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Complete Your Payment

Secure payment for your health plan

Progress: {{ $progress }}%

Payment Information

Personal Information

First Name Required

Last Name Required

Email Required

Phone Number Required

Billing Address

Street Address Required

Apartment, suite, unit, building, floor, etc. Optional

City Required

State Required

Zip Code Required

Payment Details

Card Number Required

Expiration Month Required

Expiration Year Required

CVV Required

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Complete Payment

Order Summary

Plan: {{ $plan->name }}

Duration: {{ $plan->duration_months }} {{ Str::plural('month', $plan->duration_months) }}

@if(($plan->activeDiscount && Session::get('plan.hasInsurance') === 'yes') || $plan->extraHelpDiscount)

Original Price: ${{ number_format($plan->price, 2) }}

@if($plan->activeDiscount && Session::get('plan.hasInsurance') === 'yes')

Insurance Discount: @if($plan->activeDiscount->type === 'percentage') -${{ number_format($plan->price * $plan->activeDiscount->value / 100, 2) }} ({{ $plan->activeDiscount->value }}%) @else -${{ number_format(min($plan->activeDiscount->value, $plan->price), 2) }} @endif

@endif @if($plan->extraHelpDiscount)

ExtraHelp Discount: @if($plan->extraHelpDiscount->type === 'percentage') @php $basePrice = $plan->price; if($plan->activeDiscount && Session::get('plan.hasInsurance') === 'yes') { if($plan->activeDiscount->type === 'percentage') { $basePrice = $basePrice * (1 - $plan->activeDiscount->value / 100); } else { $basePrice = $basePrice - $plan->activeDiscount->value; } $basePrice = max(0, $basePrice); } $extraHelpAmount = $basePrice * $plan->extraHelpDiscount->value / 100; @endphp -${{ number_format($extraHelpAmount, 2) }} ({{ $plan->extraHelpDiscount->value }}%) @else -${{ number_format(min($plan->extraHelpDiscount->value, $plan->price), 2) }} @endif

@endif

Total Discount: -${{ number_format($plan->totalDiscountAmount, 2) }}

@endif

Total: @if(($plan->activeDiscount && Session::get('plan.hasInsurance') === 'yes') || $plan->extraHelpDiscount) ${{ number_format($plan->finalPrice, 2) }} @else ${{ number_format($plan->price, 2) }} @endif

Your subscription will automatically renew every {{ $plan->duration_months }} {{ Str::plural('month', $plan->duration_months) }}. You can cancel anytime.