Customer Support : 1-866-384-9104
Mon-Thu : 8:30AM - 7:00PM PT
Fri : 8:30AM - 6:00PM PT
Sat : 10:00AM - 4:00PM PT
Step 1/4 - Trip Details
1
TRIP DETAILS
2
COVERAGE
3
APPLICANT DETAILS
4
PAYMENT

Patriot America Insurance Application

Please note that :

  • Not available for the residents of Maryland (MD) state.
  • If initially purchased for a minimum of one month or more, coverage may be renewed.
  • For Acute Onset of Pre-existing coverage, please consider the Patriot America Plus plan.
  • No coverage for Sudden and Unexpected Recurrence of a Pre-existing Condition.
  • For people above 65 years this plan has to be purchased within 30 days of arrival in USA. For people below 65 years this plan has to be purchased within 6 months of arrival in USA. These requirements will be waived with proof of previous valid international travel insurance.
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.
Where are you traveling to? : If any part of your trip includes the United States, please select United States as your Destination Country. Other countries except Home Country on your trip is automatically covered.

(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 Patriot America due to restriction of plan. You may be eligible to purchase Global Medical Insurance.
You are not eligible to purchase Patriot America due to restriction of plan.
Where can we email your policy details?
PA

Administrative Company

IMG

Carrier / Underwriter

Sirius International

Eligibility

  • For foreign visitors traveling internationally including USA.
  • Coverage for minimum 5 days to maximum up to 365 days.

Comprehensive Coverage Plan


The comprehensive plan provides percentage of eligible expenses, up to the policy maximum.

Inside US and Canada


In-Network : After the deductible, plan pays 90% of first $5,000; then 100% up to chosen medical maximum.
Out of Network : After the deductible, plan pays 80% of first $5,000; then 100% up to chosen medical maximum.

Outside US and Canada

After the deductible, 100% up to the chosen medical maximum.

Review Policy document(Description of Coverage) ,for complete policy details including benefits and exclusions.
VisitorsCoverage.com ® is an online operating entity of Maxn Insurance Services, CA, USA License #0F17045
Copyright © 2006-2017 VisitorsCoverage.com ®. All rights reserved