Emergency Medical Insurance (Single -Trip  and Multi-Trip)

Eligibility

You can apply for this policy if you:

- Maintain Your permanent residence in Canada; and

- Are eligible for benefits under Your Provincial Government Health Insurance Plan; and

- Understand and speak either one of Canada’s official languages (English or French); and

- Meet all of the eligibility requirements outlined in your policy confirmation.

For age 60+, you are NOT eligible for coverage under this policy if:

1. You have been diagnosed with a Terminal Illness;

2. You have ever undergone a major organ transplant (heart, lung, liver, kidney or pancreas);

3. You have cancer for which You had chemotherapy (of any form, except cream) in the 6 months before the Departure Date;

4. You have a Medical Condition that, in the 24 months before the Departure Date, has required home oxygen or dialysis.

5. You require assistance with any activities of daily living (eating, dressing, personal hygiene);

6. Your Physician has recommended that You do not travel.

 

Age

• Travelers aged more than 3 months on the Departure Date are eligible for the Single Trip Plan.

• Travelers aged between 3 months and 85 years on the Effective Date can apply for the Annual Plan (Multi-Trip).

 

Single-Trip Plan

Provides coverage for a single trip outside your province of residence or Canada. This plan can be purchased to top up your insurance with Tour+Med and with other insurance providers.

 

Annual Multi-Trip Plan

The Annual Plan provides coverage for multiple Trips outside Your province of residence for a duration not exceeding the maximal duration option chosen on the application during the 12-month Policy Period. Choose from 8, 15, 30 - day multi-trip annual plans.

Individual Trips must be separated by a return to Your province of residence. You are not required to provide advance notice of the departure and return date of each Trip; however, You will be required to provide proof of Your Departure Date when filing a claim (e.g. Airline ticket or customs /immigration stamp.

The Annual Plan also provides coverage for unlimited travel within Canada but outside Your province of residence. However, if You are traveling both in and out of Canada within the same Trip, this plan will provide coverage during the maximum duration option chosen, beginning on the day You leave Your province of residence.

You must meet the policy eligibility criteria in Your application on each Departure Date.

 

Deductible

Traditional Deductible: The full amount of the deductible applies on a per Event basis.

Hospital Deductible: The full amount of the deductible applies as soon as an Event involves Your Hospitalization, visit to the emergency room of a Hospital, visit to internal or external Hospital clinic. The deductible also applies to land or air ambulance transportation.

You could choose to add a deductible of $250, $500, $1,000, $2,500, $5,000 or $10,000 in order to save between 5% and 35% on your premium. All deductibles are in Canadian dollars.

 

Family Plan

Can insure parents and up to 4 children on the same policy, for a single trip or on an annual basis. This plan is available for trips of 48 days and less, anywhere around the world. To be eligible, parents must be 59 years old or less, and children must be between 3 months and 21 years old on departure date, unmarried, and dependent of their parent for support.

 

Refunds

Non-departure (Full Refund):

a) On a Single Trip Plan, the request must be received prior to the policy Departure Date, otherwise it will be considered and administered as an early return request.

b) On an Annual Plan the request must be received before the Effective Date.

Early return (Partial Refund for the number of unused days):

a) No claim is either paid or pending.

b) No expense has been incurred by the Insurer for an Emergency return of the Insured Person and/or his/her Travel Companion to their province of residence.

c) The Insurer must receive the request for refund and supporting documentation (exhibiting the Insured Person’s name, the date and the location of the transaction*) within 30 days of returning to his/her province of residence.

*ex.: credit card statement, credit card receipt, written confirmation obtained at the border, plane ticket or boarding pass.

 

Policy Extensions

To extend the policy period, you must contact the insurer, or your representative, at least 5 days prior to the expiration date written on your policy. You will have to pay for the additional premium, if applicable. No extension request can be permitted after the expiration date of the initial policy.

Any condition for which you received treatments in the initial portion of your policy will automatically be excluded, beginning on the first day of your extension.

The Insurer reserves the right to grant or deny an extension of coverage, on a case-by-case basis.

 

Automatic  Extensions to Coverage

At the time the period of coverage ends, coverage will be automatically extended at no additional premium :

•   For up to 72 hours for a delay considered to be beyond the Insured Person's control (e.g. Accident, Vehicle breakdown).

•   For the remaining period of your hospital confinement plus 72 hours commencing upon your release from the hospital.

 

Summary of Emergency Medical Benefits

The overall amount of benefits payable is subject to a maximum of CAN $5,000,000 per Policy Period.

Key Benefits	Details
HOSPITAL / MEDICAL EXPENSES	Hospitalization in a semi-private room
PHYSICIANS’ FEES	Up to the limit deemed reasonable and customary for the area where the Treatment is provided.
MEDICAL APPLIANCES	Costs for the purchase of splints, casts, crutches, canes, slings, trusses, orthopaedic corsets or for the rental of walkers or wheel chairs, when prescribed by the attending Physician.
PRIVATE DUTY NURSING CARE	Up to a maximum of CAN $3,000 per Event and per Insured Person, subject to the EMERGENCY ASSISTANCE’s approval.
DIAGNOSTIC SERVICES	Laboratory tests and X-rays
PRESCRIPTION DRUGS FOR EMERGENCY TREATMENT	Cost of Medication(s) prescribed by a Physician following a covered medical Emergency. All eligible prescriptions are subject to a non refundable US $5 co-payment. Payment of the prescription will only be valid for the initial 30 days after the onset of an Emergency.
EMERGENCY DENTAL CARE	Treatment of an Injury from an Accidental blow to the mouth causing damage to natural and healthy teeth or for the Treatment of a fracture or dislocation of the jaw. Treatment must begin and end during the Policy Period. The maximum benefit payable is CAN $1,000 per Accident.
EYE TREATMENT	If surgery or laser Treatment is a medical Emergency, the first CAN $2,000 is covered at one hundred (100%) percent and the benefit shall be limited to fifty percent (50%) of the actual cost over that amount.
AMBULANCE SERVICES	The cost of local ambulance services to the nearest qualified medical facility in the case of an Emergency and for inter-Hospital transfers.
PARAMEDICAL FEES	Fifty percent (50%) of the cost of the services provided by a chiropractor, podiatrist or physiotherapist (including X-rays prescribed by these professionals), up to CAN $300.
ACCIDENTAL DEATH INSURANCE	CAN $25,000
The following services must be pre-approved and pre-arranged by the Emergency Assistance:
EMERGENCY TRANSPORTATION TO THE INSURED PERSON BEDSIDE	Round trip economy airfare will be reimbursed for one (1) Immediate Family member via the most direct route from Canada to the Hospital where the Insured Person has been a patient for no less than seven (7) consecutive days.
EMERGENCY AIR TRANSPORTATION	If medically necessary, the cost of transporting the Insured Person to his/her residence in Canada by means of air ambulance, stretcher, one-way economy airfare on a commercial airline, with or without the services of a medical attendant, as required under the circumstances.;
RETURN OF DECEASED	The reasonable and customary costs incurred for the preparation and transportation of the remains of the deceased Insured Person to his/her residence in Canada or cremation or burial at the place of death.
RETURN OF VEHICLE	Up to a maximum of CAN $2,000.
DELAYED RETURN EXPENSES	A maximum of CAN $150 per day, up to a maximum of CAN $1,000 per Insured Person, for costs of meals and accommodations, when the return portion of an insured Trip is delayed as the result of a medical Emergency, or the death of the Insured Person or his/her Immediate Family member.

 

Emergency Round Trip Benefit

This benefit does not apply to a Trip under an Annual Plan or Single Trip of less than 30 days.

This benefit will reimburse the unexpected and eligible costs incurred for air transportation for the following emergencies:

• Death or Hospitalization for a minimum period of 7 consecutive days, of a member of Your Immediate Family;

• Damages that result in Your principal residence becoming uninhabitable or Your place of business unusable.

Upon receipt of a claim form and supporting documentation, the Insurer will reimburse reasonable and customary expenses for one economy class plane ticket to the Insured Person’s province of residence, up to a maximum of CAN $1,500 per Insured Person during the Policy Period.

You are not eligible for this benefit:

• If, during the 6 months prior to Your Departure Date, the member of Your Immediate Family has been hospitalized or has been in a nursing home intended for patients with limitations requiring ongoing medical assistance (like a residential and long-term care centre (LTCH/CHSLD)) or has been diagnosed with a Terminal illness; or

• If, on the Departure Date, You were aware of circumstances which could force Your return at an earlier date than that anticipated at time of purchase.

 

Exclusions and Limitations. Travel medical insurance does not cover everything. This insurance has exclusions, conditions and limitations. Please learn them and understand the policy before you buy this insurance.

 

Pre-Existing Medical Condition Exclusion

Any conditions or Changes in Your health (except Minor Ailments) that have not been Stable and Controlled for:

- a period of three (3) months before the Departure Date for an Insured Person aged 3 months to 69 years, and

- for a period of six (6) months before the Departure Date for an Insured Person aged 70 and over,

unless specified otherwise in writing by the Insurer.

Exception: High blood pressure, diabetes, or cholesterol requires only 2 months of stability before the Departure Date.

 

“Stable and Controlled” means any medical condition (other than a Minor Ailment) for which all the following statements are true:

1. There has not been a new diagnosis, any new Treatment prescribed or recommended, or Change(s) to existing Treatment (including a stoppage in Treatment), and;

2. There has not been any Change to any existing prescribed Medication (including an increase, decrease, or stoppage to prescribed dosage), or any recommendation or starting of a new prescription Medication

(Exceptions the routine adjustment of Coumadin, Warfarin or insulin and the change from a brand name Medication to a generic brand Medication of the same dosage); and

3. There has not been any new, more frequent or more severe Symptoms, and;

4. There has not been any Hospitalization or referral to a specialist, and

5. There has not been any medical exam, investigative testing or test results showing deterioration; and

6. There has not been any Treatment recommended, planned or not yet completed, nor any outstanding test results.

 

Reduced Stability Period Option (Optional Coverage, if available)

By paying an additional premium, you can choose to reduce the period of stability mentioned above  to 30 days for a specific medical condition identified on your policy application.

 

Optional Exclusion Option (Optional Coverage, if available)

In exchange for a lower premium, you can choose the Optional Exclusion Option for any of the medical conditions mentioned in Your Personalized Medical Declaration.

 

Some Other Exclusions

This policy does not pay for expenses incurred directly or indirectly as a result of:

● Any medical service, procedure or Treatment not authorized by the EMERGENCY ASSISTANCE, or not considered to be an Emergency as defined in this policy and by the Medical Director of the EMERGENCY ASSISTANCE.

This includes but is not limited to blood tests (i.e., Coumadin), observation, exploratory and/or investigative tests or exams, experimental drugs, vaccines or preventive medicines, elective Treatments, cosmetic surgeries, MRI, check-ups, ear cleaning, cardiac catheterization, angioplasty, colonoscopy, endoscopy, biopsy, cystoscopy, surgery, and insertion, removal or adjustment of implants.

● Any Medical Condition or Symptoms for which it is reasonable to believe or expect that Treatments will be required during Your Trip.

● Any mental, psychiatric, psychological, psychotic or nervous disorder, including depression, anxiety and insomnia.

● The purchase or renewal of any Medication prescribed before the Departure Date, as well as any over-the-counter Medication.

● Any Accident, Injury or Sickness sustained during a Trip related to a remunerated activity or volunteer activity, or occupational duty if such activity or duty requires that You spend more than 14 days outside Canada in a year.

● The reason for which the Government of Canada (www.travel.gc.ca) issues a travel advisory to avoid all travel or to avoid all non-essential travel to a country, region or city, if the advisory is in effect on Your Departure Date. If the advisory is issued after Your Departure Date, We will grant You a 10-day period following issuance of the advisory to come back to Your province of residence, before the present exclusion becomes effective. It is Your responsibility to verify the status of Your destinations.

 Please refer to the policy wording for full list of exclusions. If you need assistance, please Contact us.

 

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NOTE: The product-related information is for illustration purpose only.

Please refer to the Policy Wording for details on the coverage provided, conditions, exclusion and claim procedure.

 

Get a free quote and buy Online

 

 

If you need help to complete the online application, or for the questions regarding your policy status, to make changes to your coverage or travel dates, to extend the policy, or purchase this policy over-the-phone, please call at 416-493-0101  (or 1-877-443-0101) or click here to ask your question online.   What to do if you need medical attention YOU MUST CALL THE EMERGENCY ASSISTANCE BEFORE OBTAINING ANY TREATMENT. Call toll free 1 844 820-6588 (USA & Canada), 1 888 820-6588 (elsewhere) or collect 1 819 377-2241. If You do not call the Emergency Assistance before receiving any Treatment, Your claim could be denied. If exceptional circumstances prevent You from calling the Emergency Assistance before obtaining any Treatment, You or the person accompanying You must call as soon as possible and provide proof of those exceptional circumstances.   You must accept the referral provided by the EMERGENCY ASSISTANCE. If You refuse the medical provider or Hospital referral, the Insurer reserves the right to limit the reimbursement of eligible medical expenses to the lesser of: - charges that would have been incurred within its network of medical providers; and - 70% of the eligible expenses incurred with an overall limit of CAN $25,000. The above limitations will also apply unless care is coordinated from the onset and involves the patient and/or family, the treating Physician and Emergency assistance for the full duration of the Treatment.   To apply for benefits under this policy, you will need to send a completed claim form (with all original bills attached) no later than 90 days after your return to your province of residence from your trip.

 

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