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Enrolling into a health plan with Integra Global is easy. It just involves choosing your health plan and options, filling out your Personal Details, answering our Medical Questionnaire, enrolling the dependents that you want covered under your Plan and agreeing to our Terms. It doesn’t take more than 5-10 minutes of your time.

You will be guided step by step through the process and you can chart your progress by looking at the guide below.

Step 1 — Primary Insured Details
Step 2 — Primary Insured Medical History
Step 3 — Dependent Details
Step 4 — Dependent Medical History
Step 5 — Coverage Summary
Step 6 — Declaration
Step 7 — Confirmation

Please note: Fields marked with * need to be filled out


Contact
Title:
* Firstname:
Middlename:
* Lastname:
* Job Title/Position
* Email 1
Email 2
* Phone
* Mobile Phone
	Please enter at least one phone number.
Fax:
Corresponding Mailing Address
Company
* Street
Street
* Zip Code
* City
State
	if applicable
* Country

Country of assignment address

Same as mailing address above

Company
	Only required if different from mailing address above.
Street
Street
Zip Code
City
State
	if applicable
Country

Nationality and Residence
Passport Number:
Passport Country of Issuance:
* Citizenship
	Please note: Our Health Plans are available to US and non-US citizens who live outside the US and Canada.
Personal Details
* Date of birth:
* Sex:	male female inter
* Height
* Weight
Coverage details
* Choose your plan:
* Choose your currency:
* What deductible would you like:
*Coverage requested:	Worldwide coverage NOT including US/Canada
Cover Options:	Dental
Cover Options:	AD&D Benefit
*Payment Options:	Quarterly Semi-annual Annual
	Please note that there is a 10% surcharge for quarterly payments and a 5% surcharge for semi-annual payments included in quarterly and semi-annual rates.
*Your required subscription address:	It's not what it says in the label.

Please note: Fields marked with * need to be filled out

Whether you choose to enroll in a medical insurance overseas plan or not, Integra Global respects your privacy. Your personal information given here will be used to provide customer service for an international health insurance quote or plan enrollment only. We will not share your information with any outside persons, organizations or companies. The medical information given will only be used to evaluate your eligibility for Integra Global's expatriate medical insurance.

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Contact

Corresponding Mailing Address

Country of assignment address

Nationality and Residence

Personal Details

Coverage details

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Integra Global

For Members