ChoiceAmerica Insurance Application

Travel Medical Insurance Plan for non US Citizens visiting the United States, Mexico or Canada.

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

Citizenship

Residence / Home Country

Where are you traveling to?

Sorry, we don't have an online application for your country at this time. Please contact support@visitorscoverage.com for more infomation.

Are you a US green card holder ?

US green card holder is not eligible for this plan. Here is the list of eligible plans for US green card holder.

Date of arrival

Coverage Start Date
(Begins at 12:00 AM EST)

Coverage End Date
(Ends at 11:59 PM EST)

To be able to renew this policy at the end of its term, the initial coverage period must be at least 31 days.

Coverage Area

Please use the date of birth that appears in your travel documents, for e.g passport. A request to correct date of birth after the policy is purchased may result in changes to policy premium and benefits.

Applicant Date of Birth

Spouse Coverage Needed

Spouse Date of Birth

Child Coverage Needed
(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.

+ Add Child

Is the applicant present in the USA ?

Has the applicant been in the US or one of its Territories for more than 6 months?

Did the applicant have coverage in the last 30 days ?

International Insurance Provider

Expiration Date of Current Coverage

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?

Email Address

This email address will be used to communicate the policy related information and the status of the policy application.

ChoiceAmerica

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.

Review & Download

Plan Brochure Description of Coverage

Price Guaranteed

Insurance rates are regulated by law.
You can't find the same insurance plan for a lower price anywhere else.

Purchase Your Policy

ChoiceAmerica Insurance Application

Please note that :

ChoiceAmerica

Administrative Company

Carrier / Underwriter

Eligibility

Limited Coverage Plan

Review & Download

Price Guaranteed