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Looking for Supplemental

& Gap Plans?

Already have health insurance but tired of paying high deductibles or out-of-pocket costs?
Complete the form below to receive personalized supplemental plan options that help cover your deductible, hospital stays, and unexpected medical expenses — at no cost or obligation.

Contact Info & Consent

Full Name *

Email *

Phone *

State *

Postal Code *

I consent to be contacted by phone, email, or text about insurance-related information. A licensed agent may contact you. This is a solicitation for insurance.

Not affiliated with or endorsed by any government agency or program.

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Current Coverage

Do you currently have any of these coverages?

Yes

No

Dental, Vision, Accident/Disability Supplement, Critical Illness, Hospital Indemnity, Gap Coverage

Is this tied to an employer plan?

Yes

No

Preferences

What’s most important to you?

Keeping monthly costs low

Broad provider network (dentists / vision clinics)

Comprehensive benefits (higher annual maximums, lower copays)

Bundling with existing health or life coverage

Do you have any preferred providers?

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Let's Get You the Extra Protection You Deserve

Phone: (801) 997-8196

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Fortune Shield is a licensed independent insurance agency. Not all products are available in all states. Eligibility and benefits vary by carrier and state. Enrollment subject to approval. Fortune Shield is not connected with or endorsed by the U.S. government or the federal Medicare program.