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Step 1/4 - Trip Details

CoverAmerica - Gold Insurance Application

Please note that :

  • Not available to the residents of the following countries:Islamic Republic of Iran, Syrian Arab Republic, U.S. Virgin Islands, Gambia, Ghana, Nigeria, Sierra Leone, Switzerland, Australia and Canada
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.
US green card holder is not eligible for this plan. Here is the list of eligible plans for US green card holder.

(18 years and under)
Dependent Child: Children 18 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.
Where can we email your policy details?

Administrative Company

Seven Corners

Carrier / Underwriter

Lloyd's of London


  • For Non-U.S. residents and Non-U.S. citizens, while traveling to the United States and for incidental trips to Canada, Mexico, Latin America, Bahamas and South America.
  • For Age 14 days to 79 years of age.
  • Coverage for minimum of 5 days upto 364 days.

Comprehensive Coverage Plan

The comprehensive plan provides percentage of eligible expenses, up to the policy maximum. After the deductible in network, CoverAmerica - Gold plan pays 100% up to chosen policy maximum. For out of network it covers 80% for first $5,000, Then 100% up to chosen policy 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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