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 select your state 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:
- Open
the application PDF
by selecting your state below:
- 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. (You
may also fill out our Application
Request Form and we will send you an application
right away.)
- Simply
follow the instructions on the application.
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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