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Atlas America® Non-U.S. citizens traveling to the U.S.

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Coverage Dates (mm/dd/yyyy)

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Start Date is required. Cannot contain special characters. Cannot contain letters. Please enter the Start Date in the specified date format.

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Is your Citizenship or Home Country the U.S. or a U.S. territory?

      

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Applicants listing Citizenship or Home Country as 'United States of America' are limited to 364 days of coverage per the United States Patient Protection and Affordable Care Act (PPACA). Please adjust the Coverage End Date, choose an alternate plan on this website, or contact us for further assistance.

Insureds' Age(s)

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Spouse must be at least 18 years old.

Child {{numOfTraveler-1}} age is required.Insured {{numOfTraveler+1}} Age is required.

Child {{numOfTraveler-1}} must be under 18 years old.

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