Life Quote

BASICS
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HEALTH
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DRIVING
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COVERAGE
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QUOTES
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LAST
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Life Insurance Quoting Tool

Gender

Date of birth

Zip code

Are you currently a U.S. citizen or permanent resident?

Do you have a spouse or significant other?

Great! We'll show you how to get quotes for them later (if you'd like).

You aren't required to apply with your partner, but there are some benefits:

Save time by scheduling the medical exam at the same time.
See how policies for both of you will fit into your monthly budget.
Check it off your to-do list for both of you now!

Let’s get some basic health details.

These questions help us find the best policy for you.

Height

Weight

lbs

Have you ever used any tobacco product?

Have you ever been treated for and/or taken medication for any of the following?

Alcohol abuse

Asthma

Depression

Drug abuse

High blood pressure

Sleep apnea

Other serious condition

None of the above applies to me

Anxiety

Cancer

Diabetes

Heart attack

High cholesterol

Stroke

Do you have any parents or siblings who contracted cardiovascular disease (heart attacks or strokes), cancer, diabetes, or kidney disease before age 70?

Have you had your license suspended or revoked, or had more than one ticket or accident in the past 5 years?

Your substance abuse and treatment history

Having a history of substance abuse isn’t necessarily a disqualifier.

This information helps us tailor our search to find the best policy for you.

Have you ever been treated for alcohol abuse?

When was your most recent treatment?

Have you ever been treated for drug abuse?

When was your most recent treatment?

Anxiety Details

When were you first diagnosed or treated for anxiety?

What was your diagnosis? Select a severity

When was your most recent occurrence or episode?

Are you currently taking any medications?

How many medications? Select an amount

Have you been hospitalized or missed any work due to anxiety?

Please enter any other relevant details (Optional)

Asthma details

Over 40% of applicants have a medical condition such as asthma.

This information helps us tailor our search to find the best policy for you.

When were you diagnosed with asthma?

What was your diagnosis?

Have you ever been medically treated for asthma?

Are you currently being medically treated for asthma?

Which of the following treatment type(s) have you used?

Inhaled bronchodilators

Oral medication (no steroids)

Rescue inhaler

Inhaled corticosteroids

Oral medication (with steroids)

On average, how many asthma attacks do you have per year?

Have you ever been hospitalized due to asthma?

How many times have you been hospitalized in the past year due to asthma?

How many times have you been hospitalized in your entire life due to asthma?

When was the last hospitalization?

Cancer Profile

Having a history of cancer isn’t necessarily a disqualifier.

This information helps us tailor our search to find the best policy for you.

What is the most serious type of cancer you have been diagnosed with?

When were you first diagnosed or treated?

What was the stage of the cancer?

When were you last treated?

Please enter any other relevant details

Select your coverage & policy length

Coverage Amount

What does "coverage" mean?

Coverage is the amount your loved ones would receive (as a tax-free, lump sum) if anything happens to you before your policy expires.

Rule of thumb: Most financial planners recommend having coverage around 10x your income.

For now, just pick what you think makes the most sense. You can always change it later.

Policy Length (term) - Protection for...

How do policy lengths work?

Your policy length (or “term”) determines how long your coverage lasts. After it expires, you can get a new policy or you can usually renew it at a higher rate.

Rule of thumb: Your term should cover your longest financial obligations. For example, people with young children usually pick 20 or 25 years.

Your policy would protect your loved ones with a tax free, lump sum of ${{CovSlider:Decimal;0,0}} until it expires {{CovPolicy}} from now.

We searched the market and found the best products for you

Tell us more about your smoking habits

Which of these tobacco products have you used?

This will help us determine your overall health profile.

Cigarettes/e-cigarettes?

Date you last smoked a cigarette

On average, how many cigarettes per day do you or did you smoke?

Cigars?

Date you last smoked a cigar

On average, how many cigars per month do you or did you smoke?

Pipe?

Date you last smoked a pipe

Chewing tobacco?

Date you last used chewing tobacco

Nicotine patches or gum?

Date you last used nicotine replacement

Depression details

Depression is one of the three most common conditions amongst applicants.

This information helps us tailor our search to find the best policy for you.

When were you diagnosed with depression?

What was your diagnosis?

Are you currently undergoing treatment for depression?

How many different types of medications are you currently taking?

Are you currently in psychotherapy treatment?

Have you ever taken medication or been in psychotherapy for depression?

When did your treatment (either medication or therapy) end?

Have you ever been hospitalized due to depression?

When was the last hospitalization?

Diabetes details

Over 40% of applicants have a medical condition such as diabetes.

This information helps us tailor our search to find the best policy for you.

When were you diagnosed with diabetes?

Is this type 1 or type 2 diabetes?

What was your last A1C reading?

What's your average A1C reading for the last 12 months?

Have you had any complications from diabetes?

Are you currently undergoing treatment for diabetes?

When did your treatment end?

What's your daily dosage of insulin units?

Your heart attack history

Having a heart condition isn’t necessarily a disqualifier.

This information helps us tailor our search to find the best policy for you.

When were you first diagnosed or treated for a heart attack?

When was your most recent occurrence or episode?

Please enter any other relevant details (Optional)

Your blood pressure status

High blood pressure is one of the three most common conditions. If you can take steps to lower your blood pressure, it’s likely to lower your premiums too.

Blood pressure is typically recorded as two numbers, written as a ratio like the diagram below.

What is your systolic pressure?

What is your diastolic pressure?

When were you last treated for high blood pressure?

Are you on any medication to control your blood pressure?

When did you start taking medication to control your blood pressure?

Your cholesterol levels

High cholesterol is one of the three most common conditions.

This information helps us tailor our search to find the best policy for you.

Cholesterol level

HDL ratio

When were you last treated for high cholesterol?

Are you on any medication to control your cholesterol?

When did you start taking medication to control your cholesterol?

Sleep apnea details

Over 40% of applicants have a medical condition.

This information helps us tailor our search to find the best policy for you.

When were you diagnosed with sleep apnea?

What was your diagnosis?

Have you received treatment?

When was the treatment?

Do you use a CPAP machine?

Have you done an overnight sleep study?

Oxygen saturation

Apnea-hypopnea index (AHI) events per hour of sleep

Apnea index (events per hour of sleep)

Respiratory disturbance index (RDI) - events per hour of sleep

Your stroke history

A history of stroke isn’t necessarily a disqualifier.

This information helps us tailor our search to find the best policy for you.

When were you first diagnosed or treated for a stroke?

When was your most recent occurrence or episode?

Please enter any other relevant details (Optional)

Other serious medical conditions

Fill us in on any medical conditions we should know about.

This information helps us tailor our search to find the best policy for you.

Please describe any other serious medical conditions you have, including the names of diagnoses or conditions.

When were you first diagnosed or treated?

Your driving history

Have you been convicted of drunk driving (DUI/DWI) in the last 10 years?

When was your most recent conviction for drunk driving (DUI/DWI)?

Have you been convicted of reckless driving in the last 10 years?

When was your most recent conviction for reckless driving?

Has your license been revoked or suspended in the last 10 years?

When was your most recent conviction resulting in a revoked or suspended license?

Have you had any moving violations over the past 5 years?

Total number of moving violations during the last 6 months

Total number of moving violations during the last year, more than 6 months ago

Total number of moving violations during the last 2 years, more than 1 year ago

Total number of moving violations during the last 3 years, more than 2 years ago

Total number of moving violations during the last 5 years, more than 3 years ago

Thanks you for your submission!

One of our underwriters will contact you shortly to finalize your quote.

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