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Member Registration

Step 1: Enter Member Details

Step 2: Select Plan / Provider

Step 3: Enroll

Step 1: Enter Member Details

Member Details:

First Name*

Last Name*

Date of Birth*

Age*

Gender
Male Female

Salutation*

Email*

Mobile Number*
-

Country*

State*

City*

ZIP / Postal Code*
-

Login Credentials:

UserName*

Confirm Username*

Password*

Confirm Password*

Enable 2-factor authentication :

Continue to Plan Enrollment

Step 2: Select Plan / Provider

Search by Location or Provider:

State

City

ZIP / Postal Code

Facility Name

Provider Name

Plan Name

Change search

Select a plan:

Select Plan Start Date / Payment Schedule:

Plan start date *

Step 3: Enroll

Selected Plan:

Plan Name

Plan Type

Plan Duration

Enrollment Fee
$

Plan Amount
$

Plan Start date

Plan End Date

Visit Fee
In-person visit: $35, Televisit: $25

Installment Amount
$

Installment Fee
$

Payment Schedule

Terms (No. of payments)

Plan Decription

Pay Now:

Please Enter Card Details :

Amount * $

Card Number*

Name On Card*

Expiry Date (MM/YY)*

CVV*

I Accept the Terms & Conditions for Member