Quote Questionnaire | Travel MedEvac
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Due to government restrictions, the following countries are restricted:
Algeria, Australia, Chad, Chechnya, Congo DR, Iran, Ivory Coast, Liberia, North Korea, Palestinian territories, Sierra Leone, Republic of South Sudan, Republic of the Sudan, Somalia and Syria

Our Global Plans provide coverage throughout the world, as long as you are 150 miles away from home.

Due to government restrictions and limitations, the following countries and regions are not available for transport currently: Algeria, Australia, Chad, Chechnya, Congo DR, Iran, Ivory Coast, Liberia, North Korea, Palestinian territories, Sierra Leone, Republic of South Sudan, Republic of the Sudan, Somalia, Syria, plus Antarctica and the Arctic Ocean region. Subject to change, see terms.

Our coverage only when in Mexico plan(s) provides coverage for evacuations from Mexico to the USA or Canada only.

A maximum of 10 travelers can be added per policy. If you need to cover more than 10 travelers, please complete this policy, then start a new policy for the next 10 or less travelers.

Semi Annual Plans are effective for 180 days from the day you start your policy.

Our plans do not cover anyone over 84 years of age.

To qualify for Medical Tourism coverage, all travelers must be between the age of 18 and 65. Treatment and Services must be provided by licensed physicians, dentists, clinics and hospitals that are in good standing with regulatory authorities, standards and laws of the respective country in which the procedure will take place. Coverage is limited to traveling outside your home country and is only for procedures that take place in Mexico, the Caribbean, Central America and the Bahamas.

Immediate family includes parents/legal guardians and their children/legal dependents

Travel MedEvac plans are available to U.S. residents/U.S. expatriates with a valid U.S. billing address.

Please select the state where you currently reside/U.S. billing address.

Select a Province

What is the maximum length of any single trip you take?

No plans exceeding 180 days per trip are currently unavailable to Missouri residents.

No plans exceeding 180 days per trip are currently unavailable to Maryland residents.

No plans exceeding 180 days per trip are currently unavailable to New York residents.

No plans exceeding 180 days per trip are currently unavailable to South Dakota residents.

Are you traveling for medical reasons/medical tourism?

To qualify for Medical Tourism coverage, all travelers must be between the age of 18 and 65. Treatment and Services must be provided by licensed physicians, dentists, clinics and hospitals that are in good standing with regulatory authorities, standards and laws of the respective country in which the procedure will take place. Coverage is limited to traveling outside your home country and is only for procedures that take place in Mexico, the Caribbean, Central America and the Bahamas.

Please select from the following covered procedures. Any procedure not listed is excluded.

Dental Procedures

Do you want coverage for:

Global Plan (includes domestic and international coverage)
Mexico Only

How many travelers do you want covered, including yourself?

How many travelers are between the ages of 75 - 84?

Do you travel more than 40 days per year?

Yes
No
Please fill out the missing information.

Are you traveling with your immediate family?

Immediate Family includes two parents/legal guardians and their children/legal dependents.
Dependent Child(ren) means Your child (or children), including an unmarried child, stepchild, legally adopted child or foster child who is: (1) less than age nineteen (19) and primarily dependent on You for support and maintenance; or (2) who is at least age nineteen (19) but less than age twenty-six (26) and is enrolled as a student.

If you are traveling as a group it may be less expensive to purchase a policy for each traveler individually. To get a quote for an individual policy click on the back arrow and choose one (1) traveler.

When do you leave on your next trip / preferred start date?

When do you return from your next trip?

An annual option will be quoted with any return date selected when available.

When do you leave on your trip?

When do you return?

Emergency Medical Coverage

Although Travel MedEvac and its providers will work expeditiously to transport you home when a flight is warranted, there are often unavoidable expenses out of pocket for emergency medical services in the hospital where you are first admitted that are not always covered by your health insurance or other plans when traveling. Travel with the peace of mind knowing you have emergency accident and sickness medical coverage as well.

View Benefits

Plan Selected:

Emergency Medical for
traveler(s)
Only an additional $

Emergency Medical Coverage

Although Travel MedEvac and its providers will work expeditiously to transport you home when a flight is warranted, there are often unavoidable expenses out of pocket for emergency medical services in the hospital where you are first admitted that are not always covered by your health insurance or other plans when traveling. Travel with the peace of mind knowing you have emergency accident and sickness medical coverage as well.

Benefits Limits
Emergency Accident and Sickness, Physician Services, Hospital Confinement, Use of Operating Rooms, Laboratory Tests, X-Ray Examinations or Treatments, Anesthetics (including administration), Medicines and Therapeutic Services. $100,000
Emergency Dental Expense $750

Emergency Medical Coverage has a $250 deductible and will be paid after any other primary collectible insurance or indemnity has paid the claim and the primary policy limits have been exhausted. Benefits can be reimbursed up to the limits shown.

All limits and deductibles are in U.S. dollars
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