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Patriot America® Short-term travel medical insurance for individuals and families.

  • Quote
  • Coverage
  • Applicant Details
  • Review
  • Payment
  • Insurance Confirmation

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Please enter the information in English only.

Insureds' Age(s)


Primary Age is required.


Spouse Age is required.

Child {{form.travelerInfos[1] && form.travelerInfos[1].travelerType === 'spouse' ? index-1 : index}}

Child {{index-1}} age is required.

Child {{index-1}} must be under 18 years old.Child {{index-1}} must be under 19 years old.

Age is required for each proposed insured.

Add Child

Please enter the age(s) of child(ren).


Country of Citizenship is required.

Country of Residence is required.

Primary Destination Country is required.

Residence Country and Primary Destination Country cannot be the same.

Destination Country cannot be US or US territory if Country of Residence is US or US territory.

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