COVERAGE ASSESSMENT

It's helpful to gather the following information so you can find the best coverage. Help us understand your current healthcare needs by answering the following questions:

About how many times do you visit your Primary Care Doctor per year?
Do you see any specialist doctors?
About how many times do you visit this specialist per year?
About how many times do you visit this specialist per year?
About how many times do you visit this specialist per year?
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Do you have out-of-state providers?
Do you qualify for Rx Extra Help and/or Medicaid?
Additional services that interest you: (select all that apply)

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