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Health Questions

If you answer YES to any questions below you will not be offered coverage at this time.
If you have any questions regarding underwriting, please call us at 1.888.793.6111 or email helpme@retirementguard.com. Other conditions and co-morbid situations could also result in a decline.

1. Have you ever received medical advice, consultation or treatment for any of the following illnesses?

  • Diabetes Treated with Insulin
  • Amyotrophic Lateral Sclerosis
  • Any Diabetes with Skin Ulcers
  • Multiple Joint Replacements
  • Any Joint Deformities
  • Kidney Disease
  • Liver Cirrhosis
  • Hepatitis B,C,D, or E
  • Stroke or Transient Ischemic Attach (TIA)
  • Memory Loss, Alzheimer's Disease, or Dementia
  • Bipolar Disorder, Schizophrenia
  • Psychosis, Mental Retardation
  • Myasthenia Gravis
  • Parkinson's Disease/Parkinsonism
  • Post-Polio Syndrome
  • Scleroderma
  • Organ or Bone Marrow Transplants
  • Metastatic Cancer, Multiple Myeloma
  • Carotid Artery Disease
  • AIDS - Acquired Immune Deficiency Syndrome**
  • Multiple Sclerosis
  • Muscular or Neurological Conditions causing Limits
  • Lupus (SLE)
  • Amputation-Due to Disease
  • Brain or Spinal Tumors-benign or malignant
  • Pulmonary Embolism
  • Peripheral Vascular Disease

  • ** You need not check YES if you have only tested positive for Human Immunodeficiency Virus (HIV)

2. In the PAST YEAR have you needed assistance or supervision in taking medication, or performing these activities of daily living: Bathing, Continence, Dressing, Eating, Toileting, Transferring?

3. In the PAST YEAR have you used any Medical Equipment: Wheelchair, Walker, Motorized Scooter, Quad Cane, Canadian Crutches, Ventilators, Oxygen, Stair lift, or Home Intravenous Medications?

4. In the PAST YEAR have you been admitted to a nursing home, assisted living facility, psychiatric hospital,OR alcohol/drug rehabilitation?

HEIGHT-WEIGHT - BODY MASS INDEX.

We urge you to look at the height/weight table provided

here

to see if you qualify.

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