Diaspora Subscription Request

I confirm that the information provided above is accurate and that I am proceeding to make payment.

By continuing, I acknowledge and accept the following:
All Mediplan Diaspora Health Plans are annual healthcare service contracts, even if I choose to make payment monthly, quarterly, or annually.
I understand that payment must be made manually via bank transfer and that my subscription will only be activated once payment is confirmed.
Early termination of the plan before the 12-month duration may attract a penalty fee or result in forfeiture of any unused balance, based on usage and review.

I have read and agree to the Terms and Conditions and Privacy Policy.