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 traveling internationally, including the USA
For U.S citizens living abroad and visiting the USA for a short trip
Age for Coverage
14 days to 99 years
Coverage Duration
Minimum of 5 days to a maximum of 365 days
Extendable
Yes, up to 365 days
Purchase Restrictions
Purchase Restrictions
Not available if Home Country/Country of Residences are: Botswana (BWA), Cuba (CUB), Gambia (GMB), Ghana (GHA), Iran (IRN), Kosovo (XKX), Niger (NER), Nigeria (NGA), North Korea (PRK), Puerto Rico (PRI), Sierra Leone (SLE), Syria (SYR), United States (USA), Venezuela (VEN) & Virgin Islands (USA) (VIR)
Not available for Citizens of: Botswana (BWA), Gambia (GMB), Ghana (GHA), Kosovo (XKX), Niger (NER), Nigeria (NGA) & Sierra Leone (SLE)
Not Available for Purchase from the Following U.S. States/Territories: Maryland (MD) & New York (NY)
Note: These U.S state restrictions are only applicable for purchase. The policy will still cover travelers visiting and temporarily staying in these U.S states
Not available to individuals who non U.S citizens residing in the states of: Maryland (MD)
Note: These U.S state restrictions are only applicable for purchase. The policy will still cover travelers visiting and temporarily staying in these U.S states
Policy Maximum, Deductibles & Medical Coverage Limits
Period of Coverage
5 days up to 12 months
Period of Coverage limit
• Through age 69: $50,000, $100,000, $500,000 or $1,000,000
• Ages 70 to 79: $50,000
• Ages 80 and older: $10,000
Deductible Options
$0, $100, $250, $500, $1,000 or $2,500 per Insured Person, as indicated on the Declaration
Coinsurance (In-Network)
100% up to the maximum limit
Coinsurance (Out-of-Network)
80% up to $5,000, then 100%
Emergency Coverage
Ambulance Expenses
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter
Emergency Room(ER)
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter
Separate deductible of $250 applies to ER visit for illness that does not result in direct inpatient hospital admission
Out-Patient
Dr. / Physician Visit
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter, up to policy maximum
Urgent Care
$25 co-pay applies for Urgent Care
$15 co-pay applies to walk in clinics
Co-pay waived if $0 deductible is chosen
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter
Surgical Treatment
In-Network: 100% covered by insurance up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter, up to policy maximum
Prescription Drugs / Medicines
Up to policy maximum
Lab & X-rays
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter up to policy maximum
Physical Therapy
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter up to policy maximum
In-Patient
Hospital Room
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter up to the policy maximum
Surgical Treatment
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000.
100% covered thereafter
Hospital Intensive Care Unit
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter
Dental Coverage
Unexpected Pain Or Treatment Due To An Accident
Up to $300
Traumatic Dental Injury
In-Network: 100% covered up to policy maximum
Out-of-Network: 80% covered for first $5,000
100% covered thereafter
Travel Coverage
Emergency Medical Evacuation / Repatriation
Up to $1,000,000
Return of Remains
Up to the period of coverage limit for return of mortal remains to the insured’s home country or up to $5,000 for the preparation, local burial and cremation of your mortal remains at the place of death
Emergency Reunion
Up to $100,000. Not subject to deductible but must be approved beforehand
Return of minor Child(ren)
Up to $100,000. Not subject to deductible but must be approved beforehand
Return Travel
Up to $10,000
Loss of checked Baggage
$50 per item up to $500 maximum per period of coverage
Additional Coverage Options
Terrorism Coverage
Up to $50,000 Maximum Limit
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