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Group Medical Services
(GMS) - Immigrants & Visitors to Canada
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Manulife
Visitors to Canada
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Manulife
Financial - Student Plan
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Allianz
Global Assistance
Visitors
to Canada
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21st Century Travel
Visitors to Canada Insurance (underwritten by Manulife
Financial)
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TuGo Visitors to Canada Insurance
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Travelance Visitors to Canada (Premier Plan)
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Destination Travel
Group Visitors to Canada Insurance
Call us at
1-877-443-0101 (416-493-0101) for free consultation or
ask
your question ONLINE
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Allianz Global Assistance
1)
Pre-existing Conditions
Exclusion
a) If
you
are 59 years of age or under
on the effective date:
Benefits are not payable for costs
incurred due to or resulting from
your
medical condition or related condition that was not
stable
at any time during the
stability period.
b) If
you
are 60 to 79 years of age on
the effective date:
i. Benefits are
not payable for costs incurred due to or resulting from
any of the following
pre-existing conditions,
unless you have completed a Medical Questionnaire, have been approved in writing by Allianz Global
Assistance and have paid the required premium:
•
heart condition
• stroke or mini-stroke ( TIA-
transient ischemic attack):
ii. Benefits are not payable for
costs incurred due to or resulting from any
pre-existing condition
not listed under i) unless it was
stable
during the
stability period.
c) If
you
are 80 to 89 years of age on the
effective date:
Benefits are not payable for any
pre-existing condition
unless you have completed a
Medical Questionnaire, have been approved in
writing by Allianz
Global Assistance and have paid the required premium.
Stability period:
a) if
you are age 59 or under, is
the 90 days immediately before the
effective date.
b) if
you are age 60 to 79, is the
180 days immediately before the
effective date.
Stable
describes any
medical condition or related condition, including any
heart condition
or
lung condition, for which:
a) there has been
no new treatment;
and
b) there has been
no change in treatment
or change in
treatment
frequency or type; and
c) there have
been no signs or symptoms
or new diagnosis; and
d) there have 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 surgery or 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 to control diabetes provided the
insulin 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 increase or decrease in dosage.
c) A minor ailment, which describes
a sickness
or
injury during the
stability period
which ended prior to the
effective date and which did
not require:
i.
treatment
for a period longer than 15
consecutive days; or
ii. more than one
follow-up visit to a
physician; or
iii. hospitalization, surgery, or
referral to a specialist.
The following conditions are
not considered stable:
a) any
lung condition
for which
you
were prescribed or are taking prednisone;
b) any
heart condition
for which
you
were prescribed or are taking nitroglycerin.
2)
Benefits are not payable
for any costs incurred due to any
sickness for which
signs or symptoms occurred
within 48 hours after the
effective date, except when
applying for coverage:
a) before the
expiry date of
your existing Allianz policy; or
b) prior to the date
you exit
your country of origin
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21st Century Travel Insurance
(underwritten by Manulife
Financial)
The
company will not reimburse you for
Insured services
or pay an Accidental Death and Dismemberment claim
and/or any other expenses directly or indirectly from:
Basic Plan (no age limit)
- Any pre-existing medical
condition:
Standard Plan (available for ages 55 to 85 on the policy effective date)
- Any pre-existing medical condition:
Enhanced Plan (for ages up to 85)
i) if you are under age 55
- Other than a stable chronic
condition;
ii) if you are age 55 to 85
- Other than a stable chronic
condition and you were eligible
to purchase and paid the required premium for the Stable Chronic Condition Option (Medical
Declaration is required).
Stable
Chronic Condition means a
pre-existing medical condition for which, in the
180 days prior to your effective date of
insurance:
• there
have been no new symptoms or change in symptoms; and
• existing
symptoms have not become more frequent or severe; and
• physician has
not found that the medical condition has become worse;
• no
test findings have shown that the medical condition may
be getting worse; and
•
a physician has not
provided, prescribed, or recommended any new medication,
or any change
in medication; and
• a physician has not
provided, prescribed, or recommended any new treatment,
or any change in treatment; and
• there
has been no hospitalization or referral to a specialist
or specialty clinic; and
•
a physician has not
advised referral to a specialist or further testing, and
there has been no testing for which results have not yet
been received.
This policy
will not cover:
a)
any heart condition if, in the
180 days before the effective date, you required any
form of nitroglycerine for the relief
of angina pain.
b) any lung condition if, in
the 180 days before the effective date, you required
treatment with prednisone for a lung
condition.
Change
in medication means the medication dosage,
frequency or type has been reduced, increased, 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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Manulife Financial
The company
will not pay any expenses or benefits relating to:
1. Any claim within the waiting period.
2. A pre-existing condition
Plan A – the company will not pay any expenses relating
to:
a) any medical
condition, diagnosed or undiagnosed,
which existed or for which you sought or received
medical advice, consultation, investigation, or
for which treatment was
required or recommended by a physician,
within the 180 days prior to the effective date.
d) a pre-existing condition for which you
were hospitalized either more than once, or for at least
2 consecutive days, in the 12-month period before your
effective date of insurance.
Pre-existing condition
means a medical condition that existed before your
effective date.
STABLE medical
condition means that all of the following apply:
you have not had any new symptom(s);
and
existing symptom(s) have not become
more frequent or severe; and
a physician has not determined that
the medical condition has become worse; and
no test findings have shown that the
medical condition may be getting worse; and
a physician has not provided,
prescribed, or recommended any new medication, any
change in medication;
and
a physician has not provided,
prescribed or recommended any new treatment or any
change in treatment; and
there has been no admission to a
hospital or referral to a specialty clinic or
specialist; and
a physician has not advised referral
to a specialist or further testing, and there has been
no testing for which the results have not yet been
received.
Change in medication
means the medication dosage or
frequency has been reduced, increased, or stopped,
and/or new medication/s has/have been prescribed.
The following is
not considered a change in
medication:
a) 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;
b) a change from a brand-name drug to an equivalent
generic drug of the same dosage
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Manulife Financial
-
Student Travel Plan
Pre-existing condition exclusions
This policy will not pay any expenses or benefits
relating to:
1. A pre-existing condition which has not remained
Stable
in the three (3) months before the effective
date.
2. Any pre-existing condition of a covered
dependant and/or spouse that was not
Stable
in the three
(3) months before the date the dependant/spouse became
covered under this policy.
3. For covered dependants under two (2) years of age,
any medical condition related to a birth defect whether
genetic, acquired, or congenital.
Pre-Existing Condition means an injury, illness
or symptom that exists before the effective date of
insurance.
Stable means a medical condition for
which:
• you have not had any new symptom(s); and
• existing symptom(s) have not
become more frequent or severe; and
• your physician has not determined
that your medical condition has become worse; and
• no test findings have shown that
your medical condition may be getting worse; and
• you have not received, been
prescribed, taken or had a physician recommend any new
medication, any change in medication.
Exceptions: the routine
adjustment of Coumadin, warfarin, insulin to control
diabetes (as long as the medication is not newly
prescribed or stopped) and a change from a brand name
medication to a generic brand medication (provided that
the dosage is not modified); and
• you have not received, been
prescribed or had a physician recommend any new
treatment or any change in treatment; and
• you have not been hospitalized or
referred to a specialty clinic or specialist; and
• your physician has not advised you
to see a specialist or to have further tests, and you
have not undergone testing for which you have not yet
received the results.
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Group Medical Services
(GMS)
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
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
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
al 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.
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TuGo Visitors to Canada insurance
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:
1)
a)
For
insureds
who are 59 years
and under on the
application date
Pre-existing
conditions that are not
stable
in the 90
days before the policy effective date,
b) For insureds who are 60 to 69 years on the application date .
Pre-existing
conditions that are not stable
in the 120
days before the policy effective date,
c) For insureds who are 70 - 85 years on the application date.
Pre-existing
conditions that are not stable
in the 180
days before the policy effective date,
d) For insureds who are 86 years and over on the application date.
Pre-existing
conditions that are not stable
in the 365
days before the policy effective date.
2) Conditions or any
related conditions for which, prior to departure, testing or
investigative consultation took place, was scheduled to take
place or was recommended (not including routine check-up or
routine monitoring for a medical condition), and for which
results had not yet been received at the time of departure. This
includes tests that were recommended or scheduled prior to
departure, but had not yet taken place at the time of departure.
Pre-existing Condition
means:
a) A dental or medical condition,
illness or injury that has been diagnosed, and for which
you have consulted, or received dental or medical
treatment before the date you leave for your trip; or,
b) A dental or medical condition,
illness or injury that has not yet been diagnosed, and
for which you were experiencing symptoms before the date
you leave for your trip; or,
c) A medically
recognized complication or recurrence of a medical or
dental condition, illness or injury, whether or not the
condition was diagnosed 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 your condition as determined by your physician, and
b) There have been no new symptoms
or findings or more frequent or severe symptoms or
findings, and
c) There have been no symptoms
experienced by you related to the condition that remains
undiagnosed, and
d) There has been no change in
medical treatment, and,
e) There has been no alteration in
any medication for the condition, and
f) There has been no new medical
treatment prescribed or recommended by a physician or
received.
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Travelance
(Premier Plan)
There is no coverage and no benefits
will be payable for claims presented under this section
resulting from:
1. Pre-Existing Conditions or
related Medical Conditions as follows:
a) For ages 69 and under on
the Start Date, any Pre-Existing Condition or Medical
Condition that was not Stable and Controlled
during the 180 day period immediately prior to Your
Start Date.
b) For ages 70 to 79 on the
Start Date:
-
any Pre-Existing Condition
or Medical Condition that was not Stable and
Controlled during the 180 day period
immediately prior to Your Start Date; and,
-
any of the following
Pre-existing Conditions that were present on Your Start
Date:
▪ Any
heart condition including but not limited to heart
attack, angina, arrhythmia or cardiac surgery;
▪ Any
brain condition including but not limited to stroke,
transient ischemic attack (TIA), mini-stroke, aneurysm
or seizure;
▪ Any
lung condition including but not limited to chronic
obstructive pulmonary disease (COPD), asthma, chronic
bronchitis or emphysema.
c) For ages 80 and over on
the Start Date, any Pre-Existing Condition or Medical
Condition that was present on Your Start Date.
Stable and Controlled
means:
- 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 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
- 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
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Destination Visitors to Canada
This policy will not provide
coverage, provide services, or pay claims for expenses
incurred directly or indirectly as a result of:
a) If you are 79 years of age
or under on the application date and selected
Option 1 at the time of application:
Any
pre-existing medical condition unless it was stable in
the 120 days immediately before the effective date.
b) If you are 79 years of age or
under on the application date and selected
Option 2 at the time of application: Any
pre-existing medical condition.
c)
If you are 80 years of age
on the application date : Any pre-existing medical
condition.
Stable means a
pre-existing medical condition that:
- did not require, or was not referred for any medical consultation;
- did not require a change in type or dosage of medication;
- did not exhibit any signs or symptoms
Medical consultation
means any medical services obtained from a physician for
a sickness, injury or medical condition, including but
not limited to any or all of: history taking, medical
examination, investigative testing, advice or treatment,
and during which a diagnosis of the medical condition
need not have been definitively made. This does not
include routine annual medical check-ups where no
medical signs or symptoms existed or were found during
the check-up.
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NOTE: The product-related information is
for illustration only. Please refer to the policy
wording for
the complete terms, benefits, conditions &
exclusions.