TuGo TRAVELLER
Travel Insurance Medical Questionnaire

Your answers on the Medical Questionnaire will determine the premium (cost) of your insurance. It’s important to answer the Medical Questionnaire correctly. If you qualify for the insurance but you inaccurately answer any of the Rate Qualification Questions, a $15,000 USD deductible applies to any incident claimed, in addition to any other deductible you may have selected.

At the time of a claim, if the answers are not complete or accurate, coverage won’t be provided until you correct your answers, and if applicable, you pay any additional premium that may be required. If you’re unsure how to answer the question, talk to your physician for advice before completing the Medical Questionnaire

Alteration: the medication usage, dosage or type has been increased, decreased or stopped and/or a new medication has been prescribed.

Alteration does not include:
• a) Changes in brand to an equivalent name brand or to an equivalent generic brand of the same or equivalent usage or dosage; or,
• b) Routine dosage adjustments within prescribed parameters for insulin or oral diabetes medication to ensure correct blood levels are maintained; blood sugar levels must be checked regularly and the medical condition must remain unchanged; or,
• c) Routine dosage adjustments within prescribed parameters for blood thinner medication to ensure correct blood levels are maintained; blood levels must be checked regularly and the medical condition must remain unchanged; or,
• d) A temporary stoppage of blood thinner medication up to a maximum of 24 hours if the stoppage is required for a surgery or a procedure; or,
• e) Usage changes due to the combination of several medications into one; the medical condition must remain unchanged.

Remission: the decrease in or the disappearance of signs and symptoms of cancer and/or the removal of cancer as determined by your physician and noted in your medical records.

Remission can be complete or partial. Complete remission means the disappearance of all signs or symptoms. Partial remission means a decrease in or disappearance of some, but not all, signs and symptoms

If you’ve been diagnosed with any type of arthritis such as osteoarthritis, rheumatoid arthritis or psoriatic arthritis, choose this condition.

If you’ve been diagnosed with diabetes that’s treated either by lifestyle changes such as diet, exercise or with any kind of medication other than insulin, choose this condition.

Don’t choose this condition if you’ve been diagnosed with Impaired Glucose Intolerance (IGT), also known as pre-diabetes.

A bladder infection is a specific type of Urinary Tract Infection (UTI). Choose this condition if you’ve had two or more bladder infections, and not any other types of UTIs.

A weight-to-height ratio measured by Body Mass Index (BMI) greater than 40. Severe obesity must be diagnosed by a physician or other registered medical practitioner and be recorded in your medical records.

If you’ve been diagnosed with Gastroesophageal Reflux Disease that’s treated with prescribed medication such as proton pump inhibitors to stop the production of acid in the stomach, choose this condition.

Don’t choose this condition if you have occasional heartburn or acid reflux that hasn’t been diagnosed as GERD, even if you’re taking over-the-counter medication for it such as TUMS® or Rolaids®.

If you’ve only been diagnosed with diverticulosis, don’t choose this condition. However, if you’ve been diagnosed with diverticulitis and diverticulosis, choose this condition.

Coronary Artery Disease can be caused by arteriosclerosis and/or atherosclerosis. If you’ve been diagnosed with CAD and arteriosclerosis and/or atherosclerosis, choose all these conditions.

Atrial fibrillation is a type of arrhythmia. Choose this condition if you’ve been diagnosed specifically with atrial fibrillation and not any other type of arrhythmia or dysrhythmia.

Choose Single Trip plan if you’d like insurance for one trip from your province of residence or Canada. (Coverage commences upon your departure from your province of residence and expires when you return to your province of residence, no matter how many countries you visit during the trip).

Choose Annual Multi-trip plan if you’d like insurance for many trips taken in the next 12 months (Coverage for each separate trip commences immediately upon your departure from your province of residence and expires when you return to your province of residence. Each trip cannot exceed the maximum days you selected when you purchased your Multi-Trip plan).

Choose Top-Up if your trip is longer than the number of days covered under your existing policy (Coverage starts on the date after the date when your existing coverage expires).

Choose Annual Multi-trip +Top-Up if you’d like insurance for many trips during 12 months and a Top-Up for one trip which is longer than the number of day per trip allowed under the multi-trip plan.