Register for Affordable Discount Healthcare Coverage Benefits Medical Savings Plans

Please fill out the following form and one of our Healthcare Specialists will contact you within the next 24 hours to review the Prime Liberty Benefits healthcare program and answer any questions you may have.

First Name	Primary Phone
Last Name	Secondary Phone
Address 1	E-Mail Address
Address 2	The best time to contact you?
City	Do you currently have insurance
State	Number of dependants
Zip Code

THIS PLAN IS NOT HEALTH INSURANCE
This Discount Card contains a 30 day cancellation period!

Hospital Discounts NOT available in MD & WV
TelaDoc is NOT available for use in OK
Pharmacy discounts are Not Insurance, and are Not Intended as a Substitute for Insurance

MD, SC and TX residents: Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after receipt of membership materials.
TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days.

THIS PLAN IS NOT AVAILABLE IN THE FOLLOWING STATES: AK, MA, MT, OK, OR, VT, WA, WV, WY.
For the plan in: CA, FL, KY, NV, please CLICK HERE