Forms for Managing Your Membership
Manage Your Membership
Billing Information Form
Submit/update billing information for automatic contributions
Needs Processing Form
Submit additional medical need information.
Adoption Assistance Needs Processing Request
Itemize eligible adoption expenses for membership sharing
Membership Update Form
Submit any new information or changes to your membership
The following must be completed online.
Please login in to your Member Portal by clicking Sign In. If you can not access the new portal, please call us at 1.888.244.3839 so we can enable it for you. This will allow you to add or remove dependents.
Requested changes must be received by the 25th of the month to allow time for processing. Approved changes go into effect on the 1st of the following month.
Annual Membership Commitment
Each year, all members of the household age 18 and over must submit a Membership Commitment Form acknowledging their continued commitment to the:
- Altrua HealthShare Membership
- Statement of Standards
- Acknowledgments section of the Membership Enrollment Application
- Escrow Instructions for sharing of Member contributions