Travel Health Insurance for Resident Physicians

THIS FORM IS FOR UNC RESIDENTS AND FELLOWS (for ACGME-accredited fellowships) ONLY. Residents are required to purchase GeoBlue International Travel and Emergency Health Insurance through UNC School of Medicine if their travel is related in any way to their medical training.

If you are traveling for leisure in a non-UNC/H role, you are NOT eligible for the GeoBlue UNC group plan. However, you can contact the insurance provider, GeoBlue, directly to inquire further.

Policy rates for GeoBlue are as follows:

Resident Full Coverage = $1.42 per day

All questions regarding Claims will go directly to GeoBlue’ s Customer Service:

Today's Date
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Date of Birth  
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Program Contact Information
Please enter the name, phone number, and email address of a contact (supervising physician preferred) located in the country you will be visiting.
Course Coverage
Beginning of Elective Period   "Elective" means the official organized experience (including direct travel to and from the elective). These dates should encompass everything that is not personal or extra tourist travel.
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End of Elective Period  
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Emergency Contact Information
Please enter the name of a person (family member, etc.) to contact in case of emergency.
Funding Sources
Were you funded for this experience?  

After submitting this form, you will receive an email within 5-10 days stating the amount of money you will need to pay for travel insurance. You will need to pay online. You will also need to sign and submit the Code of Conduct, Register your individual trip with the UNC Global Travel Registry, and register with the U.S. State Department. You will also receive an email giving you access to the GLBE999.MOD.1112 Sakai Site where you will find the two required modules and corresponding quizzes.