Option 1 |
ONLINE APPLICATION
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UniCare's Paperless Online Application
-- may reduce application processing time |
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Option 2 |
A: PAPER APPLICATION FORM
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B: MEDICAL QUESTIONNAIRES
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Download/Print the UniCare Application Form
with Submission Instructions |
Download/Print Questionnaires about Medical Conditions of Persons Applying for Coverage
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Completing Medical Questionnaires is not mandatory, but when you submit the appropriate Medical Questionnaire(s) with your UniCare application, you speed up processing and make it less likely
UniCare underwriting will require a review of your personal medical records. Do not complete the Medical Questionnaires if you are submitting an Online Application.
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Option 3 |
EMAIL OR REGULAR MAIL |
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Send me the UniCare Application
as an E-Mail Attachment or via US Postal Service |
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