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CoverAmerica - Gold Insurance Application
Please note that :
- The policy must be purchased for a minimum of 30 days to be eligible for COVID-19 benefits and coverage.
- Not Available for Addresses from the Following US States: Maryland (MD) & New York (NY).
- Not available if Home Country/Country of Residences are: Cuba (CUB), Iran (IRN), North Korea (PRK), Syria (SYR), United States (USA) & Venezuela (VEN).
- Not available for Citizens of: Botswana (BWA), Gambia (GMB), Ghana (GHA), Niger (NER), Nigeria (NGA), Sierra Leone (SLE) & United States (USA).
CA-G
Administrative Company
IMGCarrier / Underwriter
Sirius InternationalPayment Options
- Credit cards accepted:
- Debit cards with MasterCard or Visa logo are accepted.
Eligibility
- 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 up to 365 days.
- Must purchase a minimum of 30 days of coverage to be eligible for COVID-19 benefits and coverage.
Comprehensive Coverage Plan
The comprehensive plan provides a percentage coverage for eligible medical expenses, up to the policy maximum. After the deductible is satisfied, within the PPO in network, CoverAmerica - Gold plan pays 100% of all eligible medical expenses up to the policy maximum. For coverage outside of the PPO network, the plan will it pay 80% of eligible medical expenses up to $1,000 than 100% thereafter.
Review Policy document (Description of Coverage), for complete policy details including benefits and exclusions.
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