800-373-0881   customerservice@cohealthusa.com



Discount Medical Plan Application

Select the plan that best fits your needs. If you wish to pay by check or money order or would rather submit an offline form, please use our printable pdf form then mail or fax it to us as directed on the form. If you purchase a Package Plan any A La Carte items you'd like to add must be on a separate application.

First Step: Choose a plan

Student Basic Plus

includes dental, vision, pharmacy, and chiropractic.

Buy Now:
$82 Single/Year  $98 Family/Year 

Student Basic

includes dental, vision, and pharmacy.

Buy Now:
$62 Single/Year  $78 Family/Year 

A La Carte

Build your own plan choosing your own combination of benefits.

Buy Now:
Begin Creating

Disclosure: This plan is NOT insurance nor is it intended to replace insurance.
This discount card program contains a 30 day cancellation period.
Read a full list of disclosures

Discount Medical Plan Organization • New Benefits, Ltd. • 14240 Proton Rd • Dallas, TX 75244