Inscribe a tu Familia -Inscripción en Healthshare

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Freedom HealthShare Applicant Enrollment

NOTE: Please enter the following information for the Main Member (Applicant), a legal Spouse, and only legal dependent children less than 26 years of age. Only legal dependents will be eligible for medical sharing. We allow Single membership, or Member + 1 legal dependent or Family membership, which is a Member + 2 or more legal dependents.
Unique ID
Name*
First Last
Including yourself - how many family members are you applying for today?*
Please include a number - example: 3
Please enter a number from 1 to 10.
Create a 4 digit PIN #*
You will need to remember this PIN# in order to sign on to the Member Portal
Phone Number*
Email Address*
What is the best day to contact you?*
Please select a date
Date Format: MM slash DD slash YYYY
What is the best time for us to contact you?*
Please provide an available time

: HH

MM
Enrollment Payment Charge
Pick Your Plan*
Pick your AUA*:*
AUA is the Annual Unshared Amount. For a single plan: Low = $700 High = $1400 For all others: Low = $1350 High = $2700
Pick:
- Single
- Applicant +1
- Family (more than 2)
Month to Start:*
Please enter your home address.
Is your Primary Home Address an International Address?*
*
Home Address Line 1 Home Address Line 2 City State ZIP Code
Primary - Address (International)*
Home Address Line 1 Home Address Line 2 City Province / Region Postal Code Country
Is your Billing Address the same as your Home Address?*
Billing Address*
Street Address Address Line 2 City State ZIP Code
Primary - Billing Address (International)*
Street Address Address Line 2 City Province / Region Postal Code Country
Please tell us how you heard about Freedom HealthShare.
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How did you hear about us?
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Please Tell Us Who Referred You OR Enter You Church Assigned Freedom Number:
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Would you like assistance with your enrollment?
- Continue enrollment on my own
- I wish to enroll but want someone to call me

Pongase usted y su familia en buenas manos.

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Folleto del Proveedor

Teléfono

844-853-3189
(Option 7)

Fax

216-283-7931

getinfo@freedomhealthshare.org

20600 Chagrin Blvd - Suite 450
Cleveland, Ohio 44122

English | Legal | Política de Cookies

DESCARGO DE RESPONSABILIDAD: Este programa no es una compañía o producto de seguros. Freedom HealthShare ™ es un reconocido ministerio para compartir. Freedom HealthShare ™ no garantiza ni promete que se pagarán sus facturas médicas. Compartir las cantidades de contribución médica de los miembros no son asignables por ningún miembro a ningún proveedor. El intercambio de miembros es totalmente voluntario. Como tal, este programa nunca debe considerarse como un sustituto de una póliza de seguro. Ya sea que reciba el pago por gastos médicos y si este programa continúa o no operando, puede ser responsable de las facturas impagas o de montos que excedan un monto permitido negociado y / o un monto de acuerdo PPO para servicios fuera de la red PPO. Para facilitar la comprensión, se utilizará el término Monto anual no compartido (AUA) en lugar de la palabra "deducible" en las Pautas de uso compartido. HealthSharing Services LLC administra los programas del Ministerio. Freedom HealthShare es una organización caritativa 501c3 reconocida por el IRS.

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Manage Your Account

Freedom HealthShare Applicant Enrollment

Please enter your home address.

Please tell us how you heard about Freedom HealthShare.

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Pongase usted y su familia en buenas manos.