Refer a patient for health coverage

Our help is free to the patient and free to your office. A licensed agent reaches out within 2 hours during business hours.

What a plan costs depends on the subsidy the patient qualifies for. We show that before anything is signed.

We reach out within 2 hours
A licensed agent checks eligibility
We enroll them — no fee for our help
We confirm carrier & effective date back to your office, with the patient's permission

About the patient

First name *

Last name *

Phone *

Email (optional)

ZIP code *

County (optional)

Preferred language *

Best time to call (optional)

About you, the referrer

Your name *

Your organization *

Your work email *

Your phone (optional)

Please do not include any diagnosis, treatment details, or medical records. We do not need them.

Patient permission

Required: The patient has given me permission to share their name and contact information with United Liberty Insurance Agency, and to be contacted by phone, text, and email about health coverage options.

Optional: The patient also gives permission for United Liberty to tell my office whether they enrolled, including the carrier name and coverage effective date.

United Liberty Insurance Agency is an independent, licensed health insurance agency. We are not affiliated with, endorsed by, or acting on behalf of any government agency. United Liberty's enrollment help is provided at no charge to the patient and to the referring organization, and no compensation is paid to referral partners. Any plan premium is set by the carrier and depends on the patient's subsidy eligibility. A referral does not obligate the patient to enroll.