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TRIP DETAILS
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COVERAGE
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APPLICANT DETAILS
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PAYMENT

ChoiceAmerica Insurance Application

Please note that :

  • Has to be purchased within one month of arrival in the USA for people above 65 & within 6 months​ of arrival in the USA for people below 65.(Waived if an​ international plan was in effect within last 30 days)
  • Not Available for Addresses from the Following US States: Maryland (MD).
  • Not available if Home Country/Country of Residences are: United States (USA).
  • Not available for Citizens of: Botswana (BWA), Gambia (GMB), Ghana (GHA), Niger (NER), Nigeria (NGA), Sierra Leone (SLE) & 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 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.
US green card holder is not eligible for this plan. Here is the list of eligible plans for US green card holder.

(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 Choice America due to age restriction.
You are not eligible to purchase Choice America due to restriction of plan.
Where can we email your policy details?
CA

Administrative Company

IMG

Carrier / Underwriter

Sirius International

Eligibility

  • For Non US citizens and Non US residents traveling to the United States, Mexico or Canada.
  • Coverage for minimum 5 days to maximum up to 365 days.

Limited Coverage Plan


Plan provide basic and fixed pre defined dollar amount for covered services, as defined in the policy.

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