Please select plan.
MultiCare
StudentCare
 
Personal Information
Please fill in the following
*Date of birth
Spouse’s date of birth
Number of children    
(Unmarried children under
the age of 21 who
reside with the
main subscriber)
Age of 1st child:
Age of 2nd child:
Age of 3rd child:
Age of 4th child:
Age of 5th child:
*required fields
 
Choice of Plan
Please select one of the following plans
Premiere: Annual limit €2.000.000
Value Plus: Annual limit €100.000 (€85 annual excess)
SmartStart: Annual limit €50.000
Choice of Level of Cover
Please select one of the following levels
Comprehensive Cover
• Covers the cost of in-patient and day care treatment as well as the cost for medical practitioners’ visits and prescription drugs.
Standard Cover
• Covers the cost of in-patient and day-care treatment.
 
Choice of Geographical Area of Cover
Please select one of the following areas
Area 1
• Worldwide cover.
Area 2
• Worldwide cover excluding USA, Canada and Switzerland.
Personal Information
Please fill in the following
*Date of birth
*required fields
 
Choice of Plan
Please select one of the following plans
No Excess
Annual Excess €85
Annual Excess €170
Choice of Level of Cover
Please select one of the following levels
Comprehensive Cover
• Covers the cost of in-patient and day care treatment as well as the cost for medical practitioners’ visits and prescription drugs.
Standard Cover
• Covers the cost of in-patient and day-care treatment.
 
Choice of Geographical Area of Cover
Please select one of the following areas
Area 1
• Worldwide cover.
Area 2
• Worldwide cover excluding USA, Canada and Switzerland.