Health Net Farm Bureau Apply

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.

Before you apply, please view the Nationwide Brochure Nationwide Acrobat Reader.  It contains important information regarding benefits, exclusions, limitations, renewability, and other terms of coverage. 

Note: Nationwide plans are now being underwritten by Health Net

 

 

Apply Online

The quickest and easiest way to apply with Nationwide is to Apply Online through their Secure SSL website.  Once on their website, you will need to run a quote and then follow the link to apply online.

Gather the following information before you start the application in order to speed the process:

    1. Your doctors’ names, addresses, and phone numbers
    2. Medications you currently take or recently took, including dosage and frequency
    3. Dates of hospitalization
    4. The name of the plan for which you are applying
    5. Your requested effective date
    6. Your credit card information to cover the initial premium

Apply by Fax or Mail

You may also download the Nationwide Application Nationwide Acrobat Reader, fill it out, and send it to us via fax or mail.  Simply follow the instructions on the first page of the application.  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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