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Before
you apply, be sure to view your Humana
One state brochure PDF 
below. It contains important information regarding
benefits, exclusions, limitations, renewability, and
other terms of coverage.
Internet Explorer required
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Humana
One Brochures
by State
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Apply Online
The
easiest way to Apply with Humana
is through their Secure
SSL Online Application. Please note
that you must used Internet Explorer when you use
Humana’s online application.
Internet
Explorer required
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
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Apply
by Phone, Fax or Mail
You also have
two other options to apply with Humana:
- You can apply with Humana
by phone by calling 1-800-211-4561, and you will be connected with an
underwriter on the spot. Please note that you must let the
underwriter know that Wiley Long is your agent. This will enable
us to track your application through underwriting, and to assist you with any
questions. The phone call generally takes from 15 to 30 minutes.
However, the call can go longer based on the number of people applying
for coverage and medical history, and there is the chance that you may be on
hold for up to 30 minutes before someone can speak with you.
If your spouse is also applying
for coverage, you both need to be available to authorize any requests for medical
information from the Medical Information Bureau, if necessary. For
details on all of the information you should have available before calling Humana,
please view the Humana One Application
Preparation Sheet 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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Humana
One Application Preparation Sheet
*** Printer
Friendly Version ***
In
order to better assure the application process goes smoothly,
we strongly encourage you to
prepare for the call by having the following information
available prior to placing the call.
-
Name
of Agent Writing the Policy/Agent of Record:
Wiley
Long
-
Agent's
Business Telephone Number: 866-749-2039
-
Requested
Effective Date:
-
Requested
Medical Deductible:
Please make sure the following information is available
for each person applying for coverage:
- Birthdate
- Social
Security Number
- Height/Weight
- Current/past
prescription medications and their dosage
- Medical
history including diagnosis, treatment, dates of service
and current status
- Date
of last Doctor office visit
- Doctor's
names, addresses and phone numbers
- Information
on current and past insurance coverage including: policy
number,
effective dates, termination dates, and phone number
PAYMENT OPTIONS:
For your convenience, the following payment options are
accepted:
- For
the initial payment, Humana accepts Visa, MasterCard
or Automatic Check Draft.
- After
the initial payment, all payments need to be made either
monthly through an
Automatic Check Draft or they can be paid quarterly
or semi-annually by direct bill to you
($10 administrative charge per direct bill).
Additional
helpful hints:
- Application
calls can generally take from 15 to 30 minutes.
However, the call can go longer based on
the number of people applying for coverage and medical
history.
- If
you are applying for coverage for your spouse also,
please have your spouse available to authorize any requests
for medical information from the Medical Information
Bureau (when applicable).
To
complete the application process, contact
Humana's Application Specialists at:
1-800-211-4561
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