APPLICANT INFORMATION

Enrollment

Please fill out the following to start enrollment.

Product Selection:
  • LifeEventsTM Counseling
  • Free Doctor Call - 24/7 Telemedicine
  • My eWellness: Online Wellness Website
  • Patient Advocacy
  • Car Service Discounts
  • Everyday Savings
  • Roadside Assistance
  • PetAssure
  • Discount on Tickets
  • Pharmacy Savings
  • Dental Savings
  • Vision Savings
  • Hearing Discount
  • Savings on Diabetic Supplies
  • Pre-Paid Diagnostic Imaging Discounts
  • Pre-Paid Lab Service Discounts
  • Discounted Vitamins & Supplements
  • LifeEventsTM Counseling
  • Free Doctor Call - 24/7 Telemedicine
  • My eWellness: Online Wellness Website
  • Patient Advocacy
  • Pharmacy Savings
  • Dental Savings
  • Vision Savings
  • Hearing Discount
  • Savings on Diabetic Supplies
  • Pre-Paid Diagnostic Imaging Discounts
  • Pre-Paid Lab Service Discounts
  • Discounted Vitamins & Supplements
  • Everyday Savings
  • ID Theft Resolution
  • Legal Counseling
  • LifeEventsTM Counseling
  • Roadside Assistance
  • Free Doctor Call - 24/7 Telemedicine
  • My eWellness: Online Wellness Website
  • Patient Advocacy
(Optional)

SSP_Enrollment_0120

Disclosures: The discount medical, health and drug benefits (The Plan) are NOT insurance, a health insurance policy, a Medicare Prescription Drug Plan or a qualified health plan under the Affordable Care Act. The Plan provides discounts for certain medical services, pharmaceutical supplies, prescription drugs or medical equipment and supplies offered by providers who have agreed to participate in The Plan. The range of discounts for medical, pharmacy or ancillary services offered under The Plan will vary depending on the type of provider and products or services received. The Plan does not make and is prohibited from making members’ payments to providers for products or services received under The Plan. The Plan member is required and obligated to pay for all discounted prescription drugs, medical and pharmaceutical supplies, services and equipment received under The Plan, but will receive a discount on certain identified medical, pharmaceutical supplies, prescription drugs, medical equipment and supplies from providers in The Plan. The Discount Medical Plan/Discount Plan Organization is Alliance HealthCard of Florida, Inc., 2711 North Haskell Avenue, Suite 800, Dallas, TX 75204-2999. Call 1-800-565-3827 or email info-abs@member-questions.com for more information or visit the provider locator on this site for a list of providers. The Plan will make available before purchase and upon request, a list of program providers and the providers’ city, state and specialty, located in the member’s service area. The fees for The Plan are specified in the membership agreement. The Plan includes a 30-day cancellation provision.

Note to MA consumers: The Plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00.


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