International Students Application Form

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International Student Medical and Hospital Insurance Plan

  1. Maximum period is 365 or 366 days.
  2. Minimum period is 30 days.
  3. The earliest effective date is 3 days after tomorrow.
  4. Privacy Policy

MEDICAL AND HOSPITAL RATES

Days

30 - 365

69 years and
under

$1.77
/daily

$22.00
/policy

International Student Medical Insurance Plan Eligibility Requirements

  • If applicable, please check the boxes below.

1. You are not travelling against a physician's advice and you have not been diagnosed with a terminal condition.

2. You are a student enrolled in a school within Canada;

3. If you have already arrived in Canada, you have NOT seen physician or other registered medical practitioner since your arrival.

4. You confirm that you are in good health and that you know of no reason for which you may seek medical attention, and that currently no circumstance is known for which a claim may be made.

* Please call or e-mail us if you do not meet all of the conditions above.

Fill in the information in the light blue shaded boxes, then click the quotation button below.
It will automatically quote the number of days coverage and the total cost of the insurance.

<= Quotation Button

Yes       No

Effective Date : Y/M/D

 

Expiry Date : Y/M/D

 

 

Number of Days Coverage

Days

* Please make sure you enter the correct day, as the drop down menu has 31 days available
        regardless of the month (eg. please do not enter Feb. 30 or 31 or April 31)

$


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Male   Female

YYYY / MM DD

 VISA    MC    AMEX  

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