How many people need to be insured ?
1
2
3
4
5
6
7
8
9
What are the date of birth for each traveler ?
1:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
jan.
feb.
mar.
apr.
may
jun.
jul.
aug.
sep.
oct.
nov.
dec.
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
What is your date of departure ?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
jan.
feb.
mar.
apr.
may
jun.
jul.
aug.
sep.
oct.
nov.
dec.
2020
2021
2022
2023
2024
Departure date or Start of cover date.
What is your return date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
jan.
feb.
mar.
apr.
may
jun.
jul.
aug.
sep.
oct.
nov.
dec.
2020
2021
2022
2023
2024
From 3 months up to 1 year
Are you a member of the CFE ?
CFE = Caisse des Français de l'Etranger
What is your country of origin ?
Andorra
Austria
Belgium
Bulgaria
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
French Guiana
French Polynesia
Germany
Greece
Guadeloupe
Hungary
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Martinique
Mayotte
Monaco
Netherlands
New Caledonia
Norway
Poland
Portugal
Réunion
Romania
Saint Barthélemy
Saint Martin (French Part)
Saint Pierre And Miquelon
Slovakia
Slovenia
Spain
Sweden
Switzerland
United Kingdom
Wallis And Futuna
This is also your usual country of residence.
What is your destination ?
Europe : countries of the E.C. including Liechtenstein + Norway + Iceland but except U.K .
For Russia and Switzerland : choose World (with/without USA/Canada, depending on your trip).
For USA/Canada : including territories (Puerto Rico, USVI, ...)
What is your date of entry into the USA-Canada?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
jan.
feb.
mar.
apr.
may
jun.
jul.
aug.
sep.
oct.
nov.
dec.
2020
2021
2022
2023
2024
What is your return date to the USA-Canada?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
jan.
feb.
mar.
apr.
may
jun.
jul.
aug.
sep.
oct.
nov.
dec.
2020
2021
2022
2023
2024
Which option do you choose ?
Couple : 2 persons.
Family : 3 or 4-9 persons.
I’m aware that this contract does not cover the consequences of illness or accidents prior to subscription.
Yes
I am aware that this contract is limited to a 24-month coverage starting from the date of departure from my country of residence.
Yes
If you have a discount code, enter it here