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Please
note that all applications will be submitted in the
name of Wiley Long, the president of HSA
for America. If you have already
been working directly with one of our advisors, then
that person will be noted in our system as your personal
contact.
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Before
you apply, please view your state's brochure 
below. It contains information regarding benefits,
exclusions, limitations, renewability, and other terms
of coverage. |
Internet
Explorer required
The
fastest and easiest way to get your coverage in force is
to Apply
Online, using the link above. Gather the following
information before you start the application in order to
speed the process:
-
Your doctors’ names, addresses, and phone numbers
-
Medications you currently take or recently took, including
dosage and frequency
- Dates
of hospitalization
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The name of the plan for which you are applying
-
Your requested effective date
-
Your credit card information to cover the initial premium
Internet
Explorer required
For
security, Aetna uses 128-bit Secure Socket Layer
(SSL) encryption, the highest encryption available to most
browsers, with a public key length of 1,024 bits.
If you
do not wish to apply online, download the application pdf
below and follow the instructions on the first page.
You
may also fill out our Application
Request Form and we will send you an application
right away.
Please
fill out the application Completely.
Any unanswered questions will delay the processing.
If you have any questions about filling out the application,
email us at info@HSAforAmerica.com,
leave your name and phone number, and someone from our office
will call you back and answer any application questions
you have.
Note:
All policies come with a money-back guarantee.
After receiving your policy, you have 10 days to review
it. If for any reason you decide not to keep the policy,
you will receive a full refund of your initial premium.
Remember that you also have access to the guaranteed lowest
life insurance rates available, with easy online quotes
and applications.
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