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Medipac Travel Insurance Quick Quote
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Province of Residence:
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Trip Length Applied for in Days
Select Trip Length
Up to 3 Days
4 - 6
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184 - 190 ON & NF
191 - 200 ON & NF
201 - 212 ON & NF
I am a Federal Superannuate
and I request that my policy be issued with a Deductible of $CDN500,000 for the first 40 days of my trip.
Help
Top Up Coverage
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Yes
During the 3 YEARS
prior to the date of this application, have you smoked cigarettes?
No
I am applying for the Annual Multi-trip Add-on
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*
Plan Type
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Preferred Plus
Preferred
Standard
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Deductible
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Select Plan Type!
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Age at Departure
Select Age
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 Plus
Single Trip Rate:
SUBTRACT
Special Main Season Discount (up to Jan. 7, 2007):
Subtotal:
ADD
Annual Multi-trip Add-on Rate
(if applicable)
:
Rate subtotal:
ADD
10% if taking a $0 Deductible:
Subtotal:
ADD
10% if you have smoked cigarettes in the 3 years prior to the date of this application:
ADD
$20 Top-Up fee
or SUBTRACT
Federal Superannuate Credit
(if applicable)
:
Total Premium:
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