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Medicare Supplement Spousal Discount

Please review this important information regarding our Spousal Discount.

Links to the forms you need are included on this page and will be updated as states are approved and released.

  • Underwriting approval is not required if the policy was issued in the last 90 days. However the discount form is still required to get the discount. Fax to (281)368-7344.
  • Each spouse must pass underwriting to get the discount. If one spouse does not pass, neither applicant will get the discount. We will use claims history to determine eligibility.
  • Discounts can only be applied in the States/Companies where we have state approval.
  • Please make sure that the Spouse Discount form submitted matches the Company for the Med Supp Application.
  • A signature is not required to apply for the discount, but the form must be submitted.

Special Instructions for Existing Policyholders

  • Existing policyholders may apply for the discount as of their current paid to date, as long as we have state approval for the State/Company of their policy.  If the discount was not approved for their current company they may fill out a new application for the new company with the discount approval.  We will use claims history to determine eligibility.

The Spousal Discount is currently available in the following issue states:

Please note that the form is specific to the Company of the application.  Some states will have forms for more than one Company.

 

State

 

Philadelphia American

 

New Era

 

New Era of the Midwest

 Alabama

AL PAL Form AL New Era Form

 

 Arizona

AZ PAL Form

   

 Georgia

GA PAL Form     GA Midwest Form

 Illinois

      IL Midwest Form

 Indiana

IN PAL Form      

 Iowa

IA PAL Form

   

 Kansas

  KS New Era Form  

 Louisiana

LA PAL Form

*PLAN D Only

LA New Era Form

 

 Mississippi

MS PAL Form

MS New Era Form

 

 Nebraska

NE PALForm

   

 New Jersey

NJ PAL Form

   

 New Mexico

NM PAL Form

   

 Nevada

NV PAL Form

   

 North Carolina

 

NC New Era Form 

NC Midwest Form

 Ohio

OH PAL Form

OH New Era Form

 

 Oklahoma

OK PAL Form

OK New Era Form

 

 Pennsylvania

   

PA Midwest Form 

 South Carolina

SC PAL Form

SC New Era Form

 

 South Dakota

SD PAL Form

   

 Tennessee

 

 TN New Era Form

TN Midwest Form

 Texas

TX PAL Form

TX New Era Form 

 

 Utah

UT PAL Form

   

 Wisconsin

WI PAL Form

   

 

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