, assisted living care and in-home health care. Typically $100 to $150 per day is selected.
Benefit Period :	3 years 5 years Lifetime Explanation: Benefit Period represents the number of years your benefits will be paid from 3 years to lifetime.
Waiting Period for benefits to begin:	None 30 days 90 days Explanation: The waiting period is like a deductible and represents the number of days at the beginning of your covered stay before your benefit payments actually begin. The longer the waiting period, the lower your premium. Typically 90 days is selected.
Home Care Daily Benefits:	0% 50% 100% Explanation: Home Care Daily Benefit represents 0%, 50%, or 100% of the Long Term Care Daily Benefit for Home Care Benefits. These benefits include skilled home health care providers, adult day care, homemaker, hospice, and personal care services. 100% is recommended.
Cost of Living Adjustment Rider (COLA):	Yes No Explanation: Compound Interest Cost of Living Adjustment Rider (COLA) increases both your Long Term and Home Health Care benefits by 5% compounded each year. This is typically selected if you are under age 65.