Indiana Health Insurance Applications

Online Application Links and Print Forms

Following are links to health insurance applications -- including online applications -- for our most popular plans from Indiana health insurance companies.  Printable forms are in pdf format:

Anthem Blue Cross and Blue Shield - Indiana

Anthem Indiana Online Application
Anthem Indiana Application Form -- 101KB

UniCare

UniCare Indiana Online Application
UniCare Indiana Application Form -- 100KB

Humana One

Humana One Online Application
Humana One Phone-In Application Instructions -- 61KB

United HealthCare / Golden Rule

United HealthCare / Golden Rule Online Application
United healthCare / Golden Rule Indiana Application Form -- 89KB

Celtic

CeltiCare II (Traditional PPO) Online Application
Celtic Basic (Lower Cost PPO) Online Application
CelticSaver (HSA-Compatible) Online Application

Assurant Health (Permanent Coverage)

Assurant Online Application

Assurant Health Short-Term

Assurant Indiana Online Application
Assurant Indiana Application Form (to 6 months) -- 67KB

Anthem Traditional PPO - Indiana Anthem Lumenos HSA - Indiana Anthem Dental - Indiana UniCare Traditional PPO UniCare HSA-Compatible UniCare Dental Humana One Traditional PPO Humana One HSA-Compatible Assurant Health Celtic UnitedHealthcare Assurant Short-Term Medical Dental Insurance Indiana Group Health Insurance Anthem (Indiana) Group Plans HSA Overview HSA Contributions HSA Distributions HSA Administrators Q&A - Individual Health Insurance Q&A - Group Health Insurance Health Insurance Glossary Priority Resource Websites More Websites of Interest

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