{"id":62780,"date":"2021-02-11T10:40:27","date_gmt":"2021-02-11T16:40:27","guid":{"rendered":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/?page_id=62780"},"modified":"2025-07-30T13:55:49","modified_gmt":"2025-07-30T19:55:49","slug":"medicare-supplement","status":"publish","type":"page","link":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/insurance\/medicare-supplement\/","title":{"rendered":"Medicare Supplement"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"62780\" class=\"elementor elementor-62780\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c3791cd elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"c3791cd\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0782ddd\" data-id=\"0782ddd\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-08f96e6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"08f96e6\" data-element_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-60166ab\" data-id=\"60166ab\" data-element_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-d2bea08 elementor-widget elementor-widget-text-editor\" data-id=\"d2bea08\" data-element_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\tDo you qualify for Medicare Supplement Insurance Plans?\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-1ee59b1 elementor-widget elementor-widget-text-editor\" data-id=\"1ee59b1\" data-element_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\tWe&#8217;re here to help you answer the question in order to get the best supplement plan and enjoy maximum savings.\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\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-d5bed72 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d5bed72\" data-element_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-dbd293f\" data-id=\"dbd293f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-9b0f301 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9b0f301\" data-element_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-inner-column elementor-element elementor-element-98ff236\" data-id=\"98ff236\" data-element_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-c22ef82 elementor-widget elementor-widget-image\" data-id=\"c22ef82\" data-element_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 fetchpriority=\"high\" decoding=\"async\" width=\"500\" height=\"383\" src=\"https:\/\/cdn.agencyinfo.net\/thereynoldsagency-elem\/__domain_images_wp\/medicare-sup-couple.jpg\" class=\"attachment-full size-full wp-image-62785\" alt=\"Couple On Beach\" \/>\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\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-bf83a9c\" data-id=\"bf83a9c\" data-element_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-c956249 elementor-widget elementor-widget-text-editor\" data-id=\"c956249\" data-element_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\tWhat is Medicare Supplement Insurance?\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-fdc79b0 elementor-widget elementor-widget-text-editor\" data-id=\"fdc79b0\" data-element_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>Medicare Supplement Insurance is a type of private health insurance that helps cover certain Medicare out-of-pocket costs such as copayments, deductibles and coinsurance. Over 13 million Americans are estimated to currently have their own Medicare Supplement Insurance plan.<\/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\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-2abea06 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2abea06\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&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-58fd827\" data-id=\"58fd827\" data-element_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-f47469c elementor-widget elementor-widget-text-editor\" data-id=\"f47469c\" data-element_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\tComparison of Basic Medicare Out Of Pocket Costs VS Supplement Plan G Costs\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-98cfadf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"98cfadf\" data-element_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-25 elementor-inner-column elementor-element elementor-element-5bfd758\" data-id=\"5bfd758\" data-element_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-3ad8631 elementor-widget elementor-widget-oew-pricing\" data-id=\"3ad8631\" data-element_type=\"widget\" data-widget_type=\"oew-pricing.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div class=\"oew-pricing clr\">\n\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-header clr\">Medicare Part A Deductible<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-cost clr\">\n\n\t\t\t\t\t<div class=\"oew-pricing-amount\">Without Medicare Supplement: $1,484 per benefit period<\/div>\n\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-content clr\"><ul>\n<li>With Medicare Supplement Insurance Plan G<\/li>\n<li class=\"oew-even\">Out Of Pocket Costs: $0<\/li>\n<\/ul><\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-button clr\">\n\n\n\n\t\t\t\t<a href=\"#inquire\" title=\"INQUIRE NOW\" class=\"button\" target=\"_self\">\n\t\t\t\t\t\t\t\t\t\tINQUIRE NOW\t\t\t\t<\/a>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div><!-- .oew-pricing -->\n\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<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-0c8404c\" data-id=\"0c8404c\" data-element_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-66ef840 elementor-widget elementor-widget-oew-pricing\" data-id=\"66ef840\" data-element_type=\"widget\" data-widget_type=\"oew-pricing.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div class=\"oew-pricing clr\">\n\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-header clr\">Medicare Part A Coinsurance for Inpatient Hospital Stay<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-cost clr\">\n\n\t\t\t\t\t<div class=\"oew-pricing-amount\">Up to $742 per day<\/div>\n\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-content clr\"><ul>\n<li>With Medicare Supplement Insurance Plan G<\/li>\n<li class=\"oew-even\">Out Of Pocket Costs: $0<\/li>\n<\/ul><\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-button clr\">\n\n\n\n\t\t\t\t<a href=\"#inquire\" title=\"INQUIRE NOW\" class=\"button\" target=\"_self\">\n\t\t\t\t\t\t\t\t\t\tINQUIRE NOW\t\t\t\t<\/a>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div><!-- .oew-pricing -->\n\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<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-4d42074\" data-id=\"4d42074\" data-element_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-53e8d2b elementor-widget elementor-widget-oew-pricing\" data-id=\"53e8d2b\" data-element_type=\"widget\" data-widget_type=\"oew-pricing.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div class=\"oew-pricing clr\">\n\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-header clr\">Medicare Part A Coinsurance for Skilled Nursing Facility Care<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-cost clr\">\n\n\t\t\t\t\t<div class=\"oew-pricing-amount\">Up to $185.50 per day<\/div>\n\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-content clr\"><ul>\n<li>With Medicare Supplement Insurance Plan G<\/li>\n<li class=\"oew-even\">Out Of Pocket Costs: $0<\/li>\n<\/ul><\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-button clr\">\n\n\n\n\t\t\t\t<a href=\"#inquire\" title=\"INQUIRE NOW\" class=\"button\" target=\"_self\">\n\t\t\t\t\t\t\t\t\t\tINQUIRE NOW\t\t\t\t<\/a>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div><!-- .oew-pricing -->\n\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<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-2c3f037\" data-id=\"2c3f037\" data-element_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-728a58f elementor-widget elementor-widget-oew-pricing\" data-id=\"728a58f\" data-element_type=\"widget\" data-widget_type=\"oew-pricing.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t<div class=\"oew-pricing clr\">\n\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-header clr\">Medicare Part B Copayment<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-cost clr\">\n\n\t\t\t\t\t<div class=\"oew-pricing-amount\">Typically 20% of the Medicare approved amount<\/div>\n\n\t\t\t\t\t\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-content clr\"><ul>\n<li>With Medicare Supplement Insurance Plan G<\/li>\n<li class=\"oew-even\">Out Of Pocket Costs: $0<\/li>\n<\/ul><\/div>\n\n\t\t\t\n\t\t\t\n\t\t\t\t<div class=\"oew-pricing-button clr\">\n\n\n\n\t\t\t\t<a href=\"#inquire\" title=\"INQUIRE NOW\" class=\"button\" target=\"_self\">\n\t\t\t\t\t\t\t\t\t\tINQUIRE NOW\t\t\t\t<\/a>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div><!-- .oew-pricing -->\n\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-807caf4 elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"807caf4\" data-element_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-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-909e9ae\" data-id=\"909e9ae\" data-element_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-553f9ef elementor-widget elementor-widget-image\" data-id=\"553f9ef\" data-element_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=\"460\" height=\"301\" src=\"https:\/\/cdn.agencyinfo.net\/thereynoldsagency-elem\/__domain_images_wp\/medicare-card-sample.png\" class=\"attachment-full size-full wp-image-62786\" 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-77f4ff6 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"77f4ff6\" data-element_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-522c99c\" data-id=\"522c99c\" data-element_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-c3fa5ec elementor-widget elementor-widget-text-editor\" data-id=\"c3fa5ec\" data-element_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\tDo you qualify for Medicare Supplement Insurance? Simply complete the\u00a0following questionnaire and we&#8217;ll take care of the rest.\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\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-854161e elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"854161e\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-27e1b86\" data-id=\"27e1b86\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-91ef873 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"91ef873\" data-element_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-19bb556\" data-id=\"19bb556\" data-element_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-556cebb elementor-widget elementor-widget-menu-anchor\" data-id=\"556cebb\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"inquire\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fd9afd8 elementor-widget elementor-widget-text-editor\" data-id=\"fd9afd8\" data-element_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\tINQUIRE ONLINE\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-2930d52 elementor-widget elementor-widget-text-editor\" data-id=\"2930d52\" data-element_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\tPlease answer the following questions in order to find out if you qualify for Medicare Supplement insurance.\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\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-7376959 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7376959\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5caf239\" data-id=\"5caf239\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-4f77a5b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4f77a5b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&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-inner-column elementor-element elementor-element-4c8cf30\" data-id=\"4c8cf30\" data-element_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-9f67160 elementor-widget elementor-widget-oew-gravity-forms\" data-id=\"9f67160\" data-element_type=\"widget\" data-widget_type=\"oew-gravity-forms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework gf_stylespro_wrapper sp_goose_wrapper' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_9' id='gform_9' class=' gf_stylespro sp_goose' action='\/ins-smyrna-tn\/wp-json\/wp\/v2\/pages\/62780#gf_9' data-formid='9' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_page_9_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_9_159\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>YOUR CONTACT DETAILS:<\/h2>\n<hr height=\"3\" align=\"left\" color=\"#000000\" width=\"80%\" \/><\/li><li id=\"field_9_1\" class=\"gfield gfield--type-name gfield--input-type-name gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Your Name *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_9_1'>\n                            \n                            <span id='input_9_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_9_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_9_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_9_5\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Email Address *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_9_5_container'>\n                                <span id='input_9_5_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_5' id='input_9_5' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_9_5' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_9_5_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_5_2' id='input_9_5_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_9_5_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_9_3\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_3'>Phone *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_9_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_9_82\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_right_half gf_list_inline field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Phone Type<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_82'>\n\t\t\t<li class='gchoice gchoice_9_82_0'>\n\t\t\t\t<input name='input_82' type='radio' value='Cell'  id='choice_9_82_0'    \/>\n\t\t\t\t<label for='choice_9_82_0' id='label_9_82_0' class='gform-field-label gform-field-label--type-inline'>Cell<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_82_1'>\n\t\t\t\t<input name='input_82' type='radio' value='Work'  id='choice_9_82_1'    \/>\n\t\t\t\t<label for='choice_9_82_1' id='label_9_82_1' class='gform-field-label gform-field-label--type-inline'>Work<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_82_2'>\n\t\t\t\t<input name='input_82' type='radio' value='Home'  id='choice_9_82_2'    \/>\n\t\t\t\t<label for='choice_9_82_2' id='label_9_82_2' class='gform-field-label gform-field-label--type-inline'>Home<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_2\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gf_half o_medium\"  data-field-class=\"gf_half o_medium\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Home Address *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_9_2' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_9_2_1_container' >\n                                        <input type='text' name='input_2.1' id='input_9_2_1' value=''    aria-required='true'    \/>\n                                        <label for='input_9_2_1' id='input_9_2_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_9_2_3_container' >\n                                    <input type='text' name='input_2.3' id='input_9_2_3' value=''    aria-required='true'    \/>\n                                    <label for='input_9_2_3' id='input_9_2_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_9_2_4_container' >\n                                        <select name='input_2.4' id='input_9_2_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_2_4' id='input_9_2_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_9_2_5_container' >\n                                    <input type='text' name='input_2.5' id='input_9_2_5' value=''    aria-required='true'    \/>\n                                    <label for='input_9_2_5' id='input_9_2_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_2.6' id='input_9_2_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_9_167\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible o_medium\"  data-field-class=\"o_medium\" ><label class='gfield_label gform-field-label' >Which Statement Best Describes Your Current Age In Regards to Medicare?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_167'>\n\t\t\t<li class='gchoice gchoice_9_167_0'>\n\t\t\t\t<input name='input_167' type='radio' value='Within 6 months or less of turning 65 and not yet on Medicare.'  id='choice_9_167_0'    \/>\n\t\t\t\t<label for='choice_9_167_0' id='label_9_167_0' class='gform-field-label gform-field-label--type-inline'>Within 6 months or less of turning 65 and not yet on Medicare.<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_167_1'>\n\t\t\t\t<input name='input_167' type='radio' value='Already past my 65 birthday and on Medicare.'  id='choice_9_167_1'    \/>\n\t\t\t\t<label for='choice_9_167_1' id='label_9_167_1' class='gform-field-label gform-field-label--type-inline'>Already past my 65 birthday and on Medicare.<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_167_2'>\n\t\t\t\t<input name='input_167' type='radio' value='Under the age of 65 but receiving Medicare due to a prior disability.'  id='choice_9_167_2'    \/>\n\t\t\t\t<label for='choice_9_167_2' id='label_9_167_2' class='gform-field-label gform-field-label--type-inline'>Under the age of 65 but receiving Medicare due to a prior disability.<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_71' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='GO TO NEXT SCREEN'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' data-js='page-field-id-71' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_9_160\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>GENERAL MEDICAL HISTORY:<\/h2>\n[22 Yes or No Questions]\n<hr><\/li><li id=\"field_9_125\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you currently confined to a wheelchair or use a motorized mobility device?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_125'>\n\t\t\t<li class='gchoice gchoice_9_125_0'>\n\t\t\t\t<input name='input_125' type='radio' value='Yes'  id='choice_9_125_0'    \/>\n\t\t\t\t<label for='choice_9_125_0' id='label_9_125_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_125_1'>\n\t\t\t\t<input name='input_125' type='radio' value='No'  id='choice_9_125_1'    \/>\n\t\t\t\t<label for='choice_9_125_1' id='label_9_125_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_126\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you currently hospitalized, confined to a bed, in a nursing home or assisted living facility?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_126'>\n\t\t\t<li class='gchoice gchoice_9_126_0'>\n\t\t\t\t<input name='input_126' type='radio' value='Yes'  id='choice_9_126_0'    \/>\n\t\t\t\t<label for='choice_9_126_0' id='label_9_126_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_126_1'>\n\t\t\t\t<input name='input_126' type='radio' value='No'  id='choice_9_126_1'    \/>\n\t\t\t\t<label for='choice_9_126_1' id='label_9_126_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_127\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you currently receiving or been advised to have occupational, speech or physical therapy?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_127'>\n\t\t\t<li class='gchoice gchoice_9_127_0'>\n\t\t\t\t<input name='input_127' type='radio' value='Yes'  id='choice_9_127_0'    \/>\n\t\t\t\t<label for='choice_9_127_0' id='label_9_127_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_127_1'>\n\t\t\t\t<input name='input_127' type='radio' value='No'  id='choice_9_127_1'    \/>\n\t\t\t\t<label for='choice_9_127_1' id='label_9_127_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_128\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you been advised by a medical professional to have treatment, further diagnostic evaluation, diagnostic testing, follow up visits or any surgery that has not been performed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_128'>\n\t\t\t<li class='gchoice gchoice_9_128_0'>\n\t\t\t\t<input name='input_128' type='radio' value='Yes'  id='choice_9_128_0'    \/>\n\t\t\t\t<label for='choice_9_128_0' id='label_9_128_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_128_1'>\n\t\t\t\t<input name='input_128' type='radio' value='No'  id='choice_9_128_1'    \/>\n\t\t\t\t<label for='choice_9_128_1' id='label_9_128_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_129\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you had any medication administered in a physician\u2019s office via injection, infusion or IV in the past 24 months or are any scheduled or anticipated in the next 12 months.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_129'>\n\t\t\t<li class='gchoice gchoice_9_129_0'>\n\t\t\t\t<input name='input_129' type='radio' value='Yes'  id='choice_9_129_0'    \/>\n\t\t\t\t<label for='choice_9_129_0' id='label_9_129_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_129_1'>\n\t\t\t\t<input name='input_129' type='radio' value='No'  id='choice_9_129_1'    \/>\n\t\t\t\t<label for='choice_9_129_1' id='label_9_129_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_133\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Emphysema, Chronic Obstructive Pulmonary Disease (COPD), any other chronic pulmonary disorder or any cardio-pulmonary disorder requiring oxygen?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_133'>\n\t\t\t<li class='gchoice gchoice_9_133_0'>\n\t\t\t\t<input name='input_133' type='radio' value='Yes'  id='choice_9_133_0'    \/>\n\t\t\t\t<label for='choice_9_133_0' id='label_9_133_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_133_1'>\n\t\t\t\t<input name='input_133' type='radio' value='No'  id='choice_9_133_1'    \/>\n\t\t\t\t<label for='choice_9_133_1' id='label_9_133_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_134\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Alzheimer\u2019s disease, dementia or any other cognitive disorder?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_134'>\n\t\t\t<li class='gchoice gchoice_9_134_0'>\n\t\t\t\t<input name='input_134' type='radio' value='Yes'  id='choice_9_134_0'    \/>\n\t\t\t\t<label for='choice_9_134_0' id='label_9_134_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_134_1'>\n\t\t\t\t<input name='input_134' type='radio' value='No'  id='choice_9_134_1'    \/>\n\t\t\t\t<label for='choice_9_134_1' id='label_9_134_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_135\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Parkinson\u2019s disease, multiple sclerosis or amyotrophic lateral sclerosis(Lou Gehrig\u2019s disease)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_135'>\n\t\t\t<li class='gchoice gchoice_9_135_0'>\n\t\t\t\t<input name='input_135' type='radio' value='Yes'  id='choice_9_135_0'    \/>\n\t\t\t\t<label for='choice_9_135_0' id='label_9_135_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_135_1'>\n\t\t\t\t<input name='input_135' type='radio' value='No'  id='choice_9_135_1'    \/>\n\t\t\t\t<label for='choice_9_135_1' id='label_9_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_136\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Systemic Lupus, scleroderma or myasthenia gravis?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_136'>\n\t\t\t<li class='gchoice gchoice_9_136_0'>\n\t\t\t\t<input name='input_136' type='radio' value='Yes'  id='choice_9_136_0'    \/>\n\t\t\t\t<label for='choice_9_136_0' id='label_9_136_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_136_1'>\n\t\t\t\t<input name='input_136' type='radio' value='No'  id='choice_9_136_1'    \/>\n\t\t\t\t<label for='choice_9_136_1' id='label_9_136_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_137\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Acquired Immune Deficiency Syndrome(AIDS) or AIDS Related Complex(ARC)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_137'>\n\t\t\t<li class='gchoice gchoice_9_137_0'>\n\t\t\t\t<input name='input_137' type='radio' value='Yes'  id='choice_9_137_0'    \/>\n\t\t\t\t<label for='choice_9_137_0' id='label_9_137_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_137_1'>\n\t\t\t\t<input name='input_137' type='radio' value='No'  id='choice_9_137_1'    \/>\n\t\t\t\t<label for='choice_9_137_1' id='label_9_137_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_138\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? An organ transplant or been advised to have an organ transplant (excluding corneal transplants)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_138'>\n\t\t\t<li class='gchoice gchoice_9_138_0'>\n\t\t\t\t<input name='input_138' type='radio' value='Yes'  id='choice_9_138_0'    \/>\n\t\t\t\t<label for='choice_9_138_0' id='label_9_138_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_138_1'>\n\t\t\t\t<input name='input_138' type='radio' value='No'  id='choice_9_138_1'    \/>\n\t\t\t\t<label for='choice_9_138_1' id='label_9_138_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_139\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Chronic hepatitis or cirrhosis?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_139'>\n\t\t\t<li class='gchoice gchoice_9_139_0'>\n\t\t\t\t<input name='input_139' type='radio' value='Yes'  id='choice_9_139_0'    \/>\n\t\t\t\t<label for='choice_9_139_0' id='label_9_139_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_139_1'>\n\t\t\t\t<input name='input_139' type='radio' value='No'  id='choice_9_139_1'    \/>\n\t\t\t\t<label for='choice_9_139_1' id='label_9_139_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_140\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >At any time have you been medically diagnosed with, treated for or had surgery for any of the following? Osteoporosis with fractures?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_140'>\n\t\t\t<li class='gchoice gchoice_9_140_0'>\n\t\t\t\t<input name='input_140' type='radio' value='Yes'  id='choice_9_140_0'    \/>\n\t\t\t\t<label for='choice_9_140_0' id='label_9_140_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_140_1'>\n\t\t\t\t<input name='input_140' type='radio' value='No'  id='choice_9_140_1'    \/>\n\t\t\t\t<label for='choice_9_140_1' id='label_9_140_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_141\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you been medically diagnosed with or treated for diabetes, or have you taken or been advised by a member of the medical profession to take prescription medication(s) to control your blood sugar in addition to any of the following peripheral artery disease, peripheral venous thrombotic disease, any heart disorder, kidney disease,stroke or transient ischemic attack(TIA)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_141'>\n\t\t\t<li class='gchoice gchoice_9_141_0'>\n\t\t\t\t<input name='input_141' type='radio' value='Yes'  id='choice_9_141_0'    \/>\n\t\t\t\t<label for='choice_9_141_0' id='label_9_141_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_141_1'>\n\t\t\t\t<input name='input_141' type='radio' value='No'  id='choice_9_141_1'    \/>\n\t\t\t\t<label for='choice_9_141_1' id='label_9_141_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_142\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you have an implanted cardiac defibrillator?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_142'>\n\t\t\t<li class='gchoice gchoice_9_142_0'>\n\t\t\t\t<input name='input_142' type='radio' value='Yes'  id='choice_9_142_0'    \/>\n\t\t\t\t<label for='choice_9_142_0' id='label_9_142_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_142_1'>\n\t\t\t\t<input name='input_142' type='radio' value='No'  id='choice_9_142_1'    \/>\n\t\t\t\t<label for='choice_9_142_1' id='label_9_142_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_143\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for: Cardiomyopathy, congestive heart failure, aortic or cardiac aneurysm, vascular angioplasty, endarterectomy, any heart or heart valve disorder\/disease or implantation of a pacemaker?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_143'>\n\t\t\t<li class='gchoice gchoice_9_143_0'>\n\t\t\t\t<input name='input_143' type='radio' value='Yes'  id='choice_9_143_0'    \/>\n\t\t\t\t<label for='choice_9_143_0' id='label_9_143_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_143_1'>\n\t\t\t\t<input name='input_143' type='radio' value='No'  id='choice_9_143_1'    \/>\n\t\t\t\t<label for='choice_9_143_1' id='label_9_143_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_145\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for Alcoholism or drug abuse?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_145'>\n\t\t\t<li class='gchoice gchoice_9_145_0'>\n\t\t\t\t<input name='input_145' type='radio' value='Yes'  id='choice_9_145_0'    \/>\n\t\t\t\t<label for='choice_9_145_0' id='label_9_145_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_145_1'>\n\t\t\t\t<input name='input_145' type='radio' value='No'  id='choice_9_145_1'    \/>\n\t\t\t\t<label for='choice_9_145_1' id='label_9_145_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_146\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for: internal cancer, lymphoma or melanoma?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_146'>\n\t\t\t<li class='gchoice gchoice_9_146_0'>\n\t\t\t\t<input name='input_146' type='radio' value='Yes'  id='choice_9_146_0'    \/>\n\t\t\t\t<label for='choice_9_146_0' id='label_9_146_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_146_1'>\n\t\t\t\t<input name='input_146' type='radio' value='No'  id='choice_9_146_1'    \/>\n\t\t\t\t<label for='choice_9_146_1' id='label_9_146_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_147\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for: a heart attack, stroke or transient ischemic attack (TIA)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_147'>\n\t\t\t<li class='gchoice gchoice_9_147_0'>\n\t\t\t\t<input name='input_147' type='radio' value='Yes'  id='choice_9_147_0'    \/>\n\t\t\t\t<label for='choice_9_147_0' id='label_9_147_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_147_1'>\n\t\t\t\t<input name='input_147' type='radio' value='No'  id='choice_9_147_1'    \/>\n\t\t\t\t<label for='choice_9_147_1' id='label_9_147_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_148\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for: Spinal stenosis, psoriatic arthritis, arthritis that restricts mobility or have you been advised to have joint replacement?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_148'>\n\t\t\t<li class='gchoice gchoice_9_148_0'>\n\t\t\t\t<input name='input_148' type='radio' value='Yes'  id='choice_9_148_0'    \/>\n\t\t\t\t<label for='choice_9_148_0' id='label_9_148_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_148_1'>\n\t\t\t\t<input name='input_148' type='radio' value='No'  id='choice_9_148_1'    \/>\n\t\t\t\t<label for='choice_9_148_1' id='label_9_148_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_149\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you been advised by a medical professional that surgery may be required within the next 12 months for cataract surgery?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_149'>\n\t\t\t<li class='gchoice gchoice_9_149_0'>\n\t\t\t\t<input name='input_149' type='radio' value='Yes'  id='choice_9_149_0'    \/>\n\t\t\t\t<label for='choice_9_149_0' id='label_9_149_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_149_1'>\n\t\t\t\t<input name='input_149' type='radio' value='No'  id='choice_9_149_1'    \/>\n\t\t\t\t<label for='choice_9_149_1' id='label_9_149_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_150\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been hospital confined three or more times?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_150'>\n\t\t\t<li class='gchoice gchoice_9_150_0'>\n\t\t\t\t<input name='input_150' type='radio' value='Yes'  id='choice_9_150_0'    \/>\n\t\t\t\t<label for='choice_9_150_0' id='label_9_150_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_150_1'>\n\t\t\t\t<input name='input_150' type='radio' value='No'  id='choice_9_150_1'    \/>\n\t\t\t\t<label for='choice_9_150_1' id='label_9_150_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_152' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='PREVIOUS'  \/> <input type='button' id='gform_next_button_9_152' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='GO TO NEXT SCREEN'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' data-js='page-field-id-152' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_9_158\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>IF YOU ANSWER YES TO ANY QUESTION IN THIS SECTION, YOU MIGHT BE ELIGIBLE FOR COVERAGE:<\/h2>\n[5 Questions]\n<hr><\/li><li id=\"field_9_151\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you been medically diagnosed with or treated for diabetes or have taken or been advised by a member of the medical profession to take prescription medication(s) to control your blood sugar in addition to any of the following: diabetes with retinopathy, diabetes with neuropathy or diabetes with high blood pressure?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_151'>\n\t\t\t<li class='gchoice gchoice_9_151_0'>\n\t\t\t\t<input name='input_151' type='radio' value='Yes'  id='choice_9_151_0'    \/>\n\t\t\t\t<label for='choice_9_151_0' id='label_9_151_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_151_1'>\n\t\t\t\t<input name='input_151' type='radio' value='No'  id='choice_9_151_1'    \/>\n\t\t\t\t<label for='choice_9_151_1' id='label_9_151_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_132\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have been treated for or been advised by a physician to have treatment for: Coronary artery disease, angina, cardiac angioplasty, bypass surgery or stent placement?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_132'>\n\t\t\t<li class='gchoice gchoice_9_132_0'>\n\t\t\t\t<input name='input_132' type='radio' value='Yes'  id='choice_9_132_0'    \/>\n\t\t\t\t<label for='choice_9_132_0' id='label_9_132_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_132_1'>\n\t\t\t\t<input name='input_132' type='radio' value='No'  id='choice_9_132_1'    \/>\n\t\t\t\t<label for='choice_9_132_1' id='label_9_132_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for: Peripheral artery disease, peripheral venous thrombotic disease, carotid artery disease, atrial fibrillation or other heart rhythm disorder?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_131'>\n\t\t\t<li class='gchoice gchoice_9_131_0'>\n\t\t\t\t<input name='input_131' type='radio' value='Yes'  id='choice_9_131_0'    \/>\n\t\t\t\t<label for='choice_9_131_0' id='label_9_131_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_131_1'>\n\t\t\t\t<input name='input_131' type='radio' value='No'  id='choice_9_131_1'    \/>\n\t\t\t\t<label for='choice_9_131_1' id='label_9_131_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_130\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years, have you been treated for or been advised by a physician to have treatment for: Any mental or nervous disorder requiring treatment (including hospital confinement) by a psychiatrist, psychologist, counselor or therapist?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_130'>\n\t\t\t<li class='gchoice gchoice_9_130_0'>\n\t\t\t\t<input name='input_130' type='radio' value='Yes'  id='choice_9_130_0'    \/>\n\t\t\t\t<label for='choice_9_130_0' id='label_9_130_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_130_1'>\n\t\t\t\t<input name='input_130' type='radio' value='No'  id='choice_9_130_1'    \/>\n\t\t\t\t<label for='choice_9_130_1' id='label_9_130_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_153\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >In the past two years have you been treated for or been advised by a physician to have treatment for: Degenerative bone disease or rheumatoid arthritis?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_153'>\n\t\t\t<li class='gchoice gchoice_9_153_0'>\n\t\t\t\t<input name='input_153' type='radio' value='Yes'  id='choice_9_153_0'    \/>\n\t\t\t\t<label for='choice_9_153_0' id='label_9_153_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_153_1'>\n\t\t\t\t<input name='input_153' type='radio' value='No'  id='choice_9_153_1'    \/>\n\t\t\t\t<label for='choice_9_153_1' id='label_9_153_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_161\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>MEDICATION INFORMATION:<\/h2>\n[5 Questions]\n<hr><\/li><li id=\"field_9_154\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you currently taking or have you taken any prescription drugs or over-the-counter medications within the last 24 months?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_154'>\n\t\t\t<li class='gchoice gchoice_9_154_0'>\n\t\t\t\t<input name='input_154' type='radio' value='Yes'  id='choice_9_154_0'    \/>\n\t\t\t\t<label for='choice_9_154_0' id='label_9_154_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_9_154_1'>\n\t\t\t\t<input name='input_154' type='radio' value='No'  id='choice_9_154_1'    \/>\n\t\t\t\t<label for='choice_9_154_1' id='label_9_154_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_9_156\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">** You answered YES to the above medication question, medication information is required.**<\/h2><\/li><li id=\"field_9_117\" class=\"gfield gfield--type-list gfield--input-type-list gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gf_half o_medium\"  data-field-class=\"gf_half o_medium\" ><label class='gfield_label gform-field-label' >LIST MEDICATIONS *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_117_col1' class='gfield_list_col_odd' \/><col id='gfield_list_117_col2' class='gfield_list_col_even' \/><\/colgroup><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_117_cell1' ><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_9_117\" aria-label='LIST MEDICATIONS *, Row 1' data-aria-label-template='LIST MEDICATIONS *, Row {0}' type='text' name='input_117[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 20)' onkeypress='gformAddListItem(this, 20)'><img src='https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 20)' onkeypress='gformDeleteListItem(this, 20)' style=\"visibility:hidden;\"><img src='https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><div class='gfield_description' id='gfield_description_9_117'>Click the Plus(+) or Minus(-) buttons on the right to Add or Remove lines to this list.<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_157' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='PREVIOUS'  \/> <input type='button' id='gform_next_button_9_157' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='GO TO NEXT SCREEN'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' data-js='page-field-id-157' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_9_162\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>PROVIDE A PICTURE OF YOUR CURRENT MEDICARE CARD:<\/h2>\n<h3>Using one of the following 2 options, either upload an image of your current Medicare benefits card or TEXT us an image of your card.<\/h3>\n<hr><\/li><li id=\"field_9_165\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>OPTION #1:<br \/>UPLOAD IMAGE OF MEDICARE CARD<\/h2>\n\nUsing the area below, please browse your computer and upload a clear image of your card. Allowed file types are pdf, jpg, png. 3 files maximum limit. Total file(s) upload size can  not exceed 15mb.<\/li><li id=\"field_9_99\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_9_99'>Drag &amp; Drop or Select Files: *<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_9_99' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_9_99&quot;,&quot;container&quot;:&quot;gform_multifile_upload_9_99&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_9_99&quot;,&quot;filelist&quot;:&quot;gform_preview_9_99&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.thereynoldsagency.com\\\/ins-smyrna-tn\\\/?gf_page=34791c4f8e37e19&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.thereynoldsagency.com\\\/ins-smyrna-tn\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.thereynoldsagency.com\\\/ins-smyrna-tn\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf,jpg,png&quot;}],&quot;max_file_size&quot;:&quot;15728640b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:9,&quot;field_id&quot;:99,&quot;_gform_file_upload_nonce_9_99&quot;:&quot;276ec3cab1&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;3&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_9_99&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_9_99' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_9_99' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_9_99\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_9_99'>Accepted file types: pdf, jpg, png, Max. file size: 15 MB, Max. files: 3.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_9_99'><\/ul> <div id='gform_preview_9_99' class='ginput_preview_list'><\/div><\/div><\/li><li id=\"field_9_166\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2>OPTION #2:<br \/>USE YOUR PHONE'S TEXT SERVICE TO SEND IMAGE OF MEDICARE CARD<\/h2>\n\n<h3>In order to use this option, please TEXT image to the following phone number:<\/h3>\n\n<h3>615-220-4377<\/h3><\/li><li id=\"field_9_170\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_9_170'>Hidden TEXT Note for Confirmations and Notifications<\/label><div class='ginput_container ginput_container_text'><input name='input_170' id='input_9_170' type='text' value='If you decided to TEXT us the image of your current Medicare Card, then please do so as soon as possible and TEXT the image to: 615-220-4377' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_168' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='PREVIOUS'  \/> <input type='button' id='gform_next_button_9_168' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='GO TO NEXT SCREEN'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_5' class='gform_page' data-js='page-field-id-168' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_9_164\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><\/li><li id=\"field_9_171\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_turnstile'><div class=\"cf-turnstile\" id=\"cf-turnstile_9\" data-js-turnstile data-response-field-name=\"cf-turnstile-response_9\" data-theme=\"light\" data-size=\"\" data-sitekey=\"0x4AAAAAACC8O50qGMzJ19Fl\"><\/div><\/div><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='PREVIOUS'  \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='SUBMIT COMPLETED REQUEST'  \/> <input type='hidden' name='gform_ajax' value='form_id=9&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy&amp;hash=32ce42b43b3b1883ac43a79e20e8751f' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_9' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_9' id='gform_theme_9' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_9' id='gform_style_settings_9' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsImUyZWUyNDM1Yzg2MWJmNTZkMzE4ODk5MmVlMzJmMGM3Il0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_9' value='' \/>\n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_9' id='gform_ajax_frame_9' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'><\/iframe>\n\t\t                <script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 9, 'https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_9').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_9');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_9').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_9').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_9').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_9').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_9').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_9').val();gformInitSpinner( 9, 'https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [9, current_page]);window['gf_submitting_9'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_9').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_9').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [9]);window['gf_submitting_9'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_9').text());}else{jQuery('#gform_9').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"9\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_9\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_9\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_9\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 9, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n\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>Do you qualify for Medicare Supplement Insurance Plans?We&#8217;re here to help you answer the question in order to get the best supplement plan and enjoy maximum savings. What is Medicare Supplement Insurance? Medicare Supplement Insurance is a type of private health insurance that helps cover certain Medicare out-of-pocket costs such as copayments, deductibles and coinsurance. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":120,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"on","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"on","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"off","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","omw_enable_modal_window":"enable","footnotes":""},"class_list":["post-62780","page","type-page","status-publish","hentry","entry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/pages\/62780","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/comments?post=62780"}],"version-history":[{"count":2,"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/pages\/62780\/revisions"}],"predecessor-version":[{"id":63192,"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/pages\/62780\/revisions\/63192"}],"up":[{"embeddable":true,"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/pages\/120"}],"wp:attachment":[{"href":"https:\/\/www.thereynoldsagency.com\/ins-smyrna-tn\/wp-json\/wp\/v2\/media?parent=62780"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}