Parents visiting USA 
International Students 
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
Eligible for Student Visa holders who do not have specific health insurance requirements to meet
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
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
Policy Maximum, Deductibles & Medical Coverage Limits
Period of Coverage
5 days up to 12 months
Period of Coverage limit
Through age 64: $2,000,000, $5,000,000 or $8,000,000
• Ages 65 to 69: $1,000,000
• Ages 70 to 79: $100,000
• Ages 80 and older: $20,000
Deductible Options
$0, $100, $250, $500, $1,000, $2,500, $5,000, $10,000 or $25,000 per
Insured Person, as indicated on the Declaration
Pre-Existing Conditions
Acute Onset of Pre-existing Conditions
United States citizens:
• Age 64 and under without a Primary Health Plan:
Maximum Limit: $20,000
• Age 64 and under with a Primary Health Plan:
Maximum Limit: $1,000,000
• Age 65 through age 69:
Maximum Limit: $2,500
Non-United States citizens:
• Age 69 and under:
Maximum Limit: $1,000,000
Emergency Coverage
Emergency Local Ambulance
In Network 100%, Out-of-Network 90%
Subject to Deductible and Coinsurance
• Injury
• Illness resulting in an Inpatient Hospital
admission
Hospital Emergency Room:
In-Network: 100%
Out-of-Network: 90%
Separate deductible of $250 applies to ER visit for illness that does not result in direct inpatient hospital admission
Out-Patient
Urgent Care
$25 co-pay applies for Urgent Care
Co-pay waived if $0 deductible is chosen
In-Network: 100%
Out-of-Network: 90%
Surgical Treatment
In-Network: 100%
Out-of-Network: The plan pays 90%
Prescription Drugs / Medicines
Up to policy maximum
Lab & X-rays
In-Network: 100%
Out-of-Network: 90%
Physical Therapy
In-Network: 100%
Out-of-Network: 90%
In-Patient
Hospital Room
Average semi-private room rate up to the maximum limit. Includes nursing service
Hospital Intensive Care Unit
In-Network: 100%
Out-of-Network: 90%
Dental Coverage
Unexpected pain or Treatment due to an Accident
$300 maximum limit. Subject to deductible and coinsurance
Travel Coverage
Emergency Medical Evacuation
In-Network 100%, Out-of-Network 100%. covered up to the period of coverage limit
Return of Remains
Coverage up to a maximum of $50,000 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
Maximum Limit $100,000
Return of minor Child(ren)
Maximum Limit $100,000
Return Travel
Up to $10,000
Loss of checked Baggage
$50 per item up to $500 maximum limit
Additional Coverage Options
Maternity
Not covered
Terrorism Coverage
Maximum Limit $50,000
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