Medical Insurance for Canadians Working or Living Abroad

Key Features

Insurance start date

This policy takes effect on the effective date as specified on the confirmation of coverage and remains in force for the period for which premium has been paid.

Summary of Benefits

Hospital

When, by reason of injury or sickness, an insured person is hospitalized, the insurer will pay the reasonable and customary costs per insured person per injury or sickness for room and board charges (up to semi-private room accommodation), including the costs relating to physicians, surgeons, diagnostic services, nursing, operating room, laboratory tests, prescription drugs, dressings, medical appliances and any other necessary costs charged by the hospital for in-patient hospital services, as well as costs incurred in an intensive care unit.

Nursing at Home

The reasonable and customary costs for the medical services of a licensed nurse in the insured person’s home when prescribed by a physician or surgeon and related directly to a medical condition for which the insured person has received or is receiving medical treatment covered under this policy. This benefit is available for up to twelve (12) weeks to a maximum limit of $10,000 CAD. The nurse cannot be an immediate family member or currently be residing with the insured person.

Out-Patient Services

Out-patient Services which are payable for care of the insured person outside a hospital shall be limited to a maximum amount of $10,000 CAD per insured person per injury or sickness.

The insurer will pay the reasonable and customary costs incurred for the following:

1. Physician or surgeon’s service fees.

2. Diagnostic services such as but not limited to laboratory tests and x-ray services, radiographs and nuclear medicine procedures used to diagnose and treat medical conditions. Laboratory and x-ray services must be provided by or ordered by a physician or surgeon. This policy does not cover Magnetic Resonance Imaging (MRI), cardiac catheterization, Computerized Axial Tomography (CAT) scans, sonograms or ultrasounds and biopsies unless such services are pre-authorized by Assistance Centre.

3. Drugs, medicine, serums and vaccines obtainable only upon a written prescription and dispensed by a pharmacist, physician or surgeon.

4. Rental (or purchase, at the option of the insurer) of braces, crutches, wheelchair, hospital-type bed, iron lung, or other approved durable equipment for temporary therapeutic use.

5. Blood or blood plasma (includes the administration of blood).

6. Charges for splints, trusses, casts and cast materials.

Paramedical / Professional Services

The services of a chiropractor, physiotherapist, osteopath, podiatrist or acupuncturist up to a maximum of $500 CAD per profession, per injury or sickness.

Ambulance Transportation

Charges for necessary licensed ground ambulance transportation to the nearest hospital, or from one hospital to another.

Emergency Dental Treatment

When an accidental blow to the mouth or face results in injury to an insured person, the insurer will pay for the emergency dental treatment necessary to restore or replace permanently attached artificial teeth or sound natural teeth lost or damaged in an accident, for which dental treatment is initiated within forty eight (48) hours following an accident and completed within the policy period.

All indemnity payable for emergency dental treatment is subject to a maximum amount of $5,000 CAD per insured person, per injury.

Repatriation or Local Burial

Up to $10,000 for preparation and transportation of the remains to Canada, or for cremation or burial at the place of death.

Emergency Medical Evacuation

When, by reason of injury or sickness, it is deemed medically necessary to evacuate an insured person who has a critical medical condition to the nearest hospital equipped to provide appropriate care and facilities, the insurer will reimburse the reasonable and customary costs per insured person per injury or sickness for emergency medical evacuation and medical care to such hospital.

Available when approved by the Assistance Centre.

Compassionate Emergency Travel

When approved by the Assistance Centre, roundtrip economy airfare and up to $150 per day to a maximum of $3,000 for a person of your choice to be by your bedside when hospitalized.

Complicated Maternity

When an insured person is hospitalized due to a pregnancy diagnosed as complicated by a specialist, physician or surgeon, the insurer will pay the reasonable and customary costs for hospital and medical expenses incurred for pre-natal care, childbirth and post-natal care treatment subject to a maximum of $5,000 CAD per insured person, per injury or sickness.

This benefit is only payable when the expected date of birth is at least ten (10) months after the effective date of coverage of the insured person.

Emergency Coverage in the United States

Available with Worldwide – All Countries excluding USA, coverage up to 14 days per trip.

Parent Accompanying Child

When an insured person under fifteen (15) years of age is hospitalized as an in-patient, the insurer will pay the reasonable and customary costs per insured person per injury or sickness charged by the hospital for one parent to stay with the child. Furthermore, if an insured person who is a single parent is confined to a hospital as an in-patient, the insurer will pay the reasonable and customary costs for a dependent child under fifteen (15) to stay with the insured person.

Exclusions and Limitations

Travel medical insurance does not cover everything!

This insurance has exclusions, conditions and limitations.

Refer to policy wording for a complete list of Limitations and Exclusions!

Pre-existing Medical Condition

This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by any condition (except for a minor ailment) for which the insured person has sought or received medical treatment, advice, follow-up visits, counseling, or has taken prescription drugs within one hundred and eighty (180) days prior to becoming insured under this policy. Such condition shall be covered when subsequently a continuous period of not less than three hundred and sixty-five (365) consecutive days has passed during which time the insured person has not sought or received medical treatment, advice, follow-up visits, counseling, nor has taken prescription drugs related to such condition.

Some other Exclusions:

An accident that occurs while you are participating in:

• any sports as a professional athlete (person who engages in an activity as one’s main paid occupation),

• any competition, speed event or other high-risk activity involving the use of a motor vehicle on land, water or air, including training activities, whether on approved tracks or elsewhere (an organized activity of a competitive nature in which speed is a determining factor in the outcome of the event),

• scuba diving (unless you hold a basic SCUBA designation from a Canadian certified school),

• mountaineering which involves the ascent or descent of a mountain requiring the use of specialized equipment, including crampons, pickaxes, anchors, bolts, carabiners and lead or top-rope anchoring equipment,

• a flight accident (unless you are travelling as a fare paying passenger on a commercial airline),

• hang-gliding, paragliding,

• skydiving, parachuting,

• any form of BASE jumping (ie: wingsuit flying),

• rock climbing,

• bungee jumping.

If you have questions about this coverage, want to purchase a policy or extend the policy, please, call at 416-493-0101, 1-877-443-0101 or ask your question online.