Typical questions that could be on Medigap application

Are you currently hospitalized, in a nursing home or assisted living facility, receiving hospice or home health care: or, are you bedridden or confined to a wheelchair?
Have you been diagnosed with or treated for emphysema, Chronic Obstructive Pulmonary Disease (COPD) or other chronic pulmonary disorders?
Have you been diagnosed with or treated for Parkinson’s Disease, Systemic Lupus, Myasthenia Gravis, Multiple or Lateral Sclerosis, Osteoporosis with fractures, or Cirrhosis?
Have you been diagnosed with or treated for Chronic kidney disease, kidney failure, or kidney disease requiring dialysis?
Have you been diagnosed with or treated for Alzheimer’s Disease, Senile Dementia, or any other cognitive disorder?
Within the past two years have you been treated for or been advised by a physician to have treatment for internal cancer, alcoholism or drug abuse, mental or nervous disorder requiring psychiatric care or have you had any amputation caused by disease?
Within the past two years have you been treated for or been advised by a physician to have treatment for heart attack, heart, coronary or carotid artery disease (not including high blood pressure), peripheral vascular disease, congestive heart failure or enlarged heart, stroke, transient ischemic attacks (TIA) or heart rhythm disorders?
Have you been advised by a physician that surgery may be required within the next 12 months for cataracts?
Have you been advised by a physician to have surgery, medical tests, treatment or therapy that has not been performed?
Have you been hospital confined three or more times in the last two years?
Have you had an organ transplant or been advised by a physician to have an organ transplant?
Do you have diabetes that has ever required more than 50 units of insulin daily?
If you have diabetes, do you have any of the following conditions: retinopathy, peripheral vascular disease, neuropathy, any heart condition (including high blood pressure), stroke, or kidney disease?

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