MyPhysicianPlan New Member Registration

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PRIMARY CARE PLAN

Plan Options:

Monthly Plan: $65

3 Month Plan: $180

6 Month Plan: $330
[+ Free Annual Exam]

12 Month Plan: $600
[+ Free Annual Exam

+ Free Annual Exam Blood test

+ Presciptions: 80% by the plan (up to $100/yr)

Standard Plan Features:

Dedicated Primary Care Physician

Unlimited in-person or televisits

Copay: $35 for in person visits and $25 for televists

Lab Tests: 20% of Lab Test Fees (80% adjustment /discount)

Prescriptions: Up to 90% savings with plan discount

Plan Enrollment:
To enroll, please scroll down and select your preferred plan and the plan start date and click next to add member information.

Select Plan
Find a PCP

Facility Name

Physician Name
LocatonSearch

State*

City

ZIP / Postal Code*

Initial Unshareable Amount (IUA)*
Plan Pricing
* This is the maximum amount you will pay out of pocket first per episode for nonprimary care services, i.e., hospitals, etc., before sharing/contribution

Is anyone in your household a Tobacco/Vape user? No Yes

First Name*

Last Name*

Date of Birth*

Relationship*

Gender
Male Female

Email*

Mobile Number*
-

Address

Apartment, Unit, Suite, or Floor #

City*

State*

ZIP / Postal Code*

* By providing Member phone number and email address, Member consents to receive text message and email correspondence from MPPI, including but not limited to products & services, appointments, claims, partners, maintenance, and support. Message and data rates may apply. Member may opt-out at any time by replying to any text message or email with the word “STOP” or by contacting MPPI support directly. By opting-in to receive text message and email correspondence, Member acknowledges that Member is the account holder or have the account holder's permission to enroll in this service.

Login Credentials

Username *

Confirm Username*

Password*

Confirm Password*

How many members in your family excluding you will be a part of this plan? Set Family Size

First Name*

Last Name*

Date of Birth*

Relationship*

Gender
Male Female

Copy Primary Member data

Email*

Mobile Number*
-

Address

Apartment, Unit, Suite, or Floor #

City*

State*

ZIP / Postal Code*

First Name*

Last Name*

Date of Birth*

Relationship*

Gender
Male Female

Copy Primary Member data

Email*

Mobile Number*
-

Address

Apartment, Unit, Suite, or Floor #

City*

State*

ZIP / Postal Code*

First Name*

Last Name*

Date of Birth*

Relationship*

Gender
Male Female

Copy Primary Member data

Email*

Mobile Number*
-

Address

Apartment, Unit, Suite, or Floor #

City*

State*

ZIP / Postal Code*

First Name*

Last Name*

Date of Birth*

Relationship*

Gender
Male Female

Copy Primary Member data

Email*

Mobile Number*
-

Address

Apartment, Unit, Suite, or Floor #

City*

State*

ZIP / Postal Code*

Plan Name

Plan Type

Plan Duration

Visit Fee

Plan Amount
$

Enrollment Fee
$

Plan Start date

Plan End Date

Payment Schedule

Recurring Amount
$

Recurring Fee
$

Referral Discount

Terms (No. of payments)

Plan Decription

Referral Code (if available)

First Name*

Last Name*

Date of Birth*

Gender
Male Female

Email*

Mobile Number*
-

Address

Apartment, Unit, Suite, or Floor #

City*

State*

ZIP / Postal Code*

Username *

Confirm Username*

Password*

Confirm Password*

Everytime Only when system change

Please enter Card Details :

Amount * $ Plan Pricing

Card Number*

Name (as it appears on the Card)*

Expiry Date (MM/YY)*

CVV*

I Accept the Terms & Conditions for Member Participation and the Plan Terms