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Discount Plan Application

Customer Information

Form: #39457

Payment Info

 

*By pressing submit your application you affirmatively acknowledge, consent, and agree to the Terms of Use and Privacy Policy.

Disclosures:

Your membership is effective upon receipt of membership materials.
This plan is NOT insurance. 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 discount card program contains a 30 day cancellation period. 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. Member shall receive a reimbursement of all periodic membership fees if membership is cancelled within the first 30 days after the effective date. UT, AR and TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days.
Discount Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box 803475, Dallas, TX 75380-3475.

$14.99 / month +
$3.95 application fee (one-time)


All Benefits & Features

Teladoc

On-demand healthcare - wherever, whenever

Vision

20% to 60% off prescription eyewear including most frames, lenses and specialty items.

Dental

Save 15% to 50% on cleanings, X-rays, crowns, root canals and filings*.

* per visit, in most instances

Pharmacy

Save 10% to 85% on most prescriptions at over 60,000 pharmacies.

*Actual costs and savings vary by provider, service and geographical area. The discount program provides access to the Aetna Dental Access® network. This network is administered by Aetna Life Insurance Company (ALIC). Neither ALIC nor any of its affiliates offers or administers the discount program. Neither ALIC nor any of its affiliates is an affiliate, agent, representative or employee of the discount program. Dental providers are independent contractors and not employees or agents of ALIC or its affiliates. ALIC does not provide dental care or treatment and is not responsible for outcomes.

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