Discounts By Design. Non-Insurance benefits that work for you.

Health Assure

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Discount Medical Plan Application

Add Additional Card

Membership includes you and your immediate family. Primary member card and second card included in base price. All members have access to benefits using these two cards.

Additional dependent cards with printed names incur a one-time charge of $1 per card. Please input dependent's names in this area. First dependent name included in base price. If no dependent is indicated member receives two cards in primary members name.

Primary Member Included in Base Price

First Dependent Included in Base Price

Additional Dependant $1

Additional Dependant $1

Credit/Debit Card Number

Either you have Javascript disabled, or you're using an unsupported browser, amigo! That's why you're seeing this old-school credit card input form instead of a fancy new Skeuocard. On the other hand, at least you know it gracefully degrades...

Form: DBD15-HA

Thank you for signing up for the Health Assure. By signing up you agree to pay a one-time set-up fee of $5.00 and a monthly fee of $14.95.

Total billed today: $19.95

All fields are required.

Disclosures

Your membership is effective upon receipt of membership materials.

This is NOT insurance nor is it intended to replace insurance. This discount card program contains a 30 day cancellation period. The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act or Massachusetts M.G.L. c. 111M and 956 CMR 5.00. This plan provides discounts at certain healthcare providers for medical services. This plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers who have contracted with the discount plan organization. For a full list of disclosures, please click here. | Limitations, Exclusions and Exceptions | Discount Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box 803475, Dallas, TX 75380-3475.

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Not available to FL, UT, VT or WA residents.