ONLINE
Enroll online and pay securely by credit card. You'll receive your receipt and Confirmation of Insurance instantly by email.
ENROLL ONLINE
BY MAIL or FAX
Use our printable Enrollment Form (PDF) if you prefer to enroll by mail or fax. You'll receive your Confirmation of Insurance by email once your application has been processed.
DOWNLOAD FORM
BY PHONE
Call us at (800) 937-1387 to purchase your InterMedical plan over the phone, and receive Confirmation of Insurance as soon as the same day.
CALL 1-800-937-1387