EZMD

EZMD Membership Benefits Include:

Teladoc – Individual and Immediate Family - 24/7/365 Doctor Access

Discount Pharmacy Card - Discounts on Prescription Drugs

Dental - Discount Dental Services

Vision - Discount Vision Services

*You will have recurring membership charges billed to your credit card each month.

Billing Information

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First Name on Account*

Last Name on Account*

Card Number* Card Type*

Month* Year* CVV*

Member Information

Name*

Email Address*

Phone*

Date of Birth*

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Not Available to UT, VT, or WA residents.

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.

Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after the effective date. AR and TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days. Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box 671309, Dallas, TX 75367-1309.

Discount Medical Plan Application

EZMD Membership Benefits Include:

EZMD Registration Summary

Today's Total: $35.90

Billing Information

First Name on Account*

Last Name on Account*

Billing Address*

Member Information