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Your Full Name*
First Last
Email Address*
Phone Number
Address*
City State
What kind of membership are you seeking?*
What is the age of the primary member? (Person applying)*
Do you currently pay, on a monthly basis for medical coverage?*
How much per month do you currently pay for your coverage?*
(No need for $ sign, just use numbers – example: 1000)
What is your current deductible?
(No need for $ sign, just use numbers – example: 1000)
Do you or anyone in the household applying use tobacco?*
Do you live in the US?*
Currently not accepting new members in Alaska, Washington, New York, Illinois, and Vermont. Please contact us with any questions.
Untitled*
- I agree to receive information about pricing and related membership details via email from Scoop Health.
We will not share your contact information with anyone. By submitting your email and phone number, you agree to be contacted by Scoop Health and its Affiliates. You may opt-out any time.
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Member Only - 18 - 500IUA
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Member Only - 18 - 500IUA - Smoking
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Member Only - 18 - 1000IUA
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Member Only - 18 - 1000IUA - Smoking
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Member Only - 18 - 1500IUA
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Member Only - 18 - 1500IUA - Smoking
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Member Only - 18 - 2500IUA
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Member Only - 18 - 2500IUA - Smoking
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Member Only - 18 - 5000IUA
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Member Only - 18 - 5000IUA - Smoking
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Member Only - 30 - 500IUA
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Member Only - 30 - 500IUA - Smoking
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Member Only - 30 - 1000IUA
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Member Only - 30 - 1000IUA - Smoking
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Member Only - 30 - 1500IUA
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Member Only - 30 - 1500IUA - Smoking
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Member Only - 30 - 2500IUA
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Member Only - 30 - 2500IUA - Smoking
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Member Only - 30 - 5000IUA
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Member Only - 30 - 5000IUA - Smoking
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Member Only - 40 - 500IUA
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Member Only - 40 - 500IUA - Smoking
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Member Only - 40 - 1000IUA
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Member Only - 40 - 1000IUA - Smoking
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Member Only - 40 - 1500IUA
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Member Only - 40 - 1500IUA - Smoking
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Member Only - 40 - 2500IUA
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Member Only - 40 - 2500IUA - Smoking
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Member Only - 40 - 5000IUA
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Member Only - 40 - 5000IUA - Smoking
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Member Only - 50 - 500IUA
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Member Only - 50 - 500IUA - Smoking
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Member Only - 50 - 1000IUA
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Member Only - 50 - 1000IUA - Smoking
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Member Only - 50 - 1500IUA
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Member Only - 50 - 1500IUA - Smoking
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Member Only - 50 - 2500IUA
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Member Only - 50 - 2500IUA - Smoking
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Member Only - 50 - 5000IUA
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Member Only - 50 - 5000IUA - Smoking
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Member Only - 60 - 500IUA
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Member Only - 60 - 500IUA - Smoking
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Member Only - 60 - 1000IUA
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Member Only - 60 - 1000IUA - Smoking
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Member Only - 60 - 1500IUA
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Member Only - 60 - 1500IUA - Smoking
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Member Only - 60 - 2500IUA
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Member Only - 60 - 2500IUA - Smoking
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Member Only - 60 - 5000IUA
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Member Only - 60 - 5000IUA - Smoking
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Member + Spouse - 18 - 500IUA
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Member + Spouse - 18 - 500IUA - Smoking
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Member + Spouse - 18 - 1000IUA
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Member + Spouse - 18 - 1000IUA - Smoking
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Member + Spouse - 18 - 1500IUA
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Member + Spouse - 18 - 1500IUA - Smoking
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Member + Spouse - 18 - 2500IUA
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Member + Spouse - 18 - 2500IUA - Smoking
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Member + Spouse - 18 - 5000IUA
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Member + Spouse - 18 - 5000IUA - Smoking
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Member + Spouse - 30 - 500IUA
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Member + Spouse - 30 - 500IUA - Smoking
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Member + Spouse - 30 - 1000IUA
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Member + Spouse - 30 - 1000IUA - Smoking
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Member + Spouse - 30 - 1500IUA
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Member + Spouse - 30 - 1500IUA - Smoking
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Member + Spouse - 30 - 2500IUA
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Member + Spouse - 30 - 2500IUA - Smoking
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Member + Spouse - 30 - 5000IUA
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Member + Spouse - 30 - 5000IUA - Smoking
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Member + Spouse - 40 - 500IUA
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Member + Spouse - 40 - 500IUA - Smoking
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Member + Spouse - 40 - 1000IUA
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Member + Spouse - 40 - 1000IUA - Smoking
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Member + Spouse - 40 - 1500IUA
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Member + Spouse - 40 - 1500IUA - Smoking
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Member + Spouse - 40 - 2500IUA
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Member + Spouse - 40 - 2500IUA - Smoking
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Member + Spouse - 40 - 5000IUA
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Member + Spouse - 40 - 5000IUA - Smoking
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Member + Spouse - 50 - 500IUA
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Member + Spouse - 50 - 500IUA - Smoking
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Member + Spouse - 50 - 1000IUA
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Member + Spouse - 50 - 1000IUA - Smoking
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Member + Spouse - 50 - 1500IUA
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Member + Spouse - 50 - 1500IUA - Smoking
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Member + Spouse - 50 - 2500IUA
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Member + Spouse - 50 - 2500IUA - Smoking
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Member + Spouse - 50 - 5000IUA
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Member + Spouse - 50 - 5000IUA - Smoking
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Member + Spouse - 60 - 500IUA
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Member + Spouse - 60 - 500IUA - Smoking
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Member + Spouse - 60 - 1000IUA
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Member + Spouse - 60 - 1000IUA - Smoking
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Member + Spouse - 60 - 1500IUA
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Member + Spouse - 60 - 1500IUA - Smoking
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Member + Spouse - 60 - 2500IUA
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Member + Spouse - 60 - 2500IUA - Smoking
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Member + Spouse - 60 - 5000IUA
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Member + Spouse - 60 - 5000IUA - Smoking
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Member + Child - 18 - 500IUA
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Member + Child - 18 - 500IUA - Smoking
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Member + Child - 18 - 1000IUA
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Member + Child - 18 - 1000IUA - Smoking
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Member + Child - 18 - 1500IUA
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Member + Child - 18 - 1500IUA - Smoking
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Member + Child - 18 - 2500IUA
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Member + Child - 18 - 2500IUA - Smoking
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Member + Child - 18 - 5000IUA
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Member + Child - 18 - 5000IUA - Smoking
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Member + Child - 30 - 500IUA
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Member + Child - 30 - 500IUA - Smoking
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Member + Child - 30 - 1000IUA
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Member + Child - 30 - 1000IUA - Smoking
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Member + Child - 30 - 1500IUA
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Member + Child - 30 - 1500IUA - Smoking
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Member + Child - 30 - 2500IUA
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Member + Child - 30 - 2500IUA - Smoking
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Member + Child - 30 - 5000IUA
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Member + Child - 30 - 5000IUA - Smoking
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Member + Child - 40 - 500IUA
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Member + Child - 40 - 500IUA - Smoking
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Member + Child - 40 - 1000IUA
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Member + Child - 40 - 1000IUA - Smoking
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Member + Child - 40 - 1500IUA
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Member + Child - 40 - 1500IUA - Smoking
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Member + Child - 40 - 2500IUA
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Member + Child - 40 - 2500IUA - Smoking
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Member + Child - 40 - 5000IUA
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Member + Child - 40 - 5000IUA - Smoking
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Member + Child - 50 - 500IUA
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Member + Child - 50 - 500IUA - Smoking
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Member + Child - 50 - 1000IUA
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Member + Child - 50 - 1000IUA - Smoking
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Member + Child - 50 - 1500IUA
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Member + Child - 50 - 1500IUA - Smoking
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Member + Child - 50 - 2500IUA
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Member + Child - 50 - 2500IUA - Smoking
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Member + Child - 50 - 5000IUA
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Member + Child - 50 - 5000IUA - Smoking
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Member + Child - 60 - 500IUA
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Member + Child - 60 - 500IUA - Smoking
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Member + Child - 60 - 1000IUA
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Member + Child - 60 - 1000IUA - Smoking
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Member + Child - 60 - 1500IUA
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Member + Child - 60 - 1500IUA - Smoking
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Member + Child - 60 - 2500IUA
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Member + Child - 60 - 2500IUA - Smoking
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Member + Child - 60 - 5000IUA
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Member + Child - 60 - 5000IUA - Smoking
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Member + Family - 18 - 500IUA
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Member + Family - 18 - 500IUA - Smoking
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Member + Family - 18 - 1000IUA
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Member + Family - 18 - 1000IUA - Smoking
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Member + Family - 18 - 1500IUA
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Member + Family - 18 - 1500IUA - Smoking
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Member + Family - 18 - 2500IUA
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Member + Family - 18 - 2500IUA - Smoking
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Member + Family - 18 - 5000IUA
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Member + Family - 18 - 5000IUA - Smoking
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Member + Family - 30 - 500IUA
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Member + Family - 30 - 500IUA - Smoking
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Member + Family - 30 - 1000IUA
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Member + Family - 30 - 1000IUA - Smoking
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Member + Family - 30 - 1500IUA
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Member + Family - 30 - 1500IUA - Smoking
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Member + Family - 30 - 2500IUA
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Member + Family - 30 - 2500IUA - Smoking
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Member + Family - 30 - 5000IUA
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Member + Family - 30 - 5000IUA - Smoking
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Member + Family - 40 - 500IUA
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Member + Family - 40 - 500IUA - Smoking
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Member + Family - 40 - 1000IUA
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Member + Family - 40 - 1000IUA - Smoking
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Member + Family - 40 - 1500IUA
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Member + Family - 40 - 1500IUA - Smoking
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Member + Family - 40 - 2500IUA
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Member + Family - 40 - 2500IUA - Smoking
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Member + Family - 40 - 5000IUA
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Member + Family - 40 - 5000IUA - Smoking
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Member + Family - 50 - 500IUA
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Member + Family - 50 - 500IUA - Smoking
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Member + Family - 50 - 1000IUA
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Member + Family - 50 - 1000IUA - Smoking
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Member + Family - 50 - 1500IUA
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Member + Family - 50 - 1500IUA - Smoking
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Member + Family - 50 - 2500IUA
Hidden
Member + Family - 50 - 2500IUA - Smoking
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Member + Family - 50 - 5000IUA
Hidden
Member + Family - 50 - 5000IUA - Smoking
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Member + Family - 60 - 500IUA
Hidden
Member + Family - 60 - 500IUA - Smoking
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Member + Family - 60 - 1000IUA
Hidden
Member + Family - 60 - 1000IUA - Smoking
Hidden
Member + Family - 60 - 1500IUA
Hidden
Member + Family - 60 - 1500IUA - Smoking
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Member + Family - 60 - 2500IUA
Hidden
Member + Family - 60 - 2500IUA - Smoking
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Member + Family - 60 - 5000IUA
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Member + Family - 60 - 5000IUA - Smoking
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