First Name
Last Name
Phone Number() -
Email Address
Street Address
Zip Code

Telemed Package includes
learn more » Doctors by Phone from Teladoc
learn more » Medical Bill Saver™ from Health Advocate™
learn more » Medical Health Advisor from Health Advocate™
learn more » Nurseline™ from Health Advocate™
learn more » Doctors Online from eDocAmerica
learn more » Retail Pharmacy
learn more » Durable Medical Equipment from Allegro
learn more » Lab Testing from DirectLabs
learn more » MRI & CT Scans from NextImage Direct
learn more » Vitamins and Diabetic Supplies
learn more » Hearing Aids


Separate Vision and Dental Package includes
learn more » Dental
learn more » Vision


Discount Plan Type
All plans have a $3.95 one-time registration fee.
Dental and Vision - $6.95/month
Telemed - $11.95/month
Telemed with Dental and Vision - $18.90/month
   

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Form # 28278CBV-W
Not available in KS, UT, VT or WA.