Make & Submit Changes Below
AmeriPlan programs are not insurance. You MUST use an AmeriPlan Providers and pay when you receive services.
Please be advised that AmeriPlan may receive individual identifiable health information in connection with your program membership. While AmeriPlan is not a “covered entity” for purposes of the Health Insurance Portability and Accountability Act of 1996, it will not disclose, except as permitted or required by law or regulations, nonpublic personal health information about a member unless a written authorization is obtained from the member whose nonpublic personal health information is sought to be disclosed.
Disclosures to consumers:
This Plan is NOT Insurance.
The Plan provides discounts at certain providers for services.
The Plan does NOT make payments directly to the providers of services.
The Plan member is obligated to pay all healthcare services but will receive a discount from those healthcare providers who have contracted with the Discount Medical Plan Organization.
Name, address and specialty of discount medical card program providers in your service area are available before purchase and upon request by logging on to www.ameriplanusaprovidersearch.com or calling the AmeriPlan Consumer Information Center at 1-800-647-8421.
AmeriPlan® Corporation, a discount medical plan Organization
5700 Democracy Drive, Plano, Texas 75024
Oklahoma Residents Only:
If you cancel your membership within the first thirty (30) days of receipt of the discount card and this Membership Information Guide, you will receive reimbursement of the periodic charges you paid. The return of all periodic charges will be made within thirty (30) days of the date of cancellation. If all 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.
Maryland Residents Only:
Some discounts under the Physician and Hospital Referral Plan are not applicable in Maryland. Discounts are not available for all In-Patient procedures and certain OutPatient Procedures under Maryland law. Out-Patient procedures at network hospitals such as laboratory and diagnostic services are eligible for the discount.
Massachusetts Residents Only:
This medical discount plan does not meet the minimum creditable coverage requirements under Massachusetts law.
North Carolina Residents Only:
AmeriPlan Corporation maintains a surety bond in compliance with N.C.G.S. 66-135 with Travelers Casualty and Surety Company of America, 1 Tower Sq., Hartford, CT 06183.
You, the member, may cancel this contract at any time prior to midnight of the third business day after the date you receive this member agreement and guide. To cancel you must notify the company in writing of your intent to cancel.
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