Will Travel Medical Insurance Cover Your Pre-Existing Condition?

Canadian travel medical insurance may cover the majority of pre-existing medical conditions should an unforeseen health issue related to a pre-existing condition occurs during your trip. There are various options available from different travel insurance providers to meet the insurance needs of most travelers.

On this page, you can find information about travel insurance plans with coverage for pre-existing medical conditions from various Canadian travel insurance providers (Manulife, Allianz, TuGo, Destination, and more), request a personalized quote, and select the plan that best suits your health insurance needs.

Pre-existing medical condition is defined as any disease, sickness or injury (including symptoms of undiagnosed conditions), other than a minor ailment, that exists before your policy effective date. Common pre-existing conditions may include high blood pressure, diabetes, heart or lung conditions, among others.

Stability Requirements

To determine if your pre-existing condition is covered, you need to consider the stability requirements stated in the policy. Most travel insurance policies require the pre-existing condition to be STABLE for a specified period before the policy effective date or your departure date.

Important! Your condition must be STABLE as it is defined in the policy. If your doctor told you that you were fit to travel, it does  not mean that your pre-existing medical condition would be covered. Learn a definition of STABLE underlined in the policy you are applying for.

Stability periods can vary, ranging from 7 days to 365 days, depending on the insurance policy.

So, you can select a plan with stability requirements that align with your health situation.

The following are typically not considered as changes:

1. Diabetic Insulin users - Routine insulin adjustment not prescribed by your physician, as long as insulin was not first prescribed during your stability period,

2. Coumadin, Warfarin users - Routine adjustment of these medications, as long as Coumadin or Warfarin were not first prescribed during your stability period,

3. A change from a brand name medication to a generic medication of the same dosage.

Canadian travel medical insurance policies do not provide coverage for any medical condition (including symptoms) under investigation, awaiting surgery or further treatment, or scheduled for surgery or hospitalization but not completed on the departure date. This includes investigative or diagnostic tests for which results had not yet been received at the time of departure.

Unstable Pre-existing Conditions

If your condition does not meet the 7-day stability requirements, which makes it unstable in terms of regular travel insurance policy, an Individual Medically Underwriting plan may be a viable solution. This plan doesn't have stability requirements for pre-existing conditions, but eligibility criteria must be met, and a detailed medical questionnaire is mandatory.

Excluded Pre-existing Conditions

If your pre-existing condition meets the stability requirements, you are covered for any related medical issues that may arise unexpectedly during your trip, according to terms, conditions and exclusions of the policy. However, some insurance plans may exclude certain medical conditions from coverage, and it's also important to review and understand other limitations or exclusions related to pre-existing conditions stated in the policy.

Eligibility Requirements

You can purchase the policy, if you meet the eligibility requirements stated in the policy. However, some travel insurance plans may have eligibility requirements that involve health-related inquiries, and certain medical conditions could make you ineligible for purchasing these plans. Ensure that you meet the eligibility criteria for the chosen insurance plan before proceeding with the purchase.

Stability Periods for Travelers under 60

For travelers under 60 years of of age, most travel medical insurance plans require a 90-day stability period for coverage for pre-existing medical conditions.

However, shorter stability periods with amount of coverage up to the policy limit are offered by the following plans:

● TuGo Traveller Travel Insurance

Offers a 7-day stability period for pre-existing condition coverage if your trip duration does not exceed 35 days.

●  True Escape and True Senior Guide Plans

Require a 45-day  stability period before your departure date, with an option for a 7-day stability period at an additional cost.

●  Travelance Travel Insurance 

Stability period for coverage for pre-existing medical conditions is  60 days before the policy effective date.

Stability Periods for Travelers 60+ Years Old

Standard Stability Period for pre-existing medical conditions required under most travel medical insurance plans may be:

90 days (3 months), 150 days,180 days (6 months), or 365 days.

When Travel medical insurance for snowbirds and seniors includes a medical questionnaire on the application, and stability period may depend the plan you qualify for and your medical history, based on your information on this questionnaire.

Travel Medical Insurance Plans with Reduced Stability Period Options

If your medical condition does not meet the regular stability period stated in the policy, you can consider travel medical insurance policies that offer a 7-day or 30-day Reduced Stability Period options.

●  True Escape and True Senior Guard Travel Medical insurance plans

You can choose the option with reduced stability period of 7 days at an additional cost, coverage is up to $5,000,000.

●  Tour+Med Travel Medical Insurance :

Provides coverage for high blood pressure, cholesterol, or diabetes,  which have been stable within 2 months  before departure .

Optional Reduced Stability Period Rider: By paying an additional premium, you can choose to reduce the period of stability to 30 days for a specific medical condition identified on your policy application.

Total amount of coverage is $5,000,000

There is also the Optional Exclusion Option: In exchange for a lower premium, you may choose the Optional Exclusion Option  for the medical conditions mentioned in your Personalized Medical Declaration.

●  TuGo Traveller

For age 60+, the 7-day Reduced Stability Period Rider is available for unstable pre-existing medical conditions  that do not meet the regular stability period stated in this policy . Amount of coverage for a pre-existing medical condition that has been stable within 7 days before departure is $300,000.

●  Destination Snowbird  Plans

You may qualify for 30-day, 90-day or 180-day reduced stability period for your pre-existing medical condition, depending on the plan you are eligible for based on your answers to medical questions on the application. Amount of coverage for a pre-existing medical condition that has been stable within a reduced stability period is up to $150,000.

Individual Medically Underwriting Plan

If you have been denied coverage and/or have unstable pre-existing medical conditions, you may be eligible for the Individual Medically Underwriting Plan underwritten by Manulife  (no age limit).

It is emergency medical insurance that covers fully disclosed pre-existing conditions without stability requirements, and the cost of your insurance is based on your own specific health situation. ALL medical conditions must be declared, including any that have in the last 5 years been diagnosed or a traveler has received treatment and/or taken medication for.

If the eligibility requirements are met, all declared conditions will be covered during the trip.

Please call at 1-877-443-0101 for more information.

NOTE: Travel insurance does not provide coverage for regular medications and procedures the insured uses to maintain his/her pre-existing condition stable.

Explore How Various Travel Medical Insurance Policies

Cover Pre-existing Medical Conditions

► Allianz Global Assistance Emergency Medical Plan

Pre-existing Condition Exclusion

a) If you are age 64 or under, stability period for pre-existing medical conditions is 90 days immediately before the effective date.

b) If you are age 65 or over, stability period is 150 days immediately before the effective date.

To be considered STABLE during your stability period, your pre-existing medical condition or related conditions must not have resulted in any of the following:

a) New treatment (including new prescriptions),

b) Change in treatment including frequency, dosage dosage (increase / decrease, stopping, new) or type (including prescriptions),

c) Signs or symptoms,

d) A new diagnosis,

e) Test results showing your condition is worsening,

f) Hospitalization,

g) A referral to a specialist, received or recommended, or

h) Waiting for any test results, further investigation, or surgery.

The following are considered stable:

1. Diabetic Insulin users - Routine insulin adjustment not prescribed by your physician, as long as insulin was not first prescribed during your stability period,

2. Coumadin, Warfarin users - Routine adjustment of these medications, as long as Coumadin or Warfarin were not first prescribed during your stability period,

3. A change from a brand name medication to a generic medication, 

4. Minor Ailments - a sickness or injury that ended more than 30 days prior to your effective date and did not require:

- treatment (including prescriptions) for more than 30 consecutive days, or

- more than one (1) follow-up with a physician.

Exclusions: the following medical conditions are not covered:

● Pre-existing medical conditions that do not meet your stability period.

● An unrepaired aneurysm 4 cm or greater, measured in either length or diameter, diagnosed at any time before the effective date.

● Any heart condition if you used or were prescribed nitroglycerin in the 90 days before the effective date.

● Any heart condition if you were diagnosed with, received treatment for, or had an episode of congestive heart failure in the two (2) years before the effective date.

● Any kidney condition that required dialysis in the 90 days before the effective date.

● Any lung/respiratory condition if you used or were prescribed home oxygen or oral steroids (inhalers are not considered oral steroids) for a lung/respiratory condition in the 90 days before the effective date.

● Any cancer if you had any cancer treatment (other than for basal or squamous cell skin cancer or breast cancer treated only with hormone therapy) in the 90 days before the effective date.

● Any bone marrow, stem cell, or organ transplant (excluding skin or cornea) received or recommended in the two (2) years before the effective date.

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► Destination Snowbird Plan  (underwritten by Manulife Financial)

Pre-existing Medical condition exclusion:

Automatic Stability period

(i) If you qualify for the Premier Plan (based on your medical questionnaire):

Benefits are not payable for costs incurred due to any pre-existing medical condition or related condition (other than a minor condition) that was not stable at any time during the 90 days prior to the policy effective date.

 (ii) If you qualify for the Ultra Preferred Plan (based on your medical questionnaire):

Benefits are not payable for costs incurred due to any pre-existing medical condition or related condition (other than a minor condition) that was not stable at any time during the 180 days (90 days for high blood pressure) prior to the policy effective date.

(iii) If you qualify for the Super Preferred Plan or Elite Preferred Plan (based on your medical questionnaire):

Benefits are not payable for costs incurred due to any pre-existing medical condition or related condition (other than a minor condition) that was not stable at any time during the 365 days (90 days for high blood pressure) prior to the policy effective date.

Reduced Stability Period Option

(i) If you qualify for the Premier Plan:

If you selected the Reduced Stability Period Option coverage is limited to $150,000 for eligible expenses incurred due to or resulting from your medical condition or related condition, other than a minor condition, that was stable for more than 30 days but less than 90 days.

(ii) If you qualify for the Ultra Preferred Plan:

If you selected the Reduced Stability Period Option coverage is limited to $150,000 for eligible expenses incurred due to or resulting from your medical condition or related condition, other than a minor condition, that was stable for more than 30 days but less than 180 days.

(iii) If you qualify for the Super Preferred Plan or Elite Preferred Plan:

If you selected the Reduced Stability Period Option coverage is limited to $150,000 for eligible expenses incurred due to or resulting from your medical condition or related condition, other than a minor condition, that was stable for more than:

Option 1: 90 days but less than 365 days; or

Option 2: 180 days but less than 365 days.

Stable: describes all medical conditions for which:

a) there has been no new treatment; and

b) there has been no alteration in any medication for the condition or in its usage or in its dosage, nor any alteration in treatment prescribed or recommended by a physician; and

c) there has been no signs or symptoms or new diagnosis; and

d) there has been no test results showing deterioration; and

e) there has been no hospitalization; and

f) there has been no referral to a specialist (made or recommended), and you are not awaiting the results of further investigations performed by any medical professional.

The following are considered stable:

a) Routine (not prescribed by a physician) adjustment of insulin or coumadin provided it was not first prescribed during the stability period.

b) Change from a brand name medication to a generic medication provided the medication was not first prescribed during the stability period and there is no change in dosage.

c) A new medication prescribed solely as a result of a drug manufacturer’s discontinuance of the original medication taken.

d) The decrease or elimination of a medication dosage by a physician, provided that it has changed more than 90 days prior to your policy effective date and has not had any effect on the stability of your medical condition for the 90 days prior to your departure date.

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► Group Medical Services TravelStar (GMS)

You must be stable based on the definition of stable in this policy, regardless of the opinion of your physician or any other person who may provide an opinion on your medical conditions.

Stable: a medical condition is considered stable and controlled, only when all of the following statements are true.

1)  there has not been any new medical treatment prescribed or recommended, or change(s) to existing medical treatment or stopped medical treatment; and

2)  there has not been any change to any existing prescribed drug (including an increase, decrease, or stopping to prescribed dosage), except:

a. a dosage adjustment for anti-hypertensive or cholesterol lowering medication;

b. a change from brand name medication to generic medication and vice versa of the same dosage;

c. Coumadin/Warfarin prescribed as an anticoagulation therapy adjusted to ensure your INR is maintained within therapeutic range as directed by your physician[s) provided there has been no other change in your condition; and

d. insulin or oral anti-diabetic medication where blood levels are tested on a regular basis and adjustments to the dosage are made to ensure your blood glucose level is maintained within therapeutic range as directed by your physician{s) provided there has been no other change in your condition; and

3)  the medical condition has not become worse; and

4)  there have not been any new, more frequent or more severe symptoms; and

5)  there has been no hospitalization or referral to a specialist; and

6)  there has been no tests, investigation or medical treatment recommended, but not yet complete, nor any outstanding test results.

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► Manulife Financial Emergency Medical Policy for Travelling Canadians

Pre-existing Condition Exclusion

The pre-existing condition exclusion that applies to you depends on the Rate Category you qualified for when you purchased this policy.

If you are under the age 60, you automatically qualify for Rate Category A.

For applicants 60 years old and over, Rate Category depends on the answers on the medical questionnaire: it may be A, B, C.

Rate Categories  A. The company will not pay any expenses relating to:
• a pre-existing condition that is not stable in the three (3) months before your effective date; and/or,
• your heart condition if, in the three (3) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the three (3) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.

Rate Category B and C. The company will not pay any expenses relating to:
• a pre-existing condition that is not stable in the six (6) months before your effective date; and/or,
• your heart condition if, in the six (6) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the six (6) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.

NOTE: For the Travel Canada Emergency Medical plan, no pre-existing medical condition exclusion applies.

Other exclusions

The company will not pay any expenses or benefits relating to:

1. For children under two (2) years of age, any medical condition related to a birth defect.

2. For policy extensions or Top-Ups: any medical condition which first appeared, was diagnosed or treated after the scheduled departure date and prior to the effective date of the insurance extension or Top-Up.

Pre-existing condition means a medical condition that existed before your effective date.

Stable: A medical condition is considered stable when all of the following statements are true:

• there has not been any new treatment prescribed or recommended, or change(s) to existing treatment (including a stoppage in treatment), and

• there has not been any change in medication, or any recommendation or starting of a new prescription drug, and

• the medical condition has not become worse, and

• there has not been any new, more frequent or more severe symptoms, and

• there has been no hospitalization or referral to a specialist, and

• there have not been any tests, investigation or treatment recommended, but not yet complete, nor any outstanding test results, and

• there is no planned or pending treatment.

Change in medication means the medication dosage, frequency or type has been reduced, increased or stopped, and/or new medication(s) has/have been prescribed.

Exceptions: the routine adjustment of Coumadin, Warfarin or insulin (as long as they are not newly prescribed or stopped) and there has been no change in your medical condition; and a change from a brand name medication to a generic brand medication of the same dosage.

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► TourMed Travel Insurance

Pre-existing Condition Exclusion

There is no coverage and no benefits will be payable for claims resulting from:

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.

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► TuGo Traveller Travel Insurance

Pre-existing Condition Coverage

Worldwide and Worldwide excluding USA Plans

The company will not be liable to provide coverage or services, or to pay claims for expenses incurred directly or indirectly as a result of any pre-existing condition as defined, except as follows:

If you purchased this Policy to top-up any other insurance plan, the stability for pre-existing conditions is based on your total trip length.

Unstable Pre-existing Medical Condition Coverage ( Optional )

Emergency Medical Insurance Worldwide or Worldwide Excluding USA plan. .

When this Optional Coverage is purchased, the company will pay for medical and related expenses up to this coverage limit for an emergency incurred as a result of your pre-existing medical conditions that do not meet the regular stability requirements but were stable on or within the 7 days before the date of departure. Coverage Maximum limit − $300,000

Pre-existing Condition (for Emergency Medical Insurance) means:

Any disease, illness or injury (including symptoms of undiagnosed conditions) that exists on or before the date you leave for your trip.

Stable means that within the period specified in this Policy:

a) There has been no deterioration of the medical condition as determined by a physician or other registered medical practitioner, and

b) There have been no new symptoms or findings or more frequent or severe symptoms or findings, and

c) There has been no change in treatment by a physician or other registered medical practitioner or any alteration in any medication related to the medical condition, and

d) There has been no new treatment received, prescribed or recommended by a physician or other registered medical practitioner.

Travel In Canada

Pre-existing condition exclusion does not apply to this plan. 

Exclusions

1. Medical conditions or any related medical conditions for which, on or before departure, tests to follow up on the effectiveness or response to a procedure, surgery or hospitalization were scheduled to take place or were recommended. This includes tests that were scheduled or were recommended on or before departure, but had not yet taken place at the time of departure.

2. Medical conditions or any related medical conditions for which, on or before departure, diagnostic tests took place, were scheduled to take place or were recommended and for which results had not yet been received at the time of departure. This includes diagnostic tests that were scheduled or recommended on or before departure, but had not yet taken place at the time of departure.

This exclusion does not apply to:

a) Tests to monitor an existing medical condition if there have been no new or more frequent symptoms, whether or not results have been received; or,

b) Screening tests intended to prevent illness or to detect medical conditions before symptoms are noticed, whether or not results have been received.

3) Medical conditions or any related medical conditions for which before departure, medical procedures, surgeries and/or referrals to a specialist were scheduled to take place or were recommended but had not yet taken place at the time of departure.

4) Any cancer (other than basal cell or squamous cell skin cancer and/or cancer that is in remission) for which you received or were recommended to receive active cancer treatment on or within the 90 days before the date of departure. This includes active cancer treatment that you were recommended to receive but chose to decline.

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 ► True Senior Guard & True Escape Insurance Plans

Pre-existing Condition Coverage

Benefits are not payable under this policy if losses sustained or expenses incurred are the direct or indirect result of your Pre- Existing conditions that have not been Stable within a stability period before your departure date as outlined on your Confirmation of coverage.

True Senior Guard Plan

For 0-59 years of age:

A standard stability period is 45 days with option of a 7-day stability period at additional cost.

For 60+ years of age:

A standard stability period is 365 days with options of a 180-day, 90-day and 7-day stability period at additional cost.

True Escape Plan

For 0-60 years of age:

A standard stability period is 45 days with option of a 7-day stability period at additional cost.

For 61+ years of age:

A standard stability period is 365 days with options of a 180-day, 90-day and 7-day stability period at additional cost.

STABLE – a medical condition (other than minor ailment) for which all the following statements are true:

1. Has been no new diagnosis, Treatment or prescribed medication.

2. No test results showing a deterioration in Your condition.

3. No Hospitalization, referral to a specialist (made or recommended) or You are not awaiting test or Treatment.

4. No change in Your medical Treatment and/or change in dosage of a medication

EXCEPTIONS:

• The routine adjustment to Coumadin, Warfarin or insulin to maintain optimal levels is not considered a change.

• If You change from a brand name to a generic with the same dosage this condition will remain stable. Stability is calculated at the departure date of your trip.

Stability is calculated at the departure date of your trip.

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► Travelance Emergency Medical Travel Insurance

Pre-existing Condition Exclusion

There is no coverage and no benefits will be payable for claims resulting from:

1. Pre-Existing Conditions or related Medical Conditions as follows:

a) For ages 59 and under on the Departure Date, any Pre-Existing Condition or Medical Condition that was not Stable and Controlled during the 60-day period immediately prior to Your Departure Date or which, in the opinion of Your Physician, would be expected to require Treatment in the foreseeable future.

b) For ages 60 to 74 on the Departure Date, any Pre-Existing Condition or Medical Condition that was not Stable and Controlled during the 180-day period immediately prior to Your Departure Date or which, in the opinion of Your Physician, would be expected to require Treatment in the foreseeable future.

c) For ages 75 and over on the Departure Date, any Pre-Existing Condition or Medical Condition that was not Stable and Controlled during the 365-day period immediately prior to Your Departure Date or which, in the opinion of Your Physician, would be expected to require Treatment in the foreseeable future.

Stable and Controlled means a medical condition where:

1. there has not been 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 drug (including an increase, decrease, or stoppage to prescribed dosage), or any recommendation or starting of a new prescription drug.

If you require a routine adjustment to the dosage of your prescription for Coumadin, Warfarin or Insulin (unless it is newly prescribed or stopped) to ensure correct blood levels are maintained, such a change is not considered an alteration in medication provided the condition remains unchanged; and

3. the medical condition has not become worse; and

4. there has not been any new, more frequent or more severe symptoms; and

5. there has been no hospitalization or referral to a specialist; and

6. there have not been any tests, investigation or treatment recommended, but not yet complete, nor any outstanding test results; and

7. there is no planned or pending treatment.

All of the above conditions must be met for a medical condition to be considered stable and controlled.

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► 21st Century Emergency Medical Policy for Travelling Canadians (underwritten by Manulife Financial)

Pre-existing Condition Exclusion

The pre-existing condition exclusion that applies to you depends on the Rate Category you qualified for when you purchased this policy.

If you are under the age 60, you automatically qualify for Rate Category A.

For applicants 60 years old and over, Rate Category depends on the answers on the medical questionnaire: it may be A, B, C.

Rate Categories  A. The company will not pay any expenses relating to:
• a pre-existing condition that is not stable in the three (3) months before your effective date; and/or,
• your heart condition if, in the three (3) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the three (3) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.

Rate Category B and C. The company will not pay any expenses relating to:
• a pre-existing condition that is not stable in the six (6) months before your effective date; and/or,
• your heart condition if, in the six (6) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the six (6) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.

NOTE: For the Travel Canada Emergency Medical plan, no pre-existing medical condition exclusion applies.

Other exclusions

The company will not pay any expenses or benefits relating to:

1. For children under two (2) years of age, any medical condition related to a birth defect.

2. For policy extensions or Top-Ups: any medical condition which first appeared, was diagnosed or treated after the scheduled departure date and prior to the effective date of the insurance extension or Top-Up.

Pre-existing condition means a medical condition that existed before your effective date.

Stable: A medical condition is considered stable when all of the following statements are true:

• there has not been any new treatment prescribed or recommended, or change(s) to existing treatment (including a stoppage in treatment), and

• there has not been any change in medication, or any recommendation or starting of a new prescription drug, and

• the medical condition has not become worse, and

• there has not been any new, more frequent or more severe symptoms, and

• there has been no hospitalization or referral to a specialist, and

• there have not been any tests, investigation or treatment recommended, but not yet complete, nor any outstanding test results, and

• there is no planned or pending treatment.

Change in medication means the medication dosage, frequency or type has been reduced, increased or stopped, and/or new medication(s) has/have been prescribed.

Exceptions: the routine adjustment of Coumadin, Warfarin or insulin (as long as they are not newly prescribed or stopped) and there has been no change in your medical condition; and a change from a brand name medication to a generic brand medication of the same dosage.

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NOTE: The product related information is for illustration purpose only. Please refer to the policy wording for the complete terms, benefits, conditions & exclusions.