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, be sure to view the UniCare
brochure PDF 
for your state. It contains important information
regarding benefits, exclusions, limitations, renewability,
and other terms of coverage.
Apply
Online Applying
online is the easiest way to submit an application, and will reduce the underwriting
time by a few days. Security of all online apps is protected by 128-bit
Secure Socket Layer (SSL) encryption, the highest encryption available to most
browsers. As
a special consideration to online applicants, the customary $25 application
fee is waived. HSA for America
will maintain a record of your application, monitor its underwriting progress
through Unicare, and keep you informed every step of the way. Simply click
the button below to Apply
Online.
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
-
The name of the plan for which you are applying
-
Your requested effective date
-
Your credit card information to cover the initial premium
Apply
by Fax or Mail
To apply for
any plan with Unicare Insurance Company by mail, just follow the instructions
below: Simply
run an instant quote, then click "Apply"
next to the plan you are interested in and select "download an application."
When the Adobe Acrobat reader opens with the application, use the menu bar at
the top to save the application to a file or simply print it out right from
the reader. Follow
the instructions on the first page and complete the entire application. Please
fill out the application completely and include all pages.
Any unanswered questions will delay the processing. If you have any questions
about filling out the application, call application processing department at
866-749-2039, or 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. Fax
your application toll-free to 1-888-771-0010. Or Mail it to:
HSA
for America
1001-A East Harmony Road, #519
Fort Collins, CO 80525
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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