Member Agreement for Discount Medical Plan(s)
Disclosures: THIS DISCOUNT PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act.
The plan provides discounts at certain health care providers for medical services.
The Plan does not make payments directly to providers of medical services. Members are obligated to pay for all health care services at the time the services are performed but will receive a discount from contracted providers. The Discount Medical Plan Organization is Patriot Health Florida, Inc., located at 1555 Palm Beach Lakes Blvd. Ste. 810, West Palm Beach, FL 33401. To obtain additional information and an up-to-date list of contracted providers by name, city, state, and specialty in your service area, you may call Member Services at (855) 577-1611, login to your member portal at www.patriothealth.com or access the Patriot Health mobile app available for Android and iOS. This Plan is not available in all states. Plan administrators have no liability for providing or guaranteeing service or for the quality of service rendered. Participating providers are subject to change without notice and are not available in all areas.
- Entire Agreement: All provisions under this Agreement, Welcome Letter, Membership Guide, ID card, Application, and Product Descriptions constitute the entire Agreement between the Company and the Member. This contract is not protected by any state Life and Health Guaranty Association. Discounts on professional services are not available where prohibited by law.
- Complaints: Any complaint regarding Plan Membership should be directed to Member Services at (855) 577-1611, by email at email@example.com , or in writing to 1555 Palm Beach Lakes Blvd. Ste. 810, West Palm Beach, FL 33401. If you are still dissatisfied after complaint submission, you may contact your state insurance department.
- Plan Availability: This plan is not available in Alaska, California, Minnesota, Montana, North Dakota, Rhode Island, and Washington.
- Effective Date and Renewal: Your effective date is indicated on your ID card, Member Portal, and Mobile App. Your plan will be automatically renewed on your effective day, monthly, or annually depending on the option chosen, until canceled. If the effective date chosen falls between the 29th and 31st, the plan will be automatically renewed on the 1st of each month or year.
- Payment: By joining this plan, you are authorizing Patriot Health to bill your credit card for the plan you selected. This charge will remain in force on a monthly or annual basis until you request to cancel with Patriot Health. Charges are processed on the plan renewal day, monthly, or annually depending on the option chosen at enrollment. If the renewal day falls between the 29th and 31st, the plan will be automatically renewed on the 1st.
- Plan Rates: Standard Plan monthly rates: $12.00 Individual, $15.00 Couple $18.00 Family. Standard Plan annual rates: $110.00 Individual, $140.00, Couple $175.00 Family. Premium Plan Monthly rates: $14.00 Individual, $17.00 Couple, $20.00 Family. Premium Plan annual rates: $120.00 Individual, $150.00 Couple, $185.00 Family. Elite Plan monthly rates: $18.00 Individual, $25.00 Couple, $29.00 Family. Elite Plan annual rates: $175.00 Individual, $220.00 Couple, $275.00 Family. There is a one-time non-refundable processing fee of $20.00.
- Adding New Members: Under the family plan, you may add family members by calling the Member Services number shown on the back of your ID card. Under the family plan, no activation or other fee will be applied for adding new family members. However, if you are upgrading your plan from individual to family your monthly fee will reflect this change.
- Cancellation: If you are not completely satisfied, you may call (855) 577-1611
or email firstname.lastname@example.org to cancel at any time or you can send a written letter
either via fax to the attention of the Cancellation Department FAX: (561) 427-7508
or via US Mail to Cancellation Department 1555 Palm Beach Lakes Blvd. Ste. 810,
West Palm Beach, FL 33401. Call to verify that your cancelation letter has been
received. If you cancel within the first thirty (30) days, your membership fee will
be refunded, less the one-time processing fee except in the states identified below.
Refunds can take up to five (5) business days to process. If you cancel after the
first thirty (30) days, your membership will terminate at the end of the billing
cycle for which you have paid, and no refund is due. Once you have successfully
canceled, your membership will terminate, and you will not be billed further for
any discount medical plans. If the discount medical plan cancels a membership for
any reason other than nonpayment of charges, the discount medical plan shall make
a pro-rata reimbursement of all periodic charges to you.
When canceling within 30 days of your effective date, the processing fee is refundable in the following states: Arkansas, Maryland, Rhode Island, and Tennessee
Applies to Annual Renewals Only: In the event your annual membership has been automatically renewed in any year following your initial purchase, if you have not used the plan since renewal, you may request a refund of your last annual payment within 30 days of the charge.
Note to residents of OK: If you decide to cancel the membership within the first thirty (30) days after receipt of your membership kit, you will receive a reimbursement of all periodic charges paid. The return of all periodic charges shall be made within thirty (30) days of the date of the cancellation. If all the periodic charges have not been paid within thirty (30) days, interest shall be assessed and paid on the proceeds at a rate of the Treasury Bill rate of the preceding calendar year, plus two (2) percentage points.
- Best Efforts: The Company shall use its best efforts to obtain acceptance from an adequate number of Providers who will agree to provide Eligible Services to Members. The final selection of the medical professional and/or medical facility and the approval or disapproval of medical treatment is the Member’s choice alone.
- Member Card: Member will be provided with an electronic Membership Card available for viewing and/or download via the Patriot Heath member portal (www.patriothealth.com) or the Patriot Health mobile application available on Android and iOS. Such card and other forms of identification should be carried by the Member at all times to provide proof of the right to Eligible Services under the Membership Agreement. Members can request a physical card be sent by mail by contacting Member Services at (855)577-1161. The discounts contained herein may not be used in conjunction with any other discount plan. All listed or quoted prices are current prices from participating providers and are subject to change without notice. From time to time, certain providers may offer products and/or services to the general public at prices lower than the discounted prices available through this Plan. In such an event, members will be charged the lowest price. The plan may not be available or vary in some states.
- Electronic Delivery Consent: By enrolling in this plan, you consent to receive
communications regarding your plan via telephone, text message, and auto-dialer
technologies with pre-recorded messages at the telephone number provided during
enrollment. Message and data rates may apply. Consent may be revoked at any time
by calling member services at (855) 577-1611.
Note to Texas Consumers: Regulated by the Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711; telephone 1-800-803-9202 or (512) 463-6599; website: www.license.state.tx.us/complaints. Note to Illinois Consumers: To file a complaint with the Illinois Department of Insurance, please do one of the following: Call 866 445-5364, visit https://mc.insurance.illinois.gov/messagecenter.nsf, email to email@example.com, fax to (217) 558-2083, or mail to 320 W. Washington Street, Springfield, IL 62767.