Patriot Exchange ProgramSM

Please complete the following form in order to begin your Patriot Exchange ProgramSM application.

If you would like to save your application and complete it at a later time, simply click on the "Save Application" button at the bottom of any page of the application after selecting a premium amount and before submitting your credit card information. If you have the Authorization Number and Password from a previous application that was not completed, click here to continue with the previous application.

* Denotes a required field.

Primary Insured's Age or Date of Birth is required.

At time of coverage start date
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Maleselect

At time of coverage start date
Leave blank if spouse is not to be insured.
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Femaleselect
(Premium only available in monthly increments)
 
 
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Other IMG plans that may be of interest

  • Student Health AdvantageSM - Designed for students or scholars participating in a sponsored study abroad program, and desire an annually renewable comprehensive medical plan. This plan meets student visa requirements, includes benefits for maternity, mental health, organized sports and international emergency care. For groups of two or more, see Student Health Advantage (group) plan.
  • Patriot Group Exchange ProgramSM - Designed for groups of two or more students studying abroad or participants of cultural exchange programs. Coverage is designed to meet U.S. J1 visa travel insurance requirements, and short and long-term coverage is available.
  • Patriot Travel Medical Insurance® - Addresses the insurance needs of U.S. and non-U.S. citizens who need temporary medical insurance while traveling for business or pleasure anywhere outside of their home country. For groups of five or more, see our Patriot Group Travel Medical Insurance® plan.
  • Global Medical Insurance® (GMI) - Flexible, long-term, annually renewable, worldwide medical insurance program for U.S. citizens living or working abroad and for non-U.S. nationals worldwide.

For a complete list of international medical insurance plans, please click here.

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