Best Benefits Enrollment

Welcome to Best Benefits Membership Application

Thank you for your interest in Best Benefits. Best Benefits is a discount healthcare program designed to help offset the high cost of health care. Best Benefits is NOT a health insurance plan so it provides discounts on some services that insurance plans do not – it is a healthcare savings program that provides members access to health related services at reduced fees. Upon becoming a member you will receive a membership kit and identification card within 7-10 business days. Simply present your membership card to any one of our participating providers and begin saving. In addition, your membership card is good for you and all members of your household. Anyone can use the card and enjoy the savings. If you have questions about your membership program simply contact one of our friendly and helpful Member Service Representatives at the number printed on the back of your Member Identification card.

Best Benefits program is $7.95 per month.

Benefits of your membership plan include:
• Acceptance for all ages
• Choose from thousands of participating providers
• Visit any provider in the network as often as you like or nominate your own provider
• One membership includes all members in your household
• No forms to complete

Here’s what you can save:
• Save 10-50% on dental care
(tell me more)
• Save 10-60% on vision care
(tell me more)
• Save 10-20% on hearing aids and supplies
(tell me more)
• Save 20-40% on chiropractic services
(tell me more)

Please complete this form now
to sign up for Best Benefits!

* Required fields.

* First Name

* Last Name

* Address 1

Address 2

* City

* State

* Zip

* Phone

( ) -

* Credit card number

* Name On Card

* Expiration Date

* Email

* Re-enter e-mail

I hereby apply for membership in the Best Benefits, the $7.95 monthly membership fee will be billed automatically each month to the credit card account listed above for as long as I wish to remain a member. I understand I am providing the information on this form directly to Best Benefits to activate my membership. This authorization shall remain in effect until I cancel by calling the toll-free customer service number.

I accept the terms for membership listed above. Not available to Vermont or Washington residents.

Administered by Coverdell Company, Inc. (a discount medical plan organization)

Disclaimer: This is NOT a health insurance policy. The plan provides discounts at certain health care providers of medical services. The plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization. This plan is administered by Coverdell & Company, Inc. a discount medical plan organization located at 2850 W. Golf Road, Rolling Meadows, IL 60008, 1-800-308-0374. You have the right to cancel this agreement within 30 days of the effective date for a full refund of fees paid.

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