Please Identify Yourself

All fields are required.

MyBellinHealth activation code

Enter your activation code as it appears on your enrollment letter or After Visit Summary®. Your code is not case sensitive.

xxxxx
-
xxxxx

Please enter the last 4 digits of your Social Security number.

nnnn
Date of birth

Enter your date of birth in the format shown, using 4 digits for the year.

mm
/
dd
/
yyyy