You are no longer on Costco's site and are subject to the Privacy Policy of the company hosting this site.

Health & Dental Insurance: Apply Now

We're here
to help

Speak to a friendly and
knowledgeable customer
service representative.

1-866-707-4922

Monday - Friday,
8 am to 8 pm ET
OR E-mail anytime:
am_info@manulife.com

Apply Online
Personal
Information
Select Your
Plan
Co-Applicant
Information
Dependant
Information
Payment
Options
Medical
Information
Confirmation
For New and Returning Applicants
If you are a new customer and wish to apply for health and/or dental insurance, please complete an online application.

If you have previously completed a quote or partially completed an application within the last 30 days, your original application and quote information (if applicable) has been saved. To access this please use our Application Finder.