Membership application – Under 40 Plan

INDIVIDUAL: $49 per month + applicable taxes

COUPLE : $69 per month + applicable taxes

FAMILY : $89 per month + applicable taxes

Plans available to those 40 years of age and younger.

    Membership Type* :


    Personal Information:

    Company Information (If applicable):

    Spouse/Partner (Family plan only):

    Dependents (Family plan only):

    Do you have any dependents?: YesNo

    * max four, up to age 25

    Billing frequency* :


    Please note that in order to protect your financial information, we will send you a secure link to collect your credit card details and activate your membership.

    Membership Terms and Conditions:

    For the full terms and conditions, please click here

    I have read and agree to all terms and conditions

    Advica Health Inc.

    QUESTIONS? CONCERNS? Please email Advica Health at [email protected]
    Note: This application form and pricing replaces any previous Advica or VIP Health Options Inc. application forms