Quote


Requesting a personalised health cover quote couldn't be simpler.


After filling in the form below (note that fields denoted by an * are required), a member of our Health Insurance team will be in touch directly with a tailored health plan, covering you and any dependants you may choose to add to your policy.

Primary Beneficiary Details

Title(*)
Invalid Input

First Name(*)
Invalid Input

Surname(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

ID Card / Passport Number(*)
Invalid Input

Email Address(*)
Invalid Input

Telephone Number(*)
Invalid Input

I prefer to be contacted via(*)
Invalid Input

I prefer to be contacted in the:(*)
Invalid Input

Would you like to add dependants to your plan?
Invalid Input


Dependants

Enter details of additional persons covered by the same insurance plan

Dependant #1
Name and Surname(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

Add 2nd Dependant?
Invalid Input


Dependant #2
Name and Surname(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

Add 3rd Dependant?
Invalid Input


Dependant #3
Name and Surname(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

Add 4th Dependant?
Invalid Input


Dependant #4
Name and Surname(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input

Add 5th Dependant?
Invalid Input


Dependant #5
Name and Surname(*)
Invalid Input

Date of Birth(*)
/ / Invalid Input


Health Insurance Plans

Will you be residing in Malta for at least 6 out of the following 12 months?(*)
Invalid Input

Is the policy required for visa/residency permit purpose?(*)
Invalid Input

Quote required for the following health plan/s(*)

Invalid Input

Quote required for:(*)

Invalid Input

Preferred Payment Frequency(*)
Invalid Input

Security Code(*)
Security Code
  RefreshInvalid Input

Share This Page

Talk to us about your options

 

Call us today on: 21 342 342

We are here for you Monday to Friday 8am to 5pm.



Get in touch via email

Contact our client assistance team with your query or request a callback from one of our health insurance specialists.
GLOBALCAPITAL HEALTH INSURANCE AGENCY

GlobalCapital Health Insurance Agency Limited acts as an insurance agent and is regulated by the Malta Financial Services Authority (MFSA). Registered address: GlobalCapital Health Insurance Agency Limited, Testaferrata Street, Ta’ Xbiex XBX 1403, Malta.

id trans

© 2014 Bupa Malta / GlobalCapital Health Insurance Agency Ltd