Michael W. Smith Agency

Michael W. Smith Agency Logo

Home Up News Feedback Links

Individual Health

If you live outside of Minnesota click on the Agency Link System

Agency Link System

horizontal rule

We feature a full line of Health Care Plans including Major Medical Plans, HMO Plans, Medicare Supplements and Short Term Major Medical Plans from Blue Cross & Blue Shield of Minnesota, Blue Plus, FORTIS & FORTIS Medical Savings Accounts, MEDICA.
Click the IMG graphic for information, rates and to apply for International Medical Insurance.   Coverage while you are outside your home country, for traveling or Foreign Nationals visiting the U.S.

horizontal rule

This is a request for a Minnesota health insurance quote, not a policy application.  Submitting this form does not obligate you to purchase any health insurance products.  Please complete this form as accurately as possible.  Health insurance rates are subject to change.
Name
Street
City, State ZIP
E-mail
Phone
Fax:

horizontal rule

  Birthdate Tobacco Use
Individual
Spouse

horizontal rule

Please Enter the Age of Each Dependent Child to be Covered

Child 1 Child 2 Child 3
Child 4 Child 5 Child 6

horizontal rule

Choose the plan(s) you wish information on.

Hold "Ctrl" key down to make multiple selections

horizontal rule

Additional Comments

 

horizontal rule

[Home] [Up]
Number of hits since August 15, 1998

Send mail to mwsmith@visi.com with questions or comments about this web site.

Since 1978
Michael W. Smith Agency

Copyright © 2000 Michael W. Smith Agency
Last modified: April 06, 2008