INDIVIDUAL SHORT TERM MAJOR MEDICAL


Individual Plans
Individual Major Medical
Short Term Major Medical
Medicare Supplement
Long Term Care
Life Insurance
Disability Income
Travel Insurance
Dental HMO

 

Short Term Major Medical Insurance

You should never go without health insurance even for a short period of time. Short term medical can be purchased for up to 12 months.

Short term or temporary medical insurance is designed for People who are:

  • Between jobs or laid off.
  • Looking for a lower cost alternative to COBRA.
  • Recent college graduates.
  • Waiting for employer-sponsored coverage.
  • Temporary or seasonal employees.

Please complete the information below and submit it to us by either email or fax and we will reply promptly to your request. You can not submit an inquiry without supplying the information highlighted with an asterisk (*).

 
Please answer the following questions:
Name:*
Phone #:*
Date of Birth:* (MM/DD/YYYY)
Sex:* Male Female
Your Zip Code:* (5 digits)
Will Your Spouse be Insured:* Yes No
Spouse's Date of Birth:* (MM/DD/YYYY)
Will Your Children be Insured:* Yes No
Number of Children to be Insured:
Deductible Desired: $250 $500 $1000 $2500
Length of Coverage: (Enter the number of days)


Or print out form and fax to: (847) 866-7414
DISCLAIMER: FINANCIAL AND MEDICAL UNDERWRITING DECISIONS ARE THE DIRECT RESPONSIBILITY OF THE INSURANCE CARRIER. BDM Combined, Inc. ASSUMES NO LIABILITY FOR SUCH UNDERWRITING DECISIONS.

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BDM Combined, Inc.
Buffalo Grove, IL 60089
(847) 478-5101 Fax (866) 354-7414
info@bdmcombined.com