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Health Care/LTC Cost Assessment Fact Finder

  • Client and spouse/partner information

    Couples and partners sharing a household should complete all of the fields below, even if you are planning for only one spouse or partner. The assessment considers the availability of receiving care from a spouse or partner in determining the health care and long-term care cost estimate.
  • First NameLast NameGenderCurrent AgeRetirement Age
  • State(s)City* (Cities)County 
  • First NameLast NameGenderCurrent AgeRetirement Age
  • State(s)City* (Cities)County 

  • Assessment questions Check Yes or No

  • CURRENT HEALTH Assessment is not designed for persons already diagnosed with Alzheimer's, Parkinson's or other disqualifying conditions.

  • LIFESTYLE & HEALTH HISTORY

  • Annual income in retirement

    Select the range that best fits your actual or estimated post-retirement income (not your income level before retirement.) Use your modified adjusted gross income (MAGI) and assume today's dollars. Your retirement income helps determine the cost for Medicare Parts B & D.

  • Medicare coverage (select only one option)

    All Medicare premiums plus additional medical costs will be used as the default option if no other option is selected. Not required for LTC-only reports.

  • * City/metro data will be used if available, if unavailable state-wide averages will be used.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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For Agent use only. Rates are subject to change. Certain exclusions, restrictions and limitations may apply; please contact your marketer for more information. Not affiliated with the United States government or the federal Medicare program.

We have done our best to ensure that the information provided on this website and the third party industry resources and services available or otherwise presented are accurate and provide valuable support. However, nothing available on or represented through this website should be understood as a recommendation or endorsement. By your use of this site, you agree not to attempt to hold us liable for any such decisions, actions or results, including any direct, indirect, consequential, special, exemplary or other damage that may result at any time, under any circumstance, as a result of any action pertaining to use of the information provided and the third party industry resources and services available or otherwise presented.

We have done our best to ensure that the information provided on this website and the third party industry resources and services available or otherwise presented are accurate and provide valuable support. However, nothing available on or represented through this website should be understood as a recommendation or endorsement. By your use of this site, you agree not to attempt to hold us liable for any such decisions, actions or results, including any direct, indirect, consequential, special, exemplary or other damage that may result at any time, under any circumstance, as a result of any action pertaining to use of the information provided and the third party industry resources and services available or otherwise presented.
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