LRFA
Latvian Relief Fund of America, Inc.

Mutual assistance and trust since 1952
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Medicare Supplemental
Health Care
Prescription Drug Plan
Supplemental Health Care
Emergency Plan
 for Visitors
International Travel
Mortuary Benefits

Emergency Accident & Health Benefit Plan for Visitors from Abroad

Monthly Fees

MONTHLY PAYMENTS FOR 2012
Age Benefit Plan A Benefit Plan B
18 - 29 $44.00 $58.00
30 - 39 $54.00 $73.00
40 - 49 $64.00 $88.00
50 - 59 $84.00 $118.00
60 - 64 $124.00 $178.00
65 - 69 $154.00 $223.00
70 - 79 $194.00 $287.00
80+ $254.00 $373.00
  Dependent child under 18 years of age:
  $24.00 $29.00
  Dependent child under 18 years of age traveling alone:
  $44.00 $52.00

To Enroll:

Please complete the application form LRFA, Inc. Emergency Accident & Health Benefit Plan For Visitors From Abroad PDF and return it with your payment for coverage to LRFA.

These pages are designed to provide general descriptions of our benefit plans and further restrictions may apply or may have changed. For further information, please contact the LRFA office or refer to specific plan Regulations.

 

© 2010 LRFA   -   P.O. Box 8857, Elkins Park, PA 19027-0857   -   lrfa @ lrfa.org

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