Get Medically Underwritten Application And Health ...

Completing the medically underwritten application and health questionnaire can be a straightforward process when you follow the right steps. This guide provides you with a user-friendly approach to ensure that your application is completed accurately and efficiently.

Follow the steps to successfully submit your application online.

1. Click the ‘Get Form’ button to access the application and open it in your preferred application interface.
2. Carefully read the materials included with the application to understand your chosen coverage, including any cost-sharing obligations.
3. Tear off the front page along the perforation and retain it for your records. You may need to reference this if you have questions regarding your application.
4. On the first page, fill in all 'General Information' and 'Enrollment Information' requested. Include details about spouses and dependents only if they are applying for coverage as well.
5. Proceed to the second page and check the box next to the deductible amount for the product you are applying for.
6. Complete pages three through six by providing all 'Medical Information' requested. Make sure to include information about yourself and any dependents applying.
7. Read and sign pages seven and eight, if required.
8. Review the 'Conditions of Enrollment' on page nine, and ensure to sign and date the application where indicated on page ten. If both you and your spouse are applying, both signatures are required.
9. Ensure that all applicants or dependents aged 18 and older sign the application on page ten to avoid processing delays.
10. Have any licensed insurance producer complete the 'Producer's Certificate' on page eleven if applicable. Otherwise, leave this section blank.
11. Finally, return your completed application along with a check or money order for the initial premium made payable to 'Highmark Blue Cross Blue Shield' via mail to the provided address.

Start filling out your medically underwritten application and health questionnaire online today!