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Are your Health Plan deductibles and co-payments too much to handle? We can help!
Our Health Plan Supplements pick up the non-covered medical expenses on your current plan. If you have a 20% co-payment up to $5,000 for example, your supplement would help pick that NON covered expense up. Cost of coverage is VERY inexpensive, and coverage is VERY broad.
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$100,000 Term Life Insurance for only $9.35 per month! (for male age 25, non smoker; 10 Year Term.) Our personal consultants will help you find the RIGHT Life Insurance Plan for your specific needs.
Our A+ Rated Texas/Oklahoma Carrier will save you BIG money - with fast policy issuance too!

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Disability Income Insurance Quotation Form One Simple Form - takes only 2-3 Minutes! *Your Personal Data*
Your Name:
Street Address:
City:
State:
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Marital Status: Single Married	Currently Employed? Yes No

Disability Ins. Currently? (If yes, list carrier, and # of years continuous. If none, type N/C)

UNDERWRITING INFORMATION

Insured Name:		Birthdate:
Insured Height:		Insured Weight:
Insured Occupation:		Sex (M/F):
Monthly Wage (gross income)	$	Do You Smoke?	Yes No

In Dollars, How much of a monthly benefit do you want?		$


When Do You Want Your Disability Policy to Begin?

Choose Wating Period: (The time that will elapse before your disability payments begin)		30 Days 60 days 90 days 180 days 365 days

Choose Benefit Period: (The amount of time you will receive benefits for)		1 Year 2 Years 3 Years 5 Years To Age 65

Tell Us What You Want MOST in your Disability Plan, or list any other Remarks here:

Send my quotation via: E-Mail Fax
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We make purchasing health and medical insurance EASY. We have developed a website where anyone can find, compare, and purchase Texas and Oklahoma Individual Health and Medical Insurance, supplement health plans, medical insurance and other medical benefits and individual health insurance plans. We also write TX and OK life insurance, term life, and other life insurance policies, all at very low cost prices.

We provide you access to the nations strongest health insurance carriers to find you the best value on Texas and Oklahoma health insurance, and allow you to save money on your individual health insurance through A Rated carriers and approved health insurance providers. Get a free quote on your Texas or Oklahoma health insurance today! Should you have any questions about our insurance products or our website, contact us at: quotes@txok-insurance.com.