Get Illinois Standard Health Application Individual 2013 Form 2011-2025

Completing the Illinois Standard Health Application Individual 2013 Form online can seem daunting, but this guide simplifies the process. By following each step carefully, you can ensure that your application is filled out accurately and completely.

Follow the steps to successfully fill out the application online.

1. Click the ‘Get Form’ button to access the application. This will allow you to open the form in an appropriate editor for completion.
2. Begin by entering your applicant information, which includes your name, address, contact information, and preferred time to be contacted. Make sure all fields are filled correctly.
3. Fill in your employment information, including your occupation and job title, as well as that of your partner, if applicable. Indicate if you or your partner are currently employed.
4. List all persons requesting coverage. For each person, you must provide their name, date of birth, social security number (for internal use), and gender. Be sure to classify each individual correctly as self, spouse/domestic partner, or dependent.
5. Document any current or prior insurance coverage for each individual you are listing. Include the type of insurance and the effective dates.
6. Answer the health statement questions carefully for each person. If any question prompts a 'yes' response, provide additional details in Section F of the form.
7. If necessary, complete the additional information section with details about any health conditions or treatments for individuals who answered 'yes' in Section E.
8. Include information about any medications prescribed in the past twelve months for individuals applying for coverage.
9. Review the affirmation section. Ensure that you understand and agree to all conditions before signing the form.
10. After completing the form, you can save your changes, download a copy for your records, print it out, or share it as needed.

Start your application process online today to secure your health coverage.