• understand ​your insurance ​benefits and ​receive insights ​on maximizing ​them

    understand ​your insurance ​benefits and ​receive insights ​on maximizing ​them

    Please answer all questions to the best of your ability as it will help or model craft the best recommendations for you. All responses are kept confidential.

  • This form is HIPPA compliant. Your personal health data will not be shared with anyone.
  •  - -
  •  - -

  • Medical History

    Diseases/Diagnosis/Conditions - Check appropriate box and provide date of onset

  • Upload Your Complete Health Insurance Plan Below

    Uploading your insurance plan ensures that our AI technology can accurately communicate your unique benefits to you and offer you recommendations on how to best use what you pay for.

  • To download your health insurance plan, follow the below directions:

    1. Log on to your health insurer's website.

    For example, UnitedHealthcare (UHC) members should navigate to https://www.uhc.com/.

    2. Sign into your member account. Create an account if you don't have one already.

    For UHC members, log on by clicking "Member sign in".

    3. Navigate to the coverage and benefits section of your account.

    4. Download a PDF of the complete benefits.

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Should be Empty: