Parents visiting USA 
Non-US Citizens visiting USA 
B1/B2 Visa Holders to the USA Plan Details
Administrator
ISC
Coverage Type
Fixed
Plan Underwriter
SPA
Policy Maximum & Deductibles
Maximum Limit per Period of Coverage
Option 1 : $25,000 per Insured Person, as indicated on the Declaration of Insurance
Option 2 : $50,000 per Insured Person, as indicated on the Declaration of Insurance
Option 3 : $75,000 per Insured Person, as indicated on the Declaration of Insurance
Pre-Existing Conditions
Pre-Existing Conditions
For Outpatient Services
Option 1 : $1,750
Option 2 : $2,500
Option 3 : $4,500
Out-Patient
Surgical Room and Supply Expenses
Option 1 : $950
Option 2 : $1,000
Option 3 : $1,050
X-rays, laboratory procedures
Option 1 : $275
Option 2 : $400
Option 3 : $525
Hospital Emergency Room
Option 1 : $275
Option 2 : $350
Option 3 : $425
Prescription Drug Expenses
Option 1 : $75
Option 2 : $100
Option 3 : $125
In-Patient
Room & Board Charges
Option 1 : $2,700
Option 2 : $3,900
Option 3 : $4,750
Doctor Surgical Expenses
Option 1 : $2,000
Option 2 : $3,000
Option 3 : $4,000
Travel Coverage
Emergency Medical Evacuation Benefit
$10,000 Maximum Limit per Period of Coverage. Must be approved in advance and coordinated by the Claims Administrator.
Repatriation of Remains Benefit
$15,000 Maximum Limit for return of the Insured Person’s Mortal Remains or ashes to Country of Residence or
$2,000 Maximum Limit per Insured Person for preparation, local burial or cremation of the Insured Person’s Mortal Remains at the place of death.
Must be approved in advance and coordinated by the Claims Administrator.
Additional Coverage Options
Accidental Death Principal Sum
Option 1 : $5,000 per Insured
Option 2 : $7,500 per Insured
Option 3 : $10,000 per Insured
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