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Patriot Platinum America First-class travel medical insurance for individuals, families and groups of five or more.

  • Quote
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  • Coverage
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  • Applicant Details
    3
  • Review
    4
  • Payment
    5
  • Insurance Confirmation
    6

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Please enter the information in English only.

Insureds' Age(s)

Primary

Primary Age is required.

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

Dependents must be under 18 years old.Dependents must be under 19 years old.

Add Child

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

Please enter the age(s) of other(s).

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

Eligibility

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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