Thank you for deciding to become a member of our Passport to Care plan. Simply follow the steps below, provide us with all the information, and provide payment on the next screen, by phone, or in person.
Our membership plan is designed with an unlimited open enrollment period. This means you can join at any time. All memberships will begin on January 1, 2020 or at one minute past midnight on the day following when your membership is received whichever is later. After our initial enrollment period is completed on February 28, 2020, the membership fee will be pro-rated throughout the remainder of the calendar year on a month to month basis.
ALL Passport to Care Memberships expire at 11:59 P.M. on December 31.
Please enter the following information for the head of the household.
Please enter the following information pertaining to the head of household's insurance.
Please enter the following information pertaining to any secondary insurance, if applicable.
Please list any dependents you want included on the Passport to Care plan. If you need to add additional dependents, please call 210-619-1450 after submitting the application.
Select the applicable plan below. Joining in November or December includes the Membership fee for the following Plan Year.
If you prefer to make your payment in person or over the phone, please call 210-619-1450 with your intentions.
Please select the applicable plan from the drop down.
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