Insurance
 

Quote Details for your Trip to Mexico

- Answer all Questions -

Effective Date *
 
Days of Service Needed *
 
Type of Travel Party *
 
Number of Adults Traveling *
 

-Please enter the number of adults (defined as 18 to 75 years of age) in your travel party.  The adults in the travel party may reside at separate locations (the certificate issuance) system will allow for various addresses for those in the travel party.

-Individuals with less than 18 years of age (17 and younger) are considered children under the general conditions of this certificate. 

-Individuals over the age of 80 are not eligible for coverage under the general conditions of this certificate.
 
Number of Children (see More Info) Traveling *
 

Families applying for this plan will receive free benefits for the first two eligible dependent children between the ages of 14 days to 17 years when both parents have benefits under this plan. Other children beyond the first two eligible dependent children, will be charged a similar rate to an individual adult risk. Children over the age of 17 (18 and above) should be listed individually as an adult.

The term “dependent children” includes the following:

* Children through age 17:

o Who are naturally born, legally adopted, or a stepchild; or,

o For whom you have legal responsibility for supporting in anticipation of adoption; or,

o Whom you support under a court order or divorce decree.
 
How many people (adults) in your travel party? *
 

MPA_NUMBER_OF_TRAVELERS_HELP
 
How many people (adults) in your travel party? *
 

MPA_NUMBER_OF_TRAVELERS_HELP
 
How many people (adults) in your travel party? *
 

MPA_NUMBER_OF_TRAVELERS_HELP
 
How many people (adults) in your travel party? *
 

MPA_NUMBER_OF_TRAVELERS_HELP
 
Do you want to include Medical Assistance benefits? *
 
 
 

We highly recommend you include these important benefits.  For an additional premium you will receive Emergency Medical Assistance benefits such as:

A. MEDICAL COORDINATION.

B. EMERGENCY MEDICAL TRANSFERS.

C. EMERGENCY MEDICAL AIR AMBULANCE TRANSFER.

D. REPATRIATION AFTER MEDICAL TREATMENT.

E. TRANSPORTATION AND LODGING FOR FAMILY MEMBER DURING HOSPITALIZATION.

F. PAYMENT OF RETURN OR CONTINUATION OF TRIP FOR COMPANIONS.

G. PAYMENT OF HOTEL FOR CONVALESCENCE.

H. REPATRIATION OF MORTAL REMAINS OR LOCAL BURIAL.

I. ORTHODONTICS ASSISTANCE (Dentist).

J. EYEGLASSES AND CONTACT LENS REPLACEMENT ASSISTANCE.

*See the General Conditions of Service for more specific information
 
Select Main Destination (City or State) *
 

Please select the Major City (if listed) or the State of your primary destination within the Republic of Mexico. 

If you need assistance in determining what City or State in Mexico you will be visiting please click on the "Destination Search Tool" on the initial quote page.
 
 

Additional Questions

Do you reside in Mexico more than 180 days per year? *