{"id":449,"date":"2020-12-14T15:08:00","date_gmt":"2020-12-14T20:08:00","guid":{"rendered":"https:\/\/yourcarerep.com\/?page_id=449"},"modified":"2025-04-28T14:05:45","modified_gmt":"2025-04-28T14:05:45","slug":"quote","status":"publish","type":"page","link":"https:\/\/yourcarerep.com\/agent-clone-template\/quote\/","title":{"rendered":"Quote"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"449\" class=\"elementor elementor-449\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1efc4d3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1efc4d3\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-7559abe\" data-id=\"7559abe\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-558c46a\" data-id=\"558c46a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-78a9a6d elementor-widget elementor-widget-heading\" data-id=\"78a9a6d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Retirement is a big step!<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a1463bc elementor-widget elementor-widget-text-editor\" data-id=\"a1463bc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Understanding how to get the most benefits and save the most money from Medicare can be confusing. Fill out our short questionnaire and we will get back to you with relevant information catered to your specific needs.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-05b14e9 elementor-widget elementor-widget-text-editor\" data-id=\"05b14e9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Your privacy is our utmost concern. We never share your information with any third parties. We used it strictly to provide you with the best service possible.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d79c328 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d79c328\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-367c1e3\" data-id=\"367c1e3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2faa2e6 elementor-widget elementor-widget-heading\" data-id=\"2faa2e6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Fill out the Your Care Rep Questionnaire for Your No Obligation Quote<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8e35e89 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8e35e89\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-99db5df\" data-id=\"99db5df\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2f335e1 elementor-widget elementor-widget-heading\" data-id=\"2f335e1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Let\u2019s Get Started!<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3aef701 elementor-widget elementor-widget-image\" data-id=\"3aef701\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"205\" height=\"38\" src=\"https:\/\/yourcarerep.com\/agent-clone-template\/wp-content\/uploads\/sites\/7\/Gold-Down-Arrows.png\" class=\"attachment-large size-large wp-image-12982\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-e3d7405 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"e3d7405\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-fd89d51\" data-id=\"fd89d51\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6529ab5 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"6529ab5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Start Questionnaire&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;none&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Medicare Questionnaire\" aria-label=\"Medicare Questionnaire\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"449\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"6529ab5\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_3137533 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Get Started\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"&lt;svg class=&quot;e-font-icon-svg e-fas-star&quot; viewBox=&quot;0 0 576 512&quot; xmlns=&quot;http:\/\/www.w3.org\/2000\/svg&quot;&gt;&lt;path d=&quot;M259.3 17.8L194 150.2 47.9 171.5c-26.2 3.8-36.7 36.1-17.7 54.6l105.7 103-25 145.5c-4.5 26.3 23.2 46 46.4 33.7L288 439.6l130.7 68.7c23.2 12.2 50.9-7.4 46.4-33.7l-25-145.5 105.7-103c19-18.5 8.5-50.8-17.7-54.6L382 150.2 316.7 17.8c-11.7-23.6-45.6-23.9-57.4 0z&quot;&gt;&lt;\/path&gt;&lt;\/svg&gt;\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-33 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-33 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Email\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_9ec9832 elementor-col-33 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9ec9832\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_9ec9832]\" id=\"form-field-field_9ec9832\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Phone Number\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_c94b00f elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Medicare Questionnaire\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"&lt;svg class=&quot;e-font-icon-svg e-fas-star&quot; viewBox=&quot;0 0 576 512&quot; xmlns=&quot;http:\/\/www.w3.org\/2000\/svg&quot;&gt;&lt;path d=&quot;M259.3 17.8L194 150.2 47.9 171.5c-26.2 3.8-36.7 36.1-17.7 54.6l105.7 103-25 145.5c-4.5 26.3 23.2 46 46.4 33.7L288 439.6l130.7 68.7c23.2 12.2 50.9-7.4 46.4-33.7l-25-145.5 105.7-103c19-18.5 8.5-50.8-17.7-54.6L382 150.2 316.7 17.8c-11.7-23.6-45.6-23.9-57.4 0z&quot;&gt;&lt;\/path&gt;&lt;\/svg&gt;\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_187671c elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_187671c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you turning 65 and are becoming eligible for the first time or are you already receiving Medicare?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Turning 65\" id=\"form-field-field_187671c-0\" name=\"form_fields[field_187671c]\" required=\"required\"> <label for=\"form-field-field_187671c-0\">Turning 65<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Already on Medicare\" id=\"form-field-field_187671c-1\" name=\"form_fields[field_187671c]\" required=\"required\"> <label for=\"form-field-field_187671c-1\">Already on Medicare<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_8d427cb elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8d427cb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you a Veteran?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_8d427cb-0\" name=\"form_fields[field_8d427cb]\" required=\"required\"> <label for=\"form-field-field_8d427cb-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_8d427cb-1\" name=\"form_fields[field_8d427cb]\" required=\"required\"> <label for=\"form-field-field_8d427cb-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_044d432 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_044d432\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIf you are a veteran, are you receiving medical care at a VA facility through your VA benefit, or are you a retiree with TriCare getting ready to transition to TriCare for Life?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"VA Benefits\" id=\"form-field-field_044d432-0\" name=\"form_fields[field_044d432]\" required=\"required\"> <label for=\"form-field-field_044d432-0\">VA Benefits<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"TriCare for Life\" id=\"form-field-field_044d432-1\" name=\"form_fields[field_044d432]\" required=\"required\"> <label for=\"form-field-field_044d432-1\">TriCare for Life<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"CHAMPVA\" id=\"form-field-field_044d432-2\" name=\"form_fields[field_044d432]\" required=\"required\"> <label for=\"form-field-field_044d432-2\">CHAMPVA<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Not Applicable\" id=\"form-field-field_044d432-3\" name=\"form_fields[field_044d432]\" required=\"required\"> <label for=\"form-field-field_044d432-3\">Not Applicable<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_5e06b5a elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5e06b5a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHospitalizations typically have non-medical expenses. Are you prepared for those additional on unforeseen costs?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_5e06b5a-0\" name=\"form_fields[field_5e06b5a]\" required=\"required\"> <label for=\"form-field-field_5e06b5a-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_5e06b5a-1\" name=\"form_fields[field_5e06b5a]\" required=\"required\"> <label for=\"form-field-field_5e06b5a-1\">No<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Not sure\" id=\"form-field-field_5e06b5a-2\" name=\"form_fields[field_5e06b5a]\" required=\"required\"> <label for=\"form-field-field_5e06b5a-2\">Not sure<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_26bda8f elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_26bda8f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you want information on hospital indemnity plans that protect you from unexpected costs and help with hospital copays?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_26bda8f-0\" name=\"form_fields[field_26bda8f]\" required=\"required\"> <label for=\"form-field-field_26bda8f-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_26bda8f-1\" name=\"form_fields[field_26bda8f]\" required=\"required\"> <label for=\"form-field-field_26bda8f-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_f43fe91 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f43fe91\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you want a plan that helps keep you healthy with preventive services and procedures, or just one that is there when you get sick?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"With preventive care\" id=\"form-field-field_f43fe91-0\" name=\"form_fields[field_f43fe91]\" required=\"required\"> <label for=\"form-field-field_f43fe91-0\">With preventive care<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Just when I get sick\" id=\"form-field-field_f43fe91-1\" name=\"form_fields[field_f43fe91]\" required=\"required\"> <label for=\"form-field-field_f43fe91-1\">Just when I get sick<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_3c6189d elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3c6189d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you currently on Original Medicare (with or without a Medicare Supplement plan) or do you have a Medicare Advantage Plan and are looking to do a comparison of benefits to find a better plan?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Currently on Original Medicare\" id=\"form-field-field_3c6189d-0\" name=\"form_fields[field_3c6189d]\" required=\"required\"> <label for=\"form-field-field_3c6189d-0\">Currently on Original Medicare<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Currently on Original Medicare with a Medicare Supplement\" id=\"form-field-field_3c6189d-1\" name=\"form_fields[field_3c6189d]\" required=\"required\"> <label for=\"form-field-field_3c6189d-1\">Currently on Original Medicare with a Medicare Supplement<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Have Medicare Advantage but I\u2019m not happy with my plan.\" id=\"form-field-field_3c6189d-2\" name=\"form_fields[field_3c6189d]\" required=\"required\"> <label for=\"form-field-field_3c6189d-2\">Have Medicare Advantage but I\u2019m not happy with my plan.<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"I have nothing; I\u2019m new to Medicare.\" id=\"form-field-field_3c6189d-3\" name=\"form_fields[field_3c6189d]\" required=\"required\"> <label for=\"form-field-field_3c6189d-3\">I have nothing; I\u2019m new to Medicare.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_108825b elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_108825b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you aware that Medicare has deductibles, and you must pay 20% of expenses once the deductible(s) have been met?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"I wasn\u2019t aware\" id=\"form-field-field_108825b-0\" name=\"form_fields[field_108825b]\" required=\"required\"> <label for=\"form-field-field_108825b-0\">I wasn\u2019t aware<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes, I\u2019m aware of it\" id=\"form-field-field_108825b-1\" name=\"form_fields[field_108825b]\" required=\"required\"> <label for=\"form-field-field_108825b-1\">Yes, I\u2019m aware of it<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_4bb4412 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4bb4412\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you aware of MediGap (Supplement) policies that pay most of these expenses and provide added benefits, like emergency medical services when you travel?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No, I wasn\u2019t aware\" id=\"form-field-field_4bb4412-0\" name=\"form_fields[field_4bb4412]\" required=\"required\"> <label for=\"form-field-field_4bb4412-0\">No, I wasn\u2019t aware<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes, I\u2019m aware of it\" id=\"form-field-field_4bb4412-1\" name=\"form_fields[field_4bb4412]\" required=\"required\"> <label for=\"form-field-field_4bb4412-1\">Yes, I\u2019m aware of it<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_e5b2232 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e5b2232\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you currently have a MediGap policy, or would you like information on your MediGap policy options?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"I have one\" id=\"form-field-field_e5b2232-0\" name=\"form_fields[field_e5b2232]\" required=\"required\"> <label for=\"form-field-field_e5b2232-0\">I have one<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"I have one, but I\u2019m not happy with it and would like know my options.\" id=\"form-field-field_e5b2232-1\" name=\"form_fields[field_e5b2232]\" required=\"required\"> <label for=\"form-field-field_e5b2232-1\">I have one, but I\u2019m not happy with it and would like know my options.<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"I don\u2019t have one and I\u2019m interested in knowing my options.\" id=\"form-field-field_e5b2232-2\" name=\"form_fields[field_e5b2232]\" required=\"required\"> <label for=\"form-field-field_e5b2232-2\">I don\u2019t have one and I\u2019m interested in knowing my options.<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"I don\u2019t need one.\" id=\"form-field-field_e5b2232-3\" name=\"form_fields[field_e5b2232]\" required=\"required\"> <label for=\"form-field-field_e5b2232-3\">I don\u2019t need one.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_9cd5b26 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9cd5b26\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWould you like to know if you qualify for Extra Help, which would provide up to $5,300 to cover prescription drug costs, eliminating the donut hole?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes, I\u2019d like to know if I qualify.\" id=\"form-field-field_9cd5b26-0\" name=\"form_fields[field_9cd5b26]\" required=\"required\"> <label for=\"form-field-field_9cd5b26-0\">Yes, I\u2019d like to know if I qualify.<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No, I know I don\u2019t qualify.\" id=\"form-field-field_9cd5b26-1\" name=\"form_fields[field_9cd5b26]\" required=\"required\"> <label for=\"form-field-field_9cd5b26-1\">No, I know I don\u2019t qualify.<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_9a8fa7c elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9a8fa7c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo you have any special concerns or questions? If so, please write them below.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[field_9a8fa7c]\" id=\"form-field-field_9a8fa7c\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_6ed1752 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6ed1752\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWhen would be the most convenient time for us to contact you with your answers?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Mornings between 9AM and 12PM\" id=\"form-field-field_6ed1752-0\" name=\"form_fields[field_6ed1752]\"> <label for=\"form-field-field_6ed1752-0\">Mornings between 9AM and 12PM<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Early afternoon between 1PM to 3PM\" id=\"form-field-field_6ed1752-1\" name=\"form_fields[field_6ed1752]\"> <label for=\"form-field-field_6ed1752-1\">Early afternoon between 1PM to 3PM<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Late afternoon between 3PM to 6PM\" id=\"form-field-field_6ed1752-2\" name=\"form_fields[field_6ed1752]\"> <label for=\"form-field-field_6ed1752-2\">Late afternoon between 3PM to 6PM<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Evening between 6PM to 8PM\" id=\"form-field-field_6ed1752-3\" name=\"form_fields[field_6ed1752]\"> <label for=\"form-field-field_6ed1752-3\">Evening between 6PM to 8PM<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit Questionnaire<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Retirement is a big step! Understanding how to get the most benefits and save the most money from Medicare can be confusing. Fill out our short questionnaire and we will [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":110,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-449","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/pages\/449","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/comments?post=449"}],"version-history":[{"count":0,"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/pages\/449\/revisions"}],"wp:attachment":[{"href":"https:\/\/yourcarerep.com\/agent-clone-template\/wp-json\/wp\/v2\/media?parent=449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}