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Seniors Visiting Canada - Pre-existing Medical Conditions Exclusions

We get many inquiries each week mainly from the children of foreign seniors planning to visit Canada for an extended period of time. Seniors visiting Canada with medical conditions need to be aware of the medical exclusion for claims that arise from pre-existing medical conditions.

The following are excerpts from the actual policy wording of each visitors medical plans offered by TravelInsuranceQuotes.ca

ETFS

A pre-existing medical condition exclusion applies to medical conditions and/or symptoms that existed prior to your trip.

  1. This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by:
  2. Any sickness or symptoms which manifested or were contracted or treated within the first 48 hours following the effective date if you purchase this policy after your arrival in Canada.
    1. Pre-existing Condition:
      1. Any sickness, injury or medical condition for which:
        1. you have had symptoms;
        2. you have been hospitalized;
        3. you have been prescribed medication (including prescribed as needed);
        4. you have taken medication; or
        5. you have undergone a medical or surgical procedure, at any time in the 180 days prior to your effective date.
      2. Your heart condition if, for any heart condition:
        1. you have had symptoms;
        2. you have been hospitalized;
        3. you have been prescribed medication (including prescribed as needed);
        4. you have taken medication; or
        5. you have undergone a medical or surgical procedure, at any time in the 180 days prior to your effective date.
      3. Your lung condition if, for any lung condition:
        1. you have had symptoms;
        2. you have been hospitalized;
        3. you have been prescribed medication (including prescribed as needed);
        4. you have taken medication;
        5. you have undergone a medical or surgical procedure; or
        6. you have been treated with home oxygen or taken oral steroids (e.g. Prednisone), at any time in the 180 days prior to your effective date.

Manulife

Under Plan A, no benefits are payable for a pre-existing condition that existed before your effective date of insurance.

Plan A – we will not pay any expenses relating to:

  1. a pre-existing condition for which medication has been taken, received or prescribed and/or treatment has been received in the 180 days before the effective date of insurance;
  2. any heart condition if, in the 180 days before the effective date, you required any form of nitroglycerin for the relief of angina pain; and/or
  3. any lung condition, if in the 180 days before the effective date, you required treatment with oxygen or prednisone for a lung condition.

Under Plan B, no benefits are payable for a pre-existing condition that is not stable within 180 days of the effective date.

Plan B – we will not pay any expenses relating to:

  1. a pre-existing condition that is not stable in the 180 days before the effective date of insurance;
  2. any heart condition if, in the 180 days before the effective date, you required any form of nitroglycerin for the relief of angina pain; and/or
  3. any lung condition if, in the 180 days before the effective date, you required treatment with oxygen or prednisone for a lung condition.

To Qualify for Plan B you must:

  1. be at least age 35 and no older than age 85 (69 if purchasing $150,000);
  2. truthfully answer ‘No’ to all questions on the Medical Questionnaire;
    • Have you had heart bypass or valve surgery before 2000?
    • Do you have BOTH diabetes (for which you require the use of medication) AND a heart condition?
    • Have you ever received an organ transplant?
    • In the past 2 years, have you:
  3. been prescribed or taken lasix or furosemide for any condition;
  4. had congestive heart failure; and/or
  5. required treatment with oxygen or prednisone (or other oral steroid medication, not including puffers) for a lung condition?
  6. In the past 12 months, have you:
    • started treatment for and/or been diagnosed with a heart attack; stroke; Transient Ischemic Attack (TIA); mini-stroke or internal bleeding;
    • received chemotherapy or radiotherapy for the treatment of cancer; and/or
    • been hospitalized for 24 hours or more for a gastrointestinal disease or disorder?
  7. the date of your trip occurs during the time that you have been advised by a physician not to travel;
  8. you have been diagnosed with a terminal illness with less than 2 years to live;
  9. you have a kidney condition requiring dialysis;
  10. you have used home oxygen during the 12 months prior to the date of application
  11. be a resident of one of the following countries - Austria, Australia, Bahamas, Barbados, Belgium, Bermuda, Cayman Islands, Czech Republic, Denmark, Finland, France, Greece, Germany, Hungary, Hong Kong, India, Ireland, Israel, Italy, Jamaica, Japan, Netherlands, New Zealand, Norway, Poland, Slovakia, South Africa, Spain, Sweden, Switzerland, Trinidad and Tobago, United Kingdom, and the United States of America

Expenses for 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.

Continued treatment of a medical condition when you have already received emergency treatment for that condition during your trip, if our medical advisors determine that the medical emergency has ended.

A medical condition:

  • when you knew, before you left home, or before the effective date of coverage, that you would need or be required to seek treatment for that medical condition during your trip; and/or
  • for which it was reasonable to expect before you left home that you would need treatment during your trip; and/or
  • for which future investigation or treatment was planned before you left home; and/or
  • which produced symptoms that would have caused an ordinarily prudent person to seek treatment in the 3 months before leaving home; and/or
  • that had caused your physician to advise you not to travel.

TIC

  1. If you are 69 years of age or under on the effective date:
    • Any pre-existing medical condition unless it was stable in the 180 days immediately before the effective date.
  2. If you are 70 to 79 years of age on the effective date:
    • Any cardiovascular, cerebrovascular and respiratory condition that required any or all of: medical consultation, prescription medication, medical treatment or hospitalization, within 180 days immediately before the effective date unless you have completed a Medical Questionnaire, have been approved in writing by TIC and have paid the required premium; or
    • Any other pre-existing medical condition not listed under above unless it was stable in the 180 days immediately before the effective date;
  3. If you are 80 years of age or over on the effective date:
    • Any pre-existing medical condition unless you have completed a Medical Questionnaire, have been approved in writing by TIC and have paid the required premium.

AIG Travel Guard

A pre-existing condition exclusion applies to medical conditions and/or symptoms that existed prior to travel. There may be no coverage if you have a pre-existing condition.

ME#1 - If you are two (2) years of age or older and under 50 years of age

  • If at any time in the 90-day period immediately preceding your start date:
    • Your medical condition or any related condition has not been stable and controlled;
    • Your heart condition has required you to use, take, or be prescribed to take nitroglycerin in any form, more than once per a seven day period; or
    • Your lung condition has required the use of home oxygen or has required you to take oral steroids (prednisone or prednisolone);

    Then we do not cover any loss or expense related in whole or in part, directly or indirectly, to any such condition.

ME#3 -If you are 50 years of age or older

  • We do not cover any loss or expense related in whole or in part, directly or indirectly, to any medical condition for which you have taken medication, been prescribed medication, received treatment, experienced a deterioration of the condition or had cause to seek treatment at any time within the 180- day period immediately preceding and including your start date and this exclusion applies whether or not the condition has been stable and controlled.

ME#4 -If you are one month of age or older and under two (2) years of age

  • If at any time in the 90-day period immediately preceding your start date:
    • Your medical condition or any related condition has not been stable and controlled;
    • Your heart condition has required you to use, take, or be prescribed to take nitroglycerin in any form, more than once per a seven day period; or
    • Your lung condition has required the use of home oxygen or has required you to take oral steroids (prednisone or prednisolone);

Then we do not cover any loss or expense related in whole or in part, directly or indirectly, to any such condition. In addition, we do not cover any loss or expense related in whole or in part, directly or indirectly, to any medical condition arising from or related to a congenital defect.

Travel Underwriters

this Insurance does not provide payment or indemnity for expenses incurred directly or indirectly as a result of:

  1. A medical condition which existed prior to the effective date of the Policy or any condition wholly or partly, directly or indirectly, related thereto.
  2. Any loss incurred as a result of sickness that originated or was symptomatic during the waiting period:
    • the first 48 hours from the effective date of this Policy, if this Policy was purchased prior to your arrival date in Canada or within 60 days of your arrival date in Canada; or,
    • within the first seven days from the effective date of this Policy, if this Policy was purchased 61 days or more after your arrival date in Canada.
  3. Conditions or any related conditions for which, prior to arrival date in Canada, testing or investigative consultation took place, was scheduled to take place or was recommended, and for which results had not yet been received at the time of departure from country of permanent residence. This includes tests, which were recommended or scheduled prior to departure, but had not yet taken place at the time of departure.
  4. Tests and investigative consultation, including but not limited to biopsies, except when performed at the time of initial emergency sickness or injury.
  5. Medical treatment and expenses incurred while in your country of permanent residence.
  6. Any subsequent claim with respect to a sickness or injury, which occurred during the effective term of this Insurance and for which a claim has already been made or is pending.
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