Landing #1 – Insured Traveler

Coverage Area*
Start Date*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: MM slash DD slash YYYY
Number of days
Are you interested in insuring your trip?*
- No
- Yes
Primary*
Please enter a number from 0 to 99.
Spouse
Please enter a number from 1 to 99.
Child/Other
Please enter a number from 1 to 99.
Child/Other
Please enter a number from 1 to 99.
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
Child/Other
- Primary*
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Spouse
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
- Child/Other
  Please enter a number from 0 to 80.
- Trip Cost*
  Please enter a number greater than or equal to 0.
Number of travelers
- Add Spouse
- Add Child/Other
Are any of the travelers a US citizen?
- Are any of the travelers a US citizen?
In / Out US choice
- Living in the US
- Living outside of the US

Travel Medical Insurance + FREE Canada ETA / US ESTA Visa