Order form - Asistur Insurance for Cuba

To book other Cuban Adventures' products, along with travel insurance, please click here.

  • Please fill out the form below with your insurance requirements.
  • No payment is required at this stage. We will respond to you within 2 working days with confirmation of your requirements and instructions for payment.
  • We accept payment with Visa, Mastercard, or bank transfer.
  • Once we have received payment, we will put your insurance in place and then within 48 hours, send you a printable certificate for the insurance by email.

Date of Arrival to Cuba

We require a minimum of 3 days to process insurance orders. We cannot process your order if you are due to arrive to Cuba in less than 3 days time.

Date of Departure from Cuba

Personal Details: (click to open section for each traveler)

Traveler #1

Traveler #2

Traveler #3

Traveler #4

Traveler #5

Traveler #6


Payment is required only after the reservation office respond to your order form. You will receive an email confirming the amount payable, detailing how to make payment, and a payment reference number.

Your preferred method of payment:

The value of your booking will be calculated in USD, if you prefer to pay in another currency, please select from the list below. We have a different set of published prices in each of USD, GBP, and EUR.

Preferred Currency for payment

We do not charge a fee for paying by credit card (Visa and Mastercard accepted), however your own bank may do so. If you pay by bank transfer, you are responsible for paying any associated bank fees for sending the payment.


Any other comments or questions:

Terms and Conditions

Asistur medical insurance is non-refundable.
Please select this box to agree with this condition of purchase and to confirm you accept the General Conditions of the policy.