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Eligibility You are not eligible to purchase this plan if: a. you will be eighty (80) years of age or older as of the policy effective date; b. have any reason to seek medical treatment, excluding the regular care of a chronic condition or medical evaluation required to satisfy travel visa requirements c. are currently in Canada, and have ever been denied similar coverage offered by another Canadian insurer d. you are applying for coverage while in Canada and you have had more than $5,000 in medical treatment in the last twelve (12) months while you are in Canada; If you are 55 years or older, you will have to answer a number of medical questions on the application to determine your eligibility for the policy: Eligibility Questionnaire.
Amount of coverage: Choose coverage of: $25,000, $50,000, $100,000, or $150,000 per person.
Deductibles*. Choose deductible to lower premiums. Option for $0, $100, $500, or $1000 deductible. *Deductible means the dollar amount that you are responsible to pay for each claim.
1. There is no waiting period to obtain emergency medical treatment, if you apply for coverage prior to your arrival in Canada, or apply to continue coverage from an existing GMS policy or a policy providing similar coverage issued by an insurance company licensed in Canada (with no gap between coverages). 2. A two (2) day {48 hour) waiting period for medical conditions, other than injury, when you apply within the first thirty (30) days of your arrival in Canada and do not have a policy in effect providing similar coverage issued by an insurance company licensed in Canada. 3. A seven (7) day (168 hour) waiting period for medical conditions, other than injury, when you apply after the first thirty (30) days of your arrival in Canada and do not have a policy in effect providing similar coverage issued by an insurance company licensed in Canada.
Period of coverage. Any number of days up to the maximum of three hundred sixty-five (365) days per trip. Coverage ends when you depart from Canada to your home country (also see Automatic Extension).
Travel Benefits outside Canada. Emergency medical coverage is included for side trips up to 30 days or less in duration, outside of Canada provided that: a. your side trip originates and terminates in Canada; b. your total days outside Canada are not
greater than 50% of your period coverage; and c. your side trip is not to your country of origin.
Refunds Full refunds are available if no travel has taken place, when your request for a refund is received: - prior to the effective date (no administration fee); or - after the effective date, provided GMS is notified no later than 30 days after this date, subject to a $40 administration fee. Partial refunds are available, subject to a $40 administration fee, when: - your request for refund is received more than 30 days after the effective date and no travel has taken place (the refund will be calculated from the date GMS was notified); - you return to your home country. The refund will be calculated from the date you departed Canada (proof of departure will be required); - you become covered under a government health plan during the period of coverage the refund will be calculated from the date GMS is notified, not the effective date of the government health plan); or - your death occurs during the policy period. Refunds are not available: - when you request a refund after the expiry date of your policy; - if a claim has been reported under this insurance policy.
Policy Extensions - you contact GMS forty-eight (48) hours prior to the expiry date of the existing coverage; - you have not required medical treatment (whether a claim was submitted or not) during your period of coverage (excluding a medical evaluation required to satisfy travel visa requirements); - your total period of coverage (including all extensions approved or requested) will not exceed one (1) year; or - you will not be eighty (80) years of age or older as of the start date for the policy extension.
Automatic Policy Extensions Your Immigrants & Visitors plan coverage will automatically be extended at no additional cost in certain situations. The extended coverage is payable up to the maximum of your sum insured under these conditions: 1. If coverage expires while hospitalized due to a medical emergency, coverage will continue for you, your spouse and any dependants travel ling with you and are listed on your application during your hospitalization and for up to seventy-two (72) hours after discharge from hospital. 2. During your transit to Canada from your country of origin provided you: a. purchased your coverage prior to departing your country of origin; and b. arrive in Canada within 48 hours of departing your country of origin. 3. During your transit from Canada to your country of origin provided you; a. have coverage on the day you depart for your country of origin; and b. arrive in your country of origin within 48 hours of departing Canada. If the medical emergency occurs within 48 hours of departing your country of origin for Canada or departing Canada for your country of origin, expenses include all of the benefits listed under the Benefits Within Canada section of this policy.
This is a summary of the benefits. Please refer to the Policy wording before purchasing the policy for more details on the coverage provided, conditions, exclusions and claim procedure.
Exclusions and limitations. Visitors to Canada medical insurance does not cover everything. This insurance has exclusions, conditions and limitations (see Policy Wording, pg. 2). Please read them and understand the policy before you buy this insurance. A Pre-Existing Medical Condition exclusion: GMS does not cover any expenses resulting from medical condition(s, which have not been STABLE for 180 days immediately prior to your effective date, including: a. medical condition(s), for which you received medical treatment or medical consultation; and/or b. undiagnosed medical conditions(s) related to symptoms for which you received medical treatment or medical consultation. You must be 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 condition(s). STABLE: a medical condition is stable if: a. you have no reason to expect medical treatment after your effective date for the medical condition or any symptoms; b. in the 180 days before your effective date, you have not received new or different medical treatment for the medical condition; c. in the 180 days before your effective date, you have not had an alteration to an existing prescription drug or were prescribed a new drug for the medical condition; d. in the 180 days before your effective date, your medical condition has not become worse; e. in the 180 days before your effective date, you have not experienced new, more frequent or more severe symptoms; f. in the 180 days before your effective date, you have not had or needed medical consultation for undiagnosed symptoms; g. in the 180 days before your effective date, you have not needed in-hospital care; a referral to a specialist, or a follow-up visit; and h. in the 180 days before your effective date, you have not had tests or an investigation whether you know the results or not, related to the medical condition. NOTE: If there are any changes in your health after your application date and before your effective date, GMS must be notified. A change in health may affect your eligibility for coverage. Changes to your health that do not affect eligibility will still constitute a change in stability and may limit your available coverage.
Some other exclusions:
The
following expenses are not covered by the policy and no
payment for these claims will be made:
- adhere to medical treatment; - obtain investigative or diagnostic tests recommended by a medical professional; and/or - receive results from investigative or diagnostic tests. ● Any subsequent claim for the same medical condition(s) with respect to a sickness or injury, that occurred during the period of coverage and for which a claim has already been made or is pending. ● Expenses incurred as a result of pregnancy, abortion, miscarriage, childbirth or complications of any of these conditions. ● Routine or general physical examinations, checkups or services of a continued nature following emergency treatment of a sickness or injury. ● Coronary artery angioplasty, cardiac surgery or implantable cardioverter defibrillator (ICD) (including any associated diagnostic tests or charges), unless necessary in a medical emergency and approved by GMS prior to any actions. ● Any endovascular surgical procedures, either done individually or in combination with conventional surgical procedures unless necessary in a medical emergency and pre-approved by GMS. Refer to the Policy wording for full list of exclusions (pg. 2) and definitions (pg. 5-6).
Note: The product-related information is for illustration purpose only. For the full details of coverage, eligibility, exclusions, limitations and claim procedures, please refer to the Policy wording
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