Purchase Your Policy

  •  TRIP DETAILS
  •  COVERAGE
  •  APPLICANT DETAILS
  •  PAYMENT

CoverAmerica-Gold® Insurance Application

Please note that :

  • Not available if Home Country/Country of Residences are: Botswana (BWA), Cuba (CUB), Gambia (GMB), Ghana (GHA), Iran (IRN), Kosovo (XKX), Niger (NER), Nigeria (NGA), North Korea (PRK), Puerto Rico (PRI), Sierra Leone (SLE), Syria (SYR), United States (USA), Venezuela (VEN) & Virgin Islands (USA) (VIR).
  • Not available for Citizens of: Botswana (BWA), Gambia (GMB), Ghana (GHA), Kosovo (XKX), Niger (NER), Nigeria (NGA), Puerto Rico (PRI), Sierra Leone (SLE), United States (USA) & Virgin Islands (USA) (VIR).
  • Not Available for the following Destination Countries: Congo, The Democratic Republic of (COD), South Sudan (SSD) & Uganda (UGA).
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 [email protected] for more infomation.
Traveling to Multiple Countries? : 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.

(Begins at 12:00 AM EST)

(Ends at 11:59 PM EST)
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.
More than one traveler? Enter the oldest person as the Primary Applicant.

(Oldest Traveler)

(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 International due to restriction of plan.

Price Guaranteed

lowest price

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

CA-G

CoverAmerica-Gold®

Administrative Company

IMG

Carrier / Underwriter

Sirius Speciality

Payment Options

  • Credit cards accepted:
  • Debit cards with MasterCard or Visa logo are accepted.
The comprehensive plan provides a percentage of eligible expenses, up to the policy maximum.

Review the policy documents for complete policy details including benefits and exclusions.

Review & Download

Plan Brochure Description of Coverage
Loading