* = Required fields
Choose which Global Medevac enrollment option is best for you: *
Individual Monthly Plan $45/moFamily Monthly Plan $60/moIndividual Annual Plan $495/yrFamily Annual Plan $695/yrIndividual 5-Year Plan $2250Family 5-Year Plan $3150Individual Lifetime Plan $3250Family Lifetime Plan $4250
Which (optional) alternative burial benefit would you like?
Monthly Plan $8.50/mo per personAnnual Plan $100/yr per person5-year Plan $500 per personIndividual Lifetime Plan $600Family Lifetime Plan $1000No thank you. I do not need an alternative burial benefit at this time.
Designated Burial Location (City, State)
Note: Preexisting conditions are covered after 90-days
First Name *
Middle Name *
Last Name *
Your Email *
Mobile Phone Number *
Street Address *
Note: a Global Medevac agent will reach out to you to process your payment
Annual Check/Money Order PaymentAnnual Credit/Debit Card PaymentEFT/ACH Payment
(help someone else gain the ultimate peace of mind)
Mobile Phone Number
Yes, I would like to receive Global Medevac's monthly life-saving news and information. (Please be sure to add Global Medevac to your email address book to avoid our information getting lost in your spam or junk email box)
I have received, read and understand the Global Medevac Membership Agreement.