Vault Direct

1. Create Customer Account

This page is for representatives to enroll members into the Vault Direct Plan. Please input the customer's information below.

[Obtain information from member below and input into system]

Important notification for consumer: Enrollments are accepted through the 25th of each month. Enrollments received this month will become effective on the 1st of next month.

Dependent

Dependent

Dependent

Dependent

Dependent

Healthcare2U DPCplus acknowledgments:

I understand that Healthcare2U is a healthcare membership and is not health insurance.

I understand that dependents under the age of two and members over the age of 64 are not eligible for Healthcare2U's membership

I understand there are no walk-ins allowed. Unlimited services (including Virtual DPC/telehealth) must be accessed through Healthcare2U's Central Scheduling Department (CSD). In-office appointments are only available within business hours (Monday through Friday, 7 AM to 6 PM CST). The CSD may direct the member to another level of care if appropriate, depending on the member's condition and utilization of services.

I understand that there are in-office visit fees associated with my membership: $0 for Virtual DPC consultations, $10 per in-office physician visit, and $25 per urgent care visit.

I understand physicals are available after six consecutive months of membership and the well-woman pap smear pathology interpretation is not included in the annual physical provided by Healthcare2U

I understand this membership does not cover emergency services. The Membership Services are not a substitute for calling 911 in the event of a life-threatening emergency. Member acknowledges that, in the event of an emergency, Members should first call 911

2. Customer Payment Info

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We have a number of payment options available. We accept Visa, MasterCard or check/from account. Which will you be using today?

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[Read the following to the customer]

Is your contact information different from your billing information?

[If “No” simply continue. If “Yes”, check box and obtain information and input into system.].

By continuing, you acknowledge that: you are 18 years of age or older; you agree to register for a membership into Vault Direct and acknowledge that you have read, understand and agree to the Vault Direct Terms and Conditions, the Healthcare2U Terms & Conditions and hereby authorize the plan administrator, NBFSA, for Vault Direct to deduct  $82.50 from your account on a monthly basis. You understand that this authority shall remain in force until you notify Vault Direct or their plan administrator NBFSA of its cancellation; You have given accurate information provided during this enrollment process; and this is not insurance. If you are not satisfied within 30 days after the effective date, you can call 888-424-4186. The Program will then be canceled and any Charges /Fees paid, as shown above, will be refunded.

Summary

  • Membership Features

  • VaultDirect
  • VaultRx

Total

Vault Direct Membership Disclaimers

* No walk-ins allowed

*Well-woman pap smear pathology interpretation is not included. Annual physicals available after 6 consecutive months of membership.

ValutRx Membership Disclaimers

VaultRx is a platform which supports group sponsored prescription drug benefit plans. Access to the benefit plans hosted on the VaultRx platform and any use of the VaultRx platform is restricted to designated groups and their eligible members. VaultRx is not intended for use related to programs that are made available to the general public.

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