2025 SUBSCRIPTION PROGRAM

Ludlow Ambulance’s Subscription Program entitles benefits to the subscriber and any enrolled individual legally and permanently residing in the same household. Active benefits begin upon receipt of the application and fee payment on January 1, 2025, whichever is later. Ludlow Ambulance reserves the right to bill and receive payment from your insurance carrier. Payments made directly to you by your insurance carrier for services covered under this agreement are to be forwarded to Ludlow Ambulance Service. Subscriptions cannot be prorated.

After you have entered your information in the form below, press ‘submit’ to move to the payment page at pay.gov. Enter your amount ($60 or $120) and payment details on that page to complete your subscription.

APPLICATION INSTRUCTIONS

READ ALL STEPS BEFORE PROCEEDING

Step 1: Fill out all sections of the form below

Step 2: Click “Submit”

(Once submitted you will be rerouted to our payment site and a confirmation email will be sent to you)

(Under “Run Number” write Subscription)

Step 3: Complete payment form for your subscription

Step 4: Have peace of mind, knowing your covered