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Inbound Individual Online Enrollment

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1. Agreement
2. Choose a State
3. Find a Plan
4. Choose a Plan
5. Privacy Consent
6. Personal Data
7. Payment
8. Confirmation
AgreementI understand that in order to be eligible for this international student & scholar plan, all of the following statements about myself must be true:
  • I am not a permanent resident or citizen of the United States.
  • I am a visa holder or on OPT (J-1, F-1 or M-1).
  • I understand that medical expenses incurred outside of the United States are not covered by this plan.
  • I understand that medical expense(s) for any condition(s), which existed prior to the insurance start date will not be covered by this plan.
  • I certify that the personal information, which I will provide on the application that follows, will be truthful and accurate.

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Have a Question?

Email CISI

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(800) 303-8120

Premium Rates for Inbound Programs

Monthly premium
Age Basic Plan
up to 22 $88
23-30 $122
31-40 $155
41-50 $331
51-64 $441
65+ call CISI

Credit Card Number

Please provide your credit card number. We accept Visa, MasterCard and American Express.

Credit Card Expiration Date

Please indicate the expiration month and year of the credit card in the fields below.

Coverage Start Date

The earliest your coverage can begin is two days from now. Coverage start date must be on or after the program start date.

Coverage End Date

The last day on which you will need coverage. Coverage end date can not be greater than program end date plus one month.

Program Start Date

In this field please indicate the start date of your study abroad program and/or international, educational and cultural activity.

Program End Date

In this field please indicate the end date of your study abroad program and/or international, educational and cultural activity.

Why do we need your Birth Date?

Insurance cost is based on your age at the time your coverage starts.

Email Address

Please provide a valid email address to which we can send your confirmation policy materials.

Destination Country

Please note, this plan is only valid in the USA.