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

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Coverage Dates (mm/dd/yyyy) (start & end)

Start Date is required.

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End Date is required.

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End Date cannot be before Start Date.

Is your Home Country US or US territories?

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Applicants listing 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)

PrimarySpouseChild {{numOfTraveler-1}}

Primary Age is required.Insured {{numOfTraveler+1}} Age is required.

Spouse must be at least 18 years old.

Dependents must be under 18 years old.

Age is required for each proposed insured.

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

Quote

Coverage

Applicant Details

Review

Payment

Insurance Confirmation

There was a problem, please make the requested changes and submit again:

There was a problem, please make the requested changes and submit again:

Reset Application

Quote

Coverage Dates (mm/dd/yyyy) (start & end)

Insureds' Age(s)

Video Overview

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