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Step 1/4 - Trip Details
1
TRIP DETAILS
2
COVERAGE
3
APPLICANT DETAILS
4
PAYMENT

Patriot International Insurance Application

Please note that :

  • If you are purchasing this plan for Schengen visa purposes, please select a zero dollar ($0) deductible.
  • Not available to non-US citizens with Maryland (MD) address.
  • Not available for Citizens of: Botswana (BWA), Gambia (GMB), Ghana (GHA), Niger (NER), Nigeria (NGA) & Sierra Leone (SLE).
  • Not Available for the following Destination Countries: United States (USA).
All fields are required fields unless stated as optional
Sorry, we don't have an online application for your country at this time. Please contact support@visitorscoverage.com for more infomation.
Traveling to Multiple Countries? : If any part of your trip includes the United States, please select United States as your Destination Country. Other countries except Home Country on your trip is automatically covered.

(Begins at 12:00 AM EST)

(Ends at 11:59 PM EST)

(17 years and under)
Dependent Child: Children 17 years and under of the primary insured on this policy. Grandchildren, nieces, nephews etc. are not considered as dependent children. Please fill a separate application in such cases or for older children.
You are not eligible to purchase Patriot International due to restriction of plan. You may be eligible to purchase Global Medical Insurance.
You are not eligible to purchase Patriot International due to restriction of plan.
Where can we email your policy details?
You are not eligible to purchase Patriot International because your trip does include US or US territories. You may be eligible to purchase Patriot America or Patriot America Plus.
PI

Administrative Company

IMG

Carrier / Underwriter

Sirius International

Eligibility

  • For US and Non US citizens traveling outside the USA.
  • Coverage for minimum 5 days to maximum up to 365 days in a policy period.
  • Renewal option available up to a maximum of 2 years.

Comprehensive Coverage Plan


Inside US and Canada


In-Network : After the deductible, plan pays 90% of first $5,000; then 100% up to chosen medical maximum.
Out of Network : After the deductible, plan pays 80% of first $5,000; then 100% up to chosen medical maximum.

Outside US and Canada


After the deductible, 100% up to the chosen medical maximum.

Review Policy document(Description of Coverage) ,for complete policy details including benefits and exclusions.
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