Apply Now

Complete the enrollment form below.

Apply between 4/6/2026 - 4/24/2026 (4:59 pm PT)

 

Your Username will be your Social Security Number

Your Personal Identification Number (PIN)
Last 4 digits of your Social Security + Last 2 digits of your birth year

Last 4 digits of Social Security Number 12345678
Last 2 digits of Birth Year 1965
PIN 567865

We're Here to Help

Licensed long term care specialists are available to assist you in understanding the plan and rates.

Call (877) 286-2852

  Guarantee Issue Until "MM/DD/YYY"
  No Other Benefit Covers LTC
  Issue Age Rates that won't increase as you age