Membership Plan Application

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Form# 18109-W Required fields are indicated
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Member Information
Keep your membership profile information up to date to insure usage of your benefits.
Verify Membership
Make sure the chosen membership type is correct, this will affect your benefits and pricing.
Effective Date
The earliest effective date you can choose is tomorrow. Your payment will be drafted on that day of each month.
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Please contact us for membership registering assistance.
(855) SURE-MED

SureMed General Membership Disclosures:

SureMed enrollment fee payment will be withdrawn immediately upon completion of this enrollment regardless of whether a delayed application option was selected for non-SureMed benefits.

SureMed enrollment fee and recurring charges will be drafted automatically against the payment information provided until member initiates cancellation. SureMed membership will renew automatically until cancelled by member. Membership can be cancelled through member’s portal or by calling SureMed at (610) 740-0009. Cancellations must be received 3 business days prior to bill date to avoid payment from being processed. All payments are non-refundable, including enrollment fees and monthly charges. If auto-draft of payment fails, we may reattempt draft until membership lapses or cancels. We reserve the right to lapse membership at any time for nonpayment.

Only spouse, domestic partner and/or legal dependent children of the primary member may be listed and receive benefits on a family membership.

SureMed Benefit Disclosures:

Any insurance benefits offered through membership are issued to American Better Health Organization, Inc. on a group basis, and are extended to eligible members of the association.

Any material provided on this website or through any other means offers only a general description of benefits, and may be subject to terms, limitations, requirements, exclusions, pre-existing condition limitations, benefit waiting periods, lifetime maximums, termination of benefits upon attaining certain ages, and other limitations. Please refer to your specific certificate of coverage for any relevant benefits for specific terms of coverage.

If any of your membership benefits include a beneficiary and you did not specify a beneficiary, the primary member’s beneficiary designation is defaulted to the primary member’s first class surviving family members, which could include spouse, children, parents, or siblings, as directed by each benefit’s Certificate of Coverage. If there is no surviving family, benefits will pay to the primary member’s estate. In the case of any dependent (non-Primary) member’s death, any eligible death benefits for that member will automatically pay to the primary member. If the primary member is deceased, proceeds will pay according to the primary member’s beneficiary designation. If you would like to make changes to your beneficiary designation, please login to your SureMed Member Account.

SureMed Complimentary Discount Benefit Disclosures:

This program 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 program is provided at no cost as part of the association membership. This program provides discounts only at the offices of contracted health care providers, and each member is obligated to pay the discounted medical charges in full at the point of service. The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received. For Terms and Conditions, click here. Discount Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box 803475, Dallas, TX 75380-3475, 800-800-7616. Customer Service: 855.SURE-MED.

Discount benefits not available to residents of VT and WA

Doctors by Phone benefit is available to members in the states of Arkansas and Delaware, however, the first visit must be conducted by video. Subsequent visits in AR and DE can be via video or phone. Doctors by Phone benefit is available to members in the state of Idaho via video only.
© 2023 Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are registered trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. For dermatology consultations, members must complete a Dermatology Intake Form and upload a minimum of three images through the secure message center before each initial consultation.

Dental Benefit is not available to VT residents.

The discount program provides access to the Aetna Dental Access® network, which is administered by Aetna Life Insurance Company (ALIC). ALIC does not offer or administer the discount program, and is not an affiliate, agent or principal of the discount program. Dental providers are independent contractors and not employees or agents of ALIC. ALIC does not provide dental care or treatment and is not responsible for outcomes.

Lab benefit not available in NJ, NY, and RI. This program can be canceled, without notice, at any time, for any reason.