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Group Medical Services (GMS)
Immigrants & Visitors to Canada Medical Insurance
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GMS provides an affordable medical insurance plan for visitors
and immigrants to Canada, offering coverage for stable
pre-existing medical conditions. This insurance protects
against losses due to sudden, unexpected, and unforeseen medical
emergency occurring during the policy period.
Who can apply?
You are eligible to purchase this insurance if you are an
immigrant or visitor to Canada who is not covered under a
provincial or territorial government plan,
super visa applicant, parent or grandparent visiting Canada on
super visa.
To get your free online
quote directly from the insurer, please click
on the link below and you will be taken to the
GMS secure website. You can also apply
and get your instant policy on your email directly from the
insurance company (this plan is not available
in Quebec and New Brunswick). (Waiting period)
Super Visa: This insurance policy meets all requirements for parent and grandparent super visa
if amount of coverage is $100,000 or greater and period of coverage is 1 (one) year.
What
coverage will you get
Eligibility
If you are under 55 years of age you are NOT eligible if you:
1. have any reason to seek medical
treatment, excluding the regular care of a chronic
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condition or medical
evaluation required to satisfy travel visa requirements;
2. are currently in Canada, and have ever
been denied similar coverage offered by another Canadian insurer; and
3. are currently in Canada, and had more than $5,000 in medical
treatment in the last 12 months while 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.
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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.
Waiting period
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
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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.
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Immigrants & Visitors to Canada
Benefits
Emergency means a sudden or urgent happening that arose
during your trip and requires immediate medical
treatment.
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Benefit |
Details |
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Hospitalization
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Hospital accommodations up to semi-private rooms and
hospital services and supplies necessary for emergency
care during hospitalization.
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Medical Services
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Treatment by physician or surgeon.
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Diagnostic Services
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X-rays and other diagnostic tests.
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Out-Patient Treatment
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Out-patient emergency room charges.
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Prescription Drugs
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Prescription drugs and medication prescribed by a
physician. Maximum of a thirty (30) day prescription.
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Ambulance
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Covers 100% of emergency transport to a hospital.
An air ambulance must be pre-approved
by GMS.
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Paramedical Services
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Up
to $300 for the emergency services of an osteopath,
physiotherapist, chiropractor, chiropodist, and/or
podiatrist.
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Accidental Dental
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Up
to $2,000 per injury and up to $250 for the relief of
dental pain.
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Return of Remains
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Preparation and transportation to your country of
origin or destination in Canada
to a maximum of $10,000 per person, or the cost of cremation
or burial at the place of death to a
maximum of $4,000 per person.
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Child Care
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If you are hospitalized, up to $500 for licensed child
care for a dependant traveling with you.
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Out-of-Pocket Expenses
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Up to $150 per day to a maximum of
$1,000, for accommodations, meals, phone call,
transportation fares for your accompanying family
member, if you are hospitalized on the scheduled return
date. Must be pre-approved by GMS.
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Repatriation to Country of Origin
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Up to a maximum of $5,000 to transport you by common
carrier back to your country of origin for further
medical treatment, if found medically fit to travel.
Must be pre-approved and arranged by GMS.
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24-Hour Travel Assistance Services
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Coordination of all medical care, transportation, and
repatriation; telephone interpretation services in most
languages; monitoring of progress during treatment and
recovery .
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Travel Benefits
When outside
Canada
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When
eligible expenses are incurred outside of Canada,
eligible expenses include all Benefits above and:
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Air Ambulance - charges to transport you back to
your province of residence for further in-hospital
treatment.
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Special Attendant - reimbursement of a one-way trip
economy airfare ticket for a medical attendant to
accompany you back to your province of residence or
country of origin for further in-hospital treatment.
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Escort of Insured Children - reimbursement of the
cost of a one-way trip economy airfare to return an
accompanying child or children and escort, when
necessary, back to your original point of departure.
These benefits must have the prior approval of GMS. |
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:
● Expenses incurred where you act against medical advice or
the advice of GMS.
● Expenses resulting from the regular care of a chronic
condition.
● Any expenses
that are the result of your failure, prior to arriving in
Canada, to:
- adhere to medical treatment;
- obtain investigative or
diagnostic tests recommended by a medical professional; and/or
- receive results from
investigative or diagnostic tests.
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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.
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Expenses incurred as a result of pregnancy, abortion,
miscarriage, childbirth or complications of any of these
conditions.
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Routine or general physical examinations, checkups or services
of a continued
nature following emergency treatment of a sickness or injury.
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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.
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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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If
you have questions, need help to complete the online
application, want to purchase a policy or to
make changes to your existing policy, please call at
416-493-0101 (or 1-877-443-0101) or
click here to send
your question.
What
to do if you get sick or injured
Have
your policy confirmation with you at all times. You will find
emergency phone numbers on this confirmation (section IMPORTANT
INFORMATION).
For medical emergencies and assistance, please call:
toll-free 1-800-459-6604
(within Canada & US)
collect 905-762-5196
(from all other locations)
Important Notice
In the event of
sickness or injury which may result in claim, you or
someone on your behalf, must contact GMS assistance centre prior
to treatment whenever possible. When contacting the Assistance
Centre, please provide your name, your policy number,
your location and the nature of your emergency.
Failure to contact GMS
assistance centre within twenty-four (24) hours of receiving
medical treatment or admission to hospital will limit benefits
otherwise payable to 70% of eligible charges to a maximum of the
sum insured.
To apply for benefits
under this policy, you will need to send a completed claim form
(with all original bills attached) to GMS.
Consult the claim guideline in your
Policy wording (pg.5).
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