Apply Now! First Name: Last Name: E-Mail Address: Address: Address (extra): City: State: Zip: Daytime Phone: Evening Phone: Best Time To Contact: Do you have a healthcare program now? Select Yes No Current Monthly Cost: Do you have any prescription benefits? Select Yes No How did you hear about us: Select Association/Employer Internet Search Engine Insurance Agent Other if other: The HealthFlex Limited Benefits membership includes the HealthFlex Medical Discount Program and added, separate group indemnity insurance benefits. The group indemnity insurance benefits do not guarantee 100% medical coverage, and not all services or providers of services are covered. Not available in all states (click here for excluded states).