Membership Program

1. Peace of Mind.

Jordan Valley EMS Authority’s highly trained personnel brings compassion, enthusiasm, and dependability in challenging environments.

2. Supporting your EMS.

Our communities deserve access to vital high-quality emergency medical services. Become involved and join our membership program.

3 Membership benefits.

Get protection from the unexpected cost of emergency care. Call for help without worrying about the cost.

Savings Benefits of a Jordan Valley EMS Authority Freedom Membership:

No out-of-pocket expense for medically necessary ambulance service
You family can avoid the financial hardship of unexpected ambulance bills
You will get protection that goes beyond insurance and Medicare coverage
We bill Medicare or your insurance company directly
One membership covers your entire family. You can add other non-depended family members for an additional $5.00 each.

Cost of Ambulance Service

Services

Basic Life Support

Advanced Life Support

Non-Members

$500

$800 & Up

Members

$0 out-of-pocket expense

Fill out the Membership Application below

If you plan on paying with a Credit Card, please CLICK HERE and print out application and mail it in.

Membership Application Form

Member Information

List Below: Self, Spouse, Unmarried Children Under 21 Living at Home

Last Name

First Name

Birth Date

Sex

MALE

FEMALE

Add Remove

MAILING ADDRESS

City

State

Zip Code

Phone

PERMANENT ADDRESS

TOWNSHIP

City

State

Zip Code

Phone

NON-DEPENDENT MEMBERS

BY PROVIDING AN EMAIL ADDRESS, YOU CAN STAY UP TO DATE ON JVEMSA.

JVEMSA FREEDOM MEMBERSHIP WAS STARTED BECAUSE WE RECOGNIZED THAT THE HIGH COST OF AMBULANCE SERVICE WAS CREATING A BURDEN FOR MANY PEOPLE IN OUR COMMUNITY. WITH THE COST OF AMBULANCE SERVICE AVERAGING MORE THAN $700, AND BECAUSE MOST MAJOR INSURANCE CARRIERS DO NOT COVER AMBULANCE SERVICE, THIS PLAN PROTECTS YOU FROM THE UNEXPECTED COST OF EMERGENCY CARE. MORE IMPORTANTLY, JVEMSA FREEDOM MEMBERSHIP ALLOWS YOU TO CALL FOR HELP WITHOUT EVER WORRYING ABOUT THE COST.

I UNDERSTAND THAT JVEMSA FREEDOM MEMBERSHIP IS NOT INSURANCE. BY ENROLLING IN THE MEMBERSHIP, JORDAN VALLEY EMS AUTHORITY WILL RECEIVE PAYMENT FROM ANY INSURANCE COMPANIES I MAY HAVE FOR REIMBURSEMENT OF MY CHARGES OF ALL AMBULANCE SERVICES PROVIDED. I WILL BE OBLIGATED TO FORWARD ANY PAYMENT BY MY INSURANCE COMPANIES TO JORDAN VALLEY EMS AUTHORITY. EACH PERSON COVERED BY THIS CONTRACT AUTHORIZES THE RELEASE OF AMBULANCE RECORDS TO ANY INSURANCE COMPANY (OR GOVERNMENT AGENCY OR UNIT) IN ANY WAY INVOLVED IN THE PAYMENT OF YOUR AMBULANCE SERVICE. THE MEMBERSHIP IS NONREFUNDABLE.

IF YOU HAVE ANY QUESTIONS IN REGARD TO THIS PLAN AND HOW IT WORKS, CALL THE OFFICE OF JORDAN VALLEY EMS AUTHORITY AT (231) 536-7881 FROM 8 A.M.-4 P.M. MONDAY THROUGH FRIDAY.

Payment

Single Plan $50

Family Plan $60

Family Plan + 1 Non-Dependent $65 ($5 for each additional Non-Dependent)

PAYMENT METHOD

Pay By Check (Make check payable to JVEMSA)
Pay By Credit Card: Print form by clicking below and fill out entire form including Credit Card information area.

Click Here to Print Form

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Service Area

The Jordan Valley EMS Authority is an emergency services authority serving:

City of East Jordan
South Arm Township
Jordan Township
Echo Township

Banks Township
Eveline Township
Part of Wilson Township

Now Open!

New Sub-station open in Eveline Township to better serve our community