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.
*Void where prohibited: Although Altrua HealthShare offers memberships nationwide, some of the sharing options contained in the Membership Guidelines may NOT be available to Members in all geographic locations or jurisdictions. Adoption and Funeral sharing options are NOT available to Texas residents.
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 1.833.325.8782 so we can enable it for you. This will allow you to add or remove dependents.
Please call us at 1.833.325.8782 Monday through Friday 8am to 6pm CST.
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
Upon enrollment, the primary contact of the household must sign the Membership Commitment form. The primary Contact’s signature represents the continued commitment by each member of the household 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