Step 1
If you have an activation code, complete the form and click NEXT. If you do not have an activation code, please click Sign Up Now. All fields are required.
Enter your activation code as it appears on your enrollment letter or After Visit Summary®. Your code is not case sensitive.
Please enter the last 4 digits of your Social Security number.
Enter your date of birth in the format shown, using 4 digits for the year.