Easy, peasy. You choose which membership fits your needs. BRONZE PMA $100 per month, Silver PMA $160 per month, and GOLD PMA $240 per month. You will sign up for the subscription (you can cancel any time). All the money that goes in is credited to your account to use when needed on any service (Botox, injectables, or skin care). If you want a service that is over your amount credited, you simply pay the difference. You can use all the money in your bank for any service with PMA Tracee Dahlke, MSN, APRN, FNP-C (Independent contractors that work at PMA are not included in this membership). Disclaimer: there are no refunds, and you cannot gift your bank account to friends/family.