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Student Health Advantage - Platinum Insurance Application

Please note that :

  • Not Available for Addresses from the Following US States: Maryland (MD).
  • Not available for Citizens of: Botswana (BWA), Gambia (GMB), Ghana (GHA), Niger (NER), Nigeria (NGA) & Sierra Leone (SLE).
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 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 Student Health Advantage - Platinum due to restriction of plan. You may be eligible to purchase Global Medical Insurance.
Where can we email your policy details?
SHA-P

Administrative Company

IMG

Carrier / Underwriter

Sirius International

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