Chris A Roth

Hospital Indemnity Plan Needs Assessment

Answer a few questions so we can see how a hospital indemnity plan may help cover gaps in your health insurance and protect your savings.

First Name *

Last Name *

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What type of health coverage do you currently have?

How would you describe your current deductibles and copays?

Have you been hospitalized or visited the ER in the last 3–5 years?

What would you most want a hospital indemnity plan to help with?

Comfortable Monthly Budget for a Hospital Indemnity Plan

Anything specific you’d like me to know or compare?

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By checking this box and clicking “Submit My Hospital Indemnity Assessment”, you agree that Chris A. Roth and/or our partner carriers may contact you at the phone number and email address provided (including by autodialed, prerecorded, or artificial voice calls and text/SMS messages) about mortgage protection, life insurance, and related products. You understand that your consent is not a condition of purchase and that you may revoke consent at any time. Message and data rates may apply. Your information is confidential and will only be used to provide your personalized recommendations.

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