Request Informational Packet

I would like to receive an informational packet about the new Long-Term Care
Insurance Plan and access to the CareOptions OnLine resources.


Please Note: Once you click on the "Send Request" button, you may or may not get the "Thank You" confirmation message depending on your computer. Rest assured that as long as the "Send Request" button and form you filled out is no longer visible after you click on the "Send Request" button, your form has been sent to us. If the form is still visible after your click on the "Send Request" button, please check that you have completed all the required fields.

Privacy Statement: HealthChoice does not in any way share, trade, or sell
your name or information to anyone or any business. All information supplied
by you is held in the strictest of confidence and is used only to fulfill this request.