Parents visiting USA 
Non-US Citizens visiting USA 
B1/B2 Visa Holders to the USA Plan Details
Insurance Provider
International Medical Group (IMG)
Plan Underwriter
SiriusPoint Speciality Insurance Corporation
Plan Rating
A.M. Best Rating: A
Plan Category
Travel Medical Insurance
Plan Type
Comprehensive Coverage
PPO Network
United Healthcare PPO Network
Plan Eligibility
Eligibility
For non U.S. residents and non U.S. citizens, while traveling to the United States and for incidental trips to Canada, Mexico, Latin America, Bahamas and South America
Age for Coverage
14 days to 79 years
Coverage Duration
Minimum of 5 days to a maximum of 365 days
Extendable
Yes, up to 365 days
Policy Maximum, Deductibles & Medical Coverage Limits
Period of Coverage
5 days up to 12 months
Period of Coverage limit
Through age 64: $50,000, $100,000, $250,000
Ages 65 through 79: $50,000, $100,000
Deductible Options
Through Age 69: $100, $250, $500, $1,000, $2,500, or $5,000
per Insured Person, as indicated in the Declaration
Ages 70 through 79 when the $100,000 Period of Coverage
limit is elected: $1,000, $2,500, or $5,000 per Insured Person, as indicated on the Declaration
Coinsurance
In-Network: Plan pays 100% Insured pays 0%
Out-of-Network: Plan pays 80% Insured pays 20% (out-of-pocket maximum $1,000)
Pre-Existing Conditions
Acute Onset of Pre-Existing Conditions
Through age 69: up to the Period of Coverage limit
Except Cardiac Coverage for Angina, Heart Attacks and Stroke: Maximum Limit $36,000
Ages 70 through 79: Maximum Limit: $30,000
Except Cardiac Coverage for Angina, Heart Attacks and Stroke: Not covered
Emergency Coverage
Medical Expenses are limited to Usual, Reasonable and Customary
Maximum Limits per Period of Coverage unless otherwise stated
Emergency Local Ambulance
Subject to Deductible and Coinsurance
• Injury
• Illness resulting in an Inpatient Hospital admission
In-Network : Not Applicable
Out-of-Network : 80%
International : 100%
Emergency Medical Evacuation
• Independent of Maximum Limit per Period of Coverage
• Maximum Limit: $1,000,000
• Includes Pre-existing conditions
• Approved in advance and coordinated by the Company
In-Network : 100%
Out-of-Network : 100%
International : 100%
Emergency Reunion
Independent of Maximum Limit per Period of Coverage
• Maximum Limit: $100,000
• Maximum days: 15
• Maximum limit per day for reasonable and necessary travel costs, meals and accommodations: $200
• Approved in advance by the Company
In-Network : 100%
Out-of-Network : 100%
International : 100%
Out-Patient
Dr. / Physician Visit
In-Network: 100% up to policy maximum
Out-of-Network: 80% of first $5,000, 100% thereafter
Urgent Care
In-Network: $15 copay, 100% up to Policy Maximum
Out-of-Network: $15 copay, 80% of the first $5,000, 100% thereafter
Surgical Treatment
In-Network: 100% up to policy maximum
Out-of-Network: 80% of first $5,000, 100% thereafter
Lab & X-rays
In-Network: 100% up to policy maximum
Out-of-Network: 80% of first $5,000, 100% thereafter
In-Patient
Hospital Room
In-Network: 100% up to policy maximum
Out-of-Network: 80% of first $5,000, 100% thereafter
Surgical Treatment
In-Network: 100% up to policy maximum
Out-of-Network: 80% of first $5,000, 100% thereafter
Hospital Intensive Care Unit
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
Dental Coverage
Dental Treatment
Deductible per occurrence: $50
• Limit: $250
• Unexpected pain to natural teeth
In-Network: Not Applicable
Out-of-Network: 80%
International: 100%
Travel Coverage
Return of Remains
100% up to policy maximum
Trip Interruption
Up to $10,000
Additional Coverage Options
Limits per Period of Coverage unless otherwise stated.
Natural Disaster
Limit per day: $250
Maximum days: 5
In-Network: Not Applicable
Out-of-Network: 100%
International: 100%
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