For Active Lifestyle Media Subscribers
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Special limited time offer:
  1. Coverage Today. Your enrollment gives you and your family access to 2-months of funded coverage.
  2. Coverage Ongoing. Special pricing for those who wish to continue with this plan at the end of the 2-month period: $8.99 per month single or $9.99 per month for family coverage.
The Telehealth Value: Plan Details
  1. Save Money - an emergency room visit could cost up to $1,500
  2. Save Time - average wait time at the ER is over 100 minutes
  3. Avoid Exposure to Illnesses - by not visiting hospital/clinic waiting rooms.
To get started:
  1. Step 1. Fill out the enrollment form below.
  2. Step 2. Check your email! A secure link to your new account will be sent to you, and your coverage will begin.


Personal Information

           


     


Residence Address Information

           



Contact Information

     



Payment Method Information

As part of the sign-up process, you will be asked below to include payment information. This way, if you choose to extend, your coverage may continue without interruption. Be assured: you will not be charged now. We will email you prior to the end of the funded telehealth benefit and you will be given the opportunity to opt-out. If you wish to continue, take no action and your coverage will remain in place. Simply put: you can sign up for this offer in confidence, knowing that you may cancel at any time, no questions asked. For program cost information, please review the Plan Details.

ACH (Bank Account)     Visa     Mastercard     Discover     AMEX


        




Billing Address is same as Residence Address

           




Enrollment and Electronic Signature

enroll in MDLive TeleHealth provided by InsuranceTPA.com. I have read and agree to the terms of the InsuranceTPA.com TeleHealth Enrollment Agreement. By agreeing to enroll in MDLive Telehealth provided by InsuranceTPA.com, I expressly consent by my electronic signature to receive marketing communication, including telephone calls to any wireless number I have provided using an automated dialing system, and artificial or pre-recorded messages, emails and text messages (SMS) from insurance companies and brokers or their agents. I understand that I can opt out of these communications at any time by sending a written request to service@insurancetpa.com.


Collection and Use of Personal Information

InsuranceTPA.com can process my TeleHealth enrollment and collect personal information from me including my identification information, health information required for TeleHealth or insurance enrollment, financial information required to establish payment for TeleHealth or insurance products that I select and website use information to provide relevant product information as described in the InsuranceTPA.com Privacy Policy InsuranceTPA.com Privacy Policy. Consistent with the InsuranceTPA.com Privacy Policy, I agree that InsuranceTPA.com can provide my personal information to affiliated third parties so I can receive information about other insurance products that might be useful to me. I understand that my personal information may be transferred or sold by an affiliated third party. I can opt out of the sale of my personal information by clicking on this button:





Receive a two-month free trial of MDLive. Offer valid only for new subscribers through InsuranceTPA.com and its strategic partners. Offer is not valid for current or former MDLive monthly or annual subscribers. Offer only open to residents of states where MDLive is available. Once your two month free trial ends, you will be charged monthly at the rate provided during your enrollment. The two month free trial offer is available to those who provide a valid payment during enrollment. Offer expires on 12/31/2020 or when 100,000 members enroll; whichever occurs first. Click here for complete offer terms and conditions.