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Please remember! MedFund-USA provides funding assistance for our members only, we are not an insurance company. A member of our staff will contact your doctor in order to obtain verification that you do not have any pre-existing or any planned medical expenses such as, but not limited to, surgical procedures within the next 90 days. In addition to signing your registration form, your signature below will also provide your doctor with permission to release to MedFund-USA any additional information.
I SWEAR THAT THE INFORMATION PROVIDED BY ME IN THIS DOCUMENT IS TRUE AS IF SWORN UNDER OATH. By clicking the "I ACCEPT" button you are certifying that your type written name in the box below, is the same as if your physically signed name had been entered.

MedFund-USA "Members Benevolent Fund"
In addition to your monthly membership fees, you can donate $5.00 each month to the MedFund-USA "Members Benevolent Fund" for helping those less fortunate. Your donation will be held in trust for the benefit of those who would qualify to receive the benefits of a MedFund-USA membership but are unable to afford it. The Benevolent Fund money is created solely from the following sources, our Individual and corporate members, and MedFund-USA LLC .

How your money and our money will be spent: Various sources from all over the country such as Hospitals, Doctors, News Media, Individuals like yourself, it could be from any source at all, will inform us of those who are really deserving of your generosity. Once a recommended recipient has been located, an in-depth qualification procedure will be conducted by our staff to ensure that the honesty and integrity of the fund remains intact and that your dollars are truly being advanced to a worthy recipient. Primarily, your funds will be used for those who are in a life threatening emergency or are in need of serious medical procedures but are unable to afford it. We have all heard the saying, "Charity begins at home" The MedFund-USA "Members Benevolent Fund". in it's purest form is a membership of Americans helping Americans,  MedFund-USA is home to us.


I would like to contribute to the Members Benevolent Fund. Checking this box is completely optional.

DO NOT CANCEL ANY HEALTH INSURANCE COVERAGE YOU CURRENTLY HAVE OR DECLINE COBRA BENEFITS UNTIL YOU RECEIVE A LETTER FROM MEDFUND-USA LLC STATING THAT YOUR APPLICATION FOR MEMBERSHIP HAS BEEN APPROVED. MAKE SURE YOU FULLY UNDERSTAND ALL OF THE INFORMATION PRESENTED ON THIS SITE BEFORE YOU AGREE WITH THE MEDFUND-USA TERMS AND CONDITIONS. IF THERE IS ANY PORTION THAT YOU DO NOT UNDERSTAND, IT IS YOUR RESPONSIBILITY TO CONTACT THE MEDFUND-USA STAFF OR AN ATTORNEY FOR CLARIFICATION AND INTERPRETATION OF THOSE PORTIONS THAT ARE NOT CLEAR TO YOU PRIOR TO ENTERING INTO AN AGREEMENT WITH MEDFUND-USA LLC. PLEASE PAY SPECIAL ATTENTION TO THE EFFECTIVE DATE OF YOUR MEMBERSHIP, MONTHLY MEMBERSHIP FEES, WAITING PERIOD, BENEFITS AND EXCLUSIONS IF ANY.

I agree to Terms & Conditions of MedFund-USA*

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