I got this card for my daughter who lives in Canada. No restrictions on who can get them - it's just a re-loadable card. Not a debit card at POS (no fee). Holder can withdraw up to $200 per 7-day period in local currency from AMEX-branded ATMS; bank fees and AMEX charge of $1.50 apply. Currency conversion charge of 2.5% applies for all transactions outside of US. I have rarely encountered a situation in which I wanted to get something and couldn't use AMEX. If you are committed to a particular store or restaurant that doesn't take AMEX, then you have a problem. I just go elsewhere. Worldwide acceptance in Europe/Asia/Australia is not significantly different than MC/Visas - certainly better than JBC, Discover or Diners. Can't comment on Latin America but daughter will soon be in Peru so I'll know more soon.