Step 2: Membership Application

Step 2

Membership is one-time only  fee of $60.00 USD:

> January 1 – December 31 per year for the Best Doctors GROUP Policy

(note: the membership fee does not include the cost of the insurance).

Memberships are pro-rated if joining mid-year (for your first year only).

Members will receive a Membership Invoice by email for payment via our secure credit card processor, Square, where you can pay by Visa or MasterCard. If you have any problems or questions regarding this form please contact us HERE.

Please fill out the application form below:

"*" indicates required fields

Your one-time Boomer Membership Registration Fee is $60.00 USD. Your Insurance Premium is pro-rated for your first year only.
Your Name, as it appears on your MEXICAN Visa. If you do not have a middle name, please enter "n/a" in that box. This form requires an entry in "Middle"
Address (In Mexico)*
MANDATORY MEXICAN TELEPHONE INFORMATION: a Mexican Landline or Cell Phone number is required for membership.
Please indicate your landline, including the area code (i.e., 376-106-0900).
Record the 10 digits of your Mexican cell phone. (i.e., 123 456 1234)
Mexican Visa Status*
Which valid Mexican Visa do you hold? To be eligible for our yearly insurance programs you MUST possess either a valid Temporal OR Permanente Mexican Visa. You also certify that you reside in Mexico at least 6 continual months each year.
Mexican Visa Number. If you have a MX Temporal Passport, the expiration date is also required.
MM slash DD slash YYYY
You may apply for our insurance up until you are 70 years, 9 months. Once you are accepted you have lifetime renewal privileges with no age restriction.

How were you referred to*
Today's date is your Start Date, provided you pay your Membership Fee upon receipt of your Invoice. You must be a paid member BEFORE you apply for our group health insurance. You will have an insurance effective date of the 1st or 15th of the month, depending on when your necessary documents are complete and sent to Best Doctors for review and processing.
MM slash DD slash YYYY

Membership Payment Method:

For your protection, membership fees are payable by credit card only. NO CASH is accepted. (If using your credit card an additional security measure is added by requesting the zip code of the address you have on record with your credit card company).
MM slash DD slash YYYY
SO, WHAT'S NEXT? When you complete Captcha and hit the Submit button below, you will receive a "Success" notification indicating your application has been properly completed and emailed to the Boomers organization. Kindly allow up to 48 Business Hours for your application review and the processing of your Membership Invoice. Thanks!
This field is for validation purposes and should be left unchanged.