Step 2

Step 2

Annual Membership is only $60.00 USD per year:

> January 1 – December 31, 2017 for the Best Doctors Policy OR

> July, 2016 through June, 2017 for the WEA policy

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

Memberships are pro-rated if joining mid-year.

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

Please fill out the application form below:

  • 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"
  • Please indicate your landline FIRST; then a cell phone if you have one. (i.e., (376)106-0900; cell 045-333-765-1234)
  • Which valid Mexican Visa do you hold? To be eligible for our insurance you must possess either a valid Temporal or Permanente Mexican Visa.
  • Mexican Visa Number. If you have a MX Temporal Passport, the expiration date is also required.
  • If you live in the Chapala area you know that email and phone service can be problematic at times. Please indicate which local mail service provider with whom you are registered.
  • Your Boomer membership and insurance premiums will be pro-rated if you are joining mid-year)
  • You must be a paid member the month BEFORE you apply for our group health insurance. You cannot start a membership and apply for insurance during the same month.
  • Membership dues are paid only by Credit Card or the Mexican Peso equivalent deposited directly into our Mexican Bancomer Account.
  • This field is for validation purposes and should be left unchanged.