Medical Questionaire
All applicants 86 years of age and older must answer the following questions as of today’s date to determine the insurance quote. (Only for Tugo’s insurance plans)
| Myocardial infarction also known as heart attack | |
| Stroke and/or Transient Ischemic Attack (TIA) also known as mini-stroke | |
| Arterial by-pass, angioplasty and/or placement of a stent for a cardiovascular condition | |
| None of the above |
Note: Choose a condition if, in the specified timeframe, you had the condition, whether or not you received any medical care for it. This includes conditions controlled or managed by medication, a medical device, diet or exercise. Choose all applicable conditions, even if you were diagnosed more than 12 months ago. This includes conditions controlled or managed by medication, a medical device such as a stent or pacemaker, diet or exercise.
For example, if you have Coronary Artery Disease (CAD) that’s managed with a stent, choose the condition.
| Atrial fibrillation Atrial fibrillation is a type of arrhythmia. Choose this condition if you’ve been diagnosed specifically with atrial fibrillation and not any other type of arrhythmia or dysrhythmia. | |
| Diabetes requiring insulin | |
| Liver disease, excluding liver cancer | |
| Pneumonia | |
| Coronary artery disease (CAD) Coronary Artery Disease involves blockages in the coronary arteries of the heart and/or decreased pumping action of the heart. It can be caused by arteriosclerosis and/or atherosclerosis. If you’ve been diagnosed with CAD and arteriosclerosis and/or atherosclerosis, choose all these conditions. | |
| Arteriosclerosis and/or atherosclerosis also known as hardening of the arteries | |
| Chronic Obstructive Pulmonary Disease (COPD), including emphysema, not requiring home oxygen | |
| Asthma | |
| None of the above |
Q3. In the last 12 months, have you smoked any tobacco products, or vaped any nicotine products (including e-cigarettes)?