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Step 1/4 - Trip Details

Patriot Platinum International Insurance Application

Please note that :

  • If initially purchased for a minimum of one month or more, coverage may be renewed.
  • Not Available for Addresses from the Following US States: Maryland (MD).
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 for more infomation.
Traveling to multiple countries including the US? : If you are planning to visit other countries in addition to the US, your plan will provide coverage in all destinations outside your home country.

(Begins at 12:00 AM EST)

(Ends at 12:00 AM 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 Platinum International due to restriction of plan. You may be eligible to purchase Global Medical Insurance.
You are not eligible to purchase Patriot Platinum International due to restriction of plan.
Where can we email your policy details?

Administrative Company


Carrier / Underwriter

Sirius International


  • For US citizens traveling outside their home country including 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 100% up to chosen medical maximum.
Out of Network : After the deductible, plan pays 90% 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. ® is an online operating entity of Maxn Insurance Services, CA, USA License #0F17045
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