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PLEASE FILL OUT THE FOLLOWING FORM TO BE ATTENDED BY AN ADVISOR
DISCLAIMER
- You are obligated to pay the provider directly and in full for all services you receive. The plan does not pay providers, does not reimburse members, and does not guarantee payment of any kind.
- The range of discounts varies by provider and by service. Discounts are not available from providers who do not participate in the plan.
- You may cancel your membership within 30 days after purchase and receive a full refund of all membership fees paid.
- Plan administered by OMP Health Solutions, LLC, 1201 Fannin Street, Suite 262, Houston, Texas 77002. Telephone (855) 861-1693.
- For a complete and accurate list of participating providers in your area and the services to which discounts apply, call toll-free (855) 861-1693 or visit www.omphealthsolutions.com
- This is not a health insurance policy, health plan, or health maintenance organization. It provides discounts only on health care services obtained from providers who participate in the plan.