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For Blue Cross, the Family rate is equal to the "2 persons" rate. Please enter the ages of the
two oldest
adults.
Country Code
Abkhazia (+7) Afghanistan (+93) �land Islands (+1) Albania (+355) Algeria (+213) American Samoa (+685) Andorra (+376) Angola (+244) Anguilla (+1264) Antarctica (+1) Antigua and Barbuda (+1268) Argentina (+54) Armenia (+374) Aruba (+297) Australia (+61) Austria (+43) Azerbaijan (+994) Bahrain (+973) Bangladesh (+880) Barbados (+1246) Belarus (+375) Belgium (+32) Belize (+501) Benin (+229) Bermuda (+1441) Bhutan (+975) Bolivia (+591) Bosnia and Herzegovina (+387) Botswana (+267) Bouvet Island (+1) Brazil (+55) British Indian Ocean Territory (+1) British Virgin Islands (+1284) Brunei (+673) Bulgaria (+359) Burkina Faso (+226) Burma (+95) Burundi (+257) Cambodia (+855) Cameroon (+237) Canada (+1) Cape Verde (+238) Cayman Islands (+1345) Central African Republic (+236) Chad (+235) Chile (+56) China (+86) Christmas Island (+1) Clipperton Island (+1) Cocos (Keeling) Islands (+1) Colombia (+57) Comoros (+269) Cook Islands (+682) Costa Rica (+506) Cote d�Ivoire (+225) Croatia (+385) Cuba (+53) Cyprus (+357) Czech Rep. (+420) Democratic Republic of�the Congo (+243) Denmark (+45) Djibouti (+253) Dominica (+1767) Dominican Republic (+1829) Ecuador (+593) Egypt (+20) El Salvador (+503) Equatorial Guinea (+240) Eritrea (+291) Estonia (+372) Ethiopia (+251) Falkland Islands (Islas Malvinas) (+500) Faroe Islands (+298) Fiji (+679) Finland (+358) France (+33) French Guiana (+594) French Polynesia (+689) French Southern Lands (+1) Gabon (+241) Georgia (+995) Germany (+49) Ghana (+233) Gibraltar (+350) Greece (+30) Greenland (+299) Grenada (+1473) Guadeloupe (+590) Guam (+1671) Guatemala (+502) Guernsey (+1) Guinea (+224) Guinea-Bissau (+245) Guyana (+592) Haiti (+509) Heard Island and McDonald Islands (+1) Holy See (Vatican City) (+39) Honduras (+504) Hong Kong (+852) Hungary (+36) Iceland (+354) India (+91) Indonesia (+62) Iran (+98) Iraq (+964) Ireland (+353) Isle of Man (+1) Israel (+972) Italy (+39) Jamaica (+1876) Japan (+81) Jersey (+1) Jordan (+962) Kazakhstan (+7) Kenya (+254) Kiribati (+686) Korea, North (+850) Korea, South (+82) Kosovo (+381) Kuwait (+965) Laos (+856) Latvia (+371) Lebanon (+961) Lesotho (+266) Liberia (+231) Libya (+218) Liechtenstein (+423) Lithuania (+370) Luxembourg (+352) Macau (+853) Macedonia (+389) Madagascar (+261) Malawi (+265) Malaysia (+60) Maldives (+960) Mali (+223) Malta (+356) Marshall Islands (+692) Martinique (+596) Mauritania (+222) Mauritius (+230) Mayotte (+1) Mexico (+52) Micronesia, Federated States of (+691) Moldavia (+373) Monaco (+377) Mongolia (+976) Montenegro (+382) Montserrat (+1664) Morocco (+212) Mozambique (+258) Namibia (+264) Nauru (+674) Nepal (+977) Netherlands Antilles (+1) New Caledonia (+687) New Zealand (+64) Nicaragua (+505) Niger (+227) Nigeria (+234) Niue (+683) Norfolk Island (+672) Northern Mariana Islands (+1670) Norway (+47) Oman (+968) Pakistan (+92) Palau (+680) Panama (+507) Papua New Guinea (+675) Paraguay (+595) Peru (+51) Philippines (+63) Pitcairn (+1) Poland (+48) Portugal (+351) Puerto Rico (+1787) Qatar (+974) Republic of�the Congo (+242) Reunion (+262) Romania (+40) Russia (+7) Rwanda (+250) Saint Barth�lemy (+1) Saint Helena (+1) Saint Kitts and Nevis (+1869) Saint Lucia (+1758) Saint Martin (+1) Saint Pierre and Miquelon (+508) Saint Vincent and the Grenadines (+1784) Samoa (+685) San Marino (+378) Sao Tome and Principe (+239) Saudi Arabia (+966) Senegal (+221) Serbia (+381) Seychelles (+248) Sierra Leone (+232) Singapore (+65) Slovakia (+421) Solomon Islands (+677) Somalia (+252) South Africa (+27) South Georgia and the South Sandwich Islands (+1) Spain (+34) Sri Lanka (+94) Sudan (+249) Suriname (+597) Svalbard and Jan Mayen (+1) Swaziland (+268) Sweden (+46) Switzerland (+41) Syria (+963) Taiwan (+886) Tajikistan (+992) Tanzania (+255) Thailand (+66) The Bahamas (+1242) The Gambia (+220) Timor-Leste (+670) Togo (+228) Tokelau (+690) Tonga (+676) Trinidad and Tobago (+1868) Tunisia (+216) Turkey (+90) Turkmenistan (+993) Turks and Caicos Islands (+1649) Tuvalu (+688) Uganda (+256) Ukraine (+380) United Arab Emirates (+971) United Kingdom (+44) United States (+1) United States Pacific Island Wildlife Refuges (+1) Uruguay (+598) Uzbekistan (+998) Vanuatu (+678) Venezuela (+58) Vietnam (+84) Virgin Islands (+1340) Wallis and Futuna (+681) Western Sahara (+1) Yemen (+967) Zambia (+260) Zimbabwe (+263)
Country of Residence/Citizenship
Country...
Afghanistan
Aland islands
Albania
Algeria
American samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire/sint eustatius/saba
Bosnia and herzegowina
Botswana
Bouvet island
Brazil
British indian ocean territory
British virgin islands
Brunei darussalam
Bulgaria
Burkina faso
Burundi
Cambodia
Cameroon
Canada
Cape verde
Cayman islands
Central african republic
Chad
Chile
China
Christmas island
Cocos (keeling) islands
Colombia
Comoros
Congo
Congo - the democratic rep of
Cook islands
Costa rica
Cote d ivoire
Croatia (local name - hrvatska)
Cuba
Curacao
Cyprus
Czech republic
Denmark
Djibouti
Dominica
Dominican republic
Ecuador
Egypt
El salvador
Equatorial guinea
Eritrea
Estonia
Ethiopia
Falkland islands (malvinas)
Faroe islands
Fiji
Finland
France
French guiana
French polynesia
French southern territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-bissau
Guyana
Haiti
Heard and mc donald islands
Holy see (vatican city state)
Honduras
Hong kong
Hungary
Iceland
India
Indonesia
Iran (islamic republic of)
Iraq
Ireland
Isle of man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea - north
Korea - south
Kuwait
Kyrgyzstan
Lao peoples democratic republic
Latvia
Lebanon
Lesotho
Liberia
Libyan arab jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia - the frm yugoslav rep of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia - federated states of
Moldova - republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands antilles
New caledonia
New zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk island
Northern mariana islands
Norway
Oman
Pakistan
Palau
Palestinian territories
Panama
Papua new guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto rico
Qatar
Reunion
Romania
Russian federation
Rwanda
Saint barthelemy
Saint kitts and nevis
Saint lucia
Saint martin
Saint vincent and the grenadines
Samoa
San marino
Sao tome and principe
Saudi arabia
Senegal
Serbia
Seychelles
Sierra leone
Singapore
Sint maarten
Slovakia (slovak republic)
Slovenia
Solomon islands
Somalia
South africa
South georgia / south sandwich isl
South sudan
Spain
Sri lanka
St. helena
St. pierre and miquelon
Sudan
Suriname
Svalbard and jan mayen islands
Swaziland
Sweden
Switzerland
Syrian arab republic
Taiwan - province of china
Tajikistan
Tanzania - united republic of
Thailand
Timor-leste
Togo
Tokelau
Tonga
Trinidad and tobago
Tunisia
Turkey
Turkmenistan
Turks and caicos islands
Tuvalu
Uganda
Ukraine
United arab emirates
United kingdom
United states
Uruguay
Us minor outlying islands
Us virgin islands
Uzbekistan
Vanuatu
Venezuela
Viet nam
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Yemen
Zambia
Zimbabwe
Province or Territory
British Columbia
Alberta
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Manitoba
Ontario
Quebec
New Brunswick
Nova Scotia
P.E.I.
Newfoundland
Yukon
Northwest Territories
Nunavut
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Tourist/Visitor
New Immigrant
Foreign Worker
Returning Canadian
IEC/Working Holiday
International Student
Other
Your arrival date in Canada
Deductible
$0 $100 $500 $1000
$0 $100 $500 $1000
Coverage
$25000 $50000 $100000 $150000
$25000 $50000 $100000 $150000
Important Notice: Please, read the official explanation letter of
a GMS:
Monthly Payment Insurance Plan for Super Visa before you submit this application.
Click to view - Monthly Payment Plan Description.
×
Monthly payment explanation:
Premium (per month)
Administrative fee : CAD