Secure Server Online Forms for Visitors Insurance
After Completing the membership form, proceed to STEP 2 to complete insurance form
Complete one of the following Insurance Enrollment Forms.
- ACE Network Comprehensive 80/20 Plan with or without Pre-ex Coverage-- Click to Enroll in ACE Network Plan
- ACE Premier Fixed Benefit Plan with Pre-ex Coverage--Click to Enroll in ACE Premier Plan
- AXIS Fixed Benefit Plan with Limited Pre-ex Coverage--Click to Enroll in AXIS Health Insurance Plan
- ACE Standard Fixed Benefit Plan--Click to Enroll in ACE Standard Plan
- IMG VisitorCare Fixed Benefit--Click to Enroll IMG VisitorCare
- IMG Platinum Visitor Health Insurance Plan--Click to Enroll in IMG Platinum Plan
ACE Claim Forms:
Insured must complete the first page of claim form (according to policy number) and file with Administrative Concepts, Inc. (ACI) directly or along with provider office. A notarized affidavit duly signed by visitor to authorize US person to discuss claim status/questions with Administrative Concepts, Inc. (ACI).
India Network Printable PDF Forms
No cancellation or refund is available on or after effective date of insurance.
India Network Foundation membership must be active in order to enroll. The $10 membership fee is not cancellable or refundable and is good for one year
Rates based on total days times Daily Rate. Daily Rate based on monthly premium divided by 30 days.
Couple rates are calculated based on the individual rate multiplied times 2 individuals.
The member’s date of birth and passport are requested entries during enrollment process. Medical records are not required.
Accident and Sickness coverage applies while visiting the US.
Call (407)243-8760 if you have questions regarding enrollment.