Parents visiting USA 
Non-US Citizens visiting USA 
B1/B2 Visa Holders to the USA Plan Details
Administrator
INF Visitor Care
Coverage Type
Limited Or Fixed Benefits Coverage
Plan Underwriter
Tideview Risk, SPC
Plan Eligibility
Eligibility
All non-US citizen members ages 70 to 99 of the Policyholder who are traveling
to the United States, Canada or Mexico.
All non-US residents plan members ages 69 and under of the Policyholder who
are traveling outside of their Home.
Policy Maximum, Deductibles & Medical Coverage Limits
Maximum Period of Coverage
364 days
Total Maximum for all Accident or Sickness Expense Benefits:
Age 0-69 :
OPTION 1: $100,000
OPTION 2: $150,000
OPTION 3: $300,000
OPTION 4: $500,000
OPTION 5: $1,000,000
Age 70-99 : $100,000
Deductible options
Age 0-69 : $75, $100, $250, $500, $1,000, $2,500, or 5,000
Age 70-99 : $100, $250, $500, $1,000, $2,500, or $5,000
Coinsurance
100% of the Usual and Customary Charges
Pre-Existing Conditions
Pre-existing Conditions
Age 0-69:
For $100,000:
OPTION 1: $20,000 Maximum Benefit; Subject to a $1,000 Deductible
OPTION 2: $40,000 Maximum Benefit; Subject to a $5,000 Deductible
For $150,000:
OPTION 1: $30,000 Maximum Benefit; Subject to a $1,000 Deductible
OPTION 2: $60,000 Maximum Benefit; Subject to a $5,000 Deductible
For $300,000:
OPTION 1: $50,000 Maximum Benefit; Subject to a $1,000 Deductible
OPTION 2: $100,000 Maximum Benefit; Subject to a $5,000 Deductible
For $500,000:
OPTION 1: $150,000 Maximum Benefit; Subject to a $1,000 Deductible
OPTION 2: $200,000 Maximum Benefit; Subject to a $5,000 Deductible
For $1000,000:
OPTION 1: $150,000 Maximum Benefit; Subject to a $1,000 Deductible
OPTION 2: $200,000 Maximum Benefit; Subject to a $5,000 Deductible
Age 70-99:
OPTION 1: $15,000 Maximum Benefit; Subject to a $1,000 Deductible
OPTION 2: $25,000 Maximum Benefit; Subject to a $5,000 Deductible
Out-Patient
Surgical Room and Supply Expenses
Age 0-69 :
OPTION 1: Up to $1,100
OPTION 2: Up to $1,200
OPTION 3: Up to $1,800
OPTION 4: Up to $2,500
OPTION 5: Up to $3,500
Age 70-99 :
Up to $1,100
Doctor Surgical Expenses:
Age 0-69 :
OPTION 1: Up to $5,000
OPTION 2: Up to $6,000
OPTION 3: Up to $8,000
OPTION 4: Up to $10,000
OPTION 5: Up to $15,000
Age 70-99 :
Up to $5,000
X-rays, laboratory procedures
Age 0-69 :
OPTION 1: Up to $650
OPTION 2: Up to $750
OPTION 3: Up to $1,150
OPTION 4: Up to $1,500
OPTION 5: Up to $2,500
Age 70-99 :
Up to $650
Hospital Emergency Room
Age 0-69 :
OPTION 1: Up to $500
OPTION 2: Up to $750
OPTION 3: Up to $2,500
OPTION 4: Up to $3,500
OPTION 5: Up to $5,000
Age 70-99 :
Up to $500
Prescription Drug Expenses
Age 0-69 :
OPTION 1: Up to $150
OPTION 2: Up to $200
OPTION 3: Up to $300
OPTION 4: Up to $500
OPTION 5: Up to $750
Age 70-99 :
Up to $150
In-Patient
Room & Board Charges
Age 0-69 :
OPTION 1: Up to $1,750 per day to a maximum of 30 days
OPTION 2: Up to $1,900 per day to a maximum of 30 days
OPTION 3: Up to $3,000 per day to a maximum of 30 days
OPTION 4: Up to $4,500 per day to a maximum of 30 days
OPTION 5: Up to $6,000 per day to a maximum of 30 days
Age 70-99 :
Up to $1,750 per day to a maximum of 30 days
Doctor Surgical Expenses:
Age 0-69 :
OPTION 1: Up to $5,000
OPTION 2: Up to $6,000
OPTION 3: Up to $8,000
OPTION 4: Up to $10,000
OPTION 5: Up to $15,000
Age 70-99 :
Up to $5,000
Travel Coverage
Emergency Medical Evacuation Benefit
Age 0-69 :
OPTION 1: Up to $20,000
OPTION 2: Up to $25,000
OPTION 3: Up to $45,000
OPTION 4: Up to $65,000
OPTION 5: Up to $85,000
Age 70-99 :
Up to $20,000
Repatriation of Remains Benefit
Age 0-69 :
OPTION 1: Up to $15,000
OPTION 2: Up to $20,000
OPTION 3: Up to $30,000
OPTION 4: Up to $30,000
OPTION 5: Up to $30,000
Age 70-99 :
Up to $15,000
Trip Interruption Benefit
Age (0-69) : $1,000
Additional Coverage Options
Accidental Death and Dismemberment Benefit
$25,000
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