ビジター保険~既往症補償込プランについて~

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Lloyd's
Manulife Financial Travel Insurance
Allianz Global Assistance
TuGo
BestQuote Travel Insurance Agency
MSH International
GMS Insurance (Group Medical Services)
21st Century
Trustone Health
RIMI Insurance Solutions Inc.
Away Care Inc.
JF Insurance Group
Travel Guard Canada
Travelance
Travel Shield
Starr Insurance Companies
Destination Travel
Sun Life Financial
Lloyd's
Manulife Financial Travel Insurance
Allianz Global Assistance
TuGo
BestQuote Travel Insurance Agency
MSH International
GMS Insurance (Group Medical Services)
21st Century
Trustone Health
RIMI Insurance Solutions Inc.
Away Care Inc.
JF Insurance Group
Travel Guard Canada
Travelance
Travel Shield
Starr Insurance Companies
Destination Travel
Sun Life Financial
Lloyd's
Manulife Financial Travel Insurance
Allianz Global Assistance
TuGo
BestQuote Travel Insurance Agency
MSH International
GMS Insurance (Group Medical Services)
21st Century
Trustone Health
RIMI Insurance Solutions Inc.
Away Care Inc.
JF Insurance Group
Travel Guard Canada
Travelance
Travel Shield
Starr Insurance Companies
Destination Travel
Sun Life Financial
Lloyd's
Manulife Financial Travel Insurance
Allianz Global Assistance
TuGo
BestQuote Travel Insurance Agency
MSH International
GMS Insurance (Group Medical Services)
21st Century
Trustone Health
RIMI Insurance Solutions Inc.
Away Care Inc.
JF Insurance Group
Travel Guard Canada
Travelance
Travel Shield
Starr Insurance Companies
Destination Travel
Sun Life Financial

ビジター保険~既往症補償込プランについて~

旅行保険は、旅行中の予期せぬケガや病気から身を守るためのものですが、ほとんどの「カナダ訪問者向け保険」プランでは既往症が補償対象外となっています。補償されるかどうかは、保険会社が「安定している(stable)」「治療(treatment)」「医療状態(medical condition)」などの用語をどのように定義しているかによって異なります。

そのため、保険プランを慎重に比較することが非常に重要です。

ビジター保険の種類

カナダ訪問者向けに購入できる緊急医療保険には、主に3つのタイプがあります。これらの保険は、短期滞在はもちろん、International Experience Canada(IEC)ワークビザやスーパービザなどの長期滞在プログラムでの予期せぬ医療費から身を守るためのものです。

  1. 既往症は補償対象外

    • 医療費は、既往症に関連しない場合のみ補償されます。

  2. 安定した既往症をカバー

    • 保険開始前に一定期間安定していた既往症については、医療費が補償されます。

  3. 安定した既往症の一部のみ補償

    • 一部の安定した既往症について医療費が補償されますが、肺や心血管系(心臓病や脳卒中を含む)、脳血管系に関連する病気は除外されます。

保険会社ごとの違い

Manulife Travel InsuranceやDestination Canadaのような会社は、カテゴリー1(既往症なし)およびカテゴリー2(安定した既往症あり)の両方の補償を提供することが多いです。一方で、他の保険会社ではカテゴリー2の補償が年齢によって制限されており、49歳、59歳、69歳、または79歳までしか適用されません。それを超えると、補償がカテゴリー3に引き下げられるか、補償自体が提供されなくなる場合があります。

カテゴリー3の保険は、特定の医療履歴を持つ旅行者向けであり、高血圧、糖尿病、高コレステロール、循環器系の問題などの一般的な病状を持つ方には適していません。

会社ごとの安定期間と年齢制限

各保険会社には、安定した既往症(pre-existing condition)の定義が異なります。一般的には、補償が開始される前に、症状や治療内容が一定期間(90日、120日、180日など)変わらず安定している必要があります。この安定期間中は、以下の条件が求められます:

  • 新たな症状が出ないこと

  • 医療処置や薬の投与量の変更がないこと

  • 新たな診断がないこと

一部の保険会社では、ワルファリン(warfarin)、クマディン(coumadin)、インスリンなどの定期的な薬の調整については例外を認めています。

当社では補償内容を簡略化してまとめることは避けています。なぜなら、それにより重要な情報が見落とされる可能性があるためです。すべての保険プランには、独自の「安定」の定義や補償に影響する用語があり、特定の加入条件、制限、定義、除外事項が設定されています。これらによって補償範囲がさらに制限されることがあります。

このページで取り扱うすべての保険プランの既往症、制限、定義、除外事項を網羅的に記載することはできませんが、下記に一部の保険約款の文言を掲載しています。詳細は必ず各保険約款をご確認ください。

まずは、特定の文言を確認する前に、こちらのサマリーで概要を把握してください。

  • Allianz Global Assistance Visitors Plan

    • 59歳まで:安定期間90日

    • 60〜89歳:安定期間180日

  • Destination Canada

    • 保険開始前120日間安定している既往症が対象

    • 79歳まで加入可能

    • 80歳以上は既往症の補償なし

  • GMS

    • 保険開始前180日間安定している既往症が対象

    • 79歳まで加入可能

  • JF Visitors Plan

    • 保険開始前120日間安定している既往症を補償

    • 99歳まで加入可能

  • Manulife Plan B

    • 保険開始前180日間安定している既往症を補償

    • 85歳まで加入可能

  • MHS Discover Canada

    • 70歳まで:安定期間90日

    • 71〜80歳:安定期間180日

  • Travel Guard

    • 49歳まで:安定期間90日

    • 50歳以上:安定期間180日

  • Travel Shield Starr Plan

    • 保険開始前120日間安定している既往症を補償

    • 79歳まで加入可能

  • Travelance Premier Plan

    • 69歳まで:安定期間180日

    • 70〜79歳:安定期間180日だが、心血管系、脳血管系、呼吸器系の既往症は補償対象外

  • TuGo Visitors to Canada Plan

    • 59歳まで:安定期間90日

    • 60〜69歳:安定期間120日

    • 70〜85歳:安定期間180日

    • 86歳以上:安定期間365日

以下は、本ウェブサイトで提供されている一部の保険プランにおける、既往症に関する正確な保険約款の文言(および関連する定義の一部)です:

各保険会社による定義と除外項目

カナダの各保険会社は、既往症、安定状態、治療の変更、除外事項などの定義に独自の表現を使用しています。このページですべての詳細を網羅することはできませんが、主要保険会社の例を以下に示すことで、文言の違いがどれほど大きいかを確認できます。

Manulife Visitors to Canada – 既往症に関する除外項目

以下のいずれかに直接的または間接的に関連する費用・給付金は支払われません:

  1. 待機期間中に発症した病気(たとえその関連費用が待機期間後に発生した場合でも)。

  2. プランAの場合  ・保険開始日の180日前以内に存在した、または医師による診察・助言・検査・治療を受けた(または推奨された)診断済み・未診断のすべての疾患。  ・保険開始日の180日前以内に狭心症の痛みを和らげるためにニトログリセリンを使用した心疾患。  ・保険開始日の180日前以内に酸素またはプレドニゾンによる治療を必要とした肺疾患。

  3. プランBの場合  ・保険開始日の180日前以内に安定していなかった既往症。  ・保険開始日の180日前以内に狭心症の痛みを和らげるためにニトログリセリンを使用した心疾患。  ・保険開始日の180日前以内に酸素またはプレドニゾンによる治療を必要とした肺疾患。

  4. 保険開始日の12か月前の期間中に、同じ既往症で複数回入院した、または連続して2日以上入院した場合の既往症に関連する費用。

Manulife社に基づく用語定義

Means the medication dosage, frequency, or type has been reduced, increased, or stopped, and/or new medication has been prescribed. The following is not considered a change in medication: A change from a brand-name drug to an equivalent generic drug of the same dosage; A routine adjustment in the dosage of your medication, as a result of your blood levels only, if you are taking Coumadin (warfarin) or insulin and are required to have your blood levels tested on a regular basis, and your medical condition remains unchanged.

Means the date on which your coverage begins. Your coverage starts on the later of: a. The effective date of insurance as shown on your confirmation; or b. The time and date you arrive in Canada from home. Except in the case of an injury, the applicable waiting period applies to all claims if you purchased insurance after your arrival in Canada. When coverage is purchased prior to leaving home with an effective date equal to the date and time you are scheduled to arrive in Canada, coverage will also be provided with no additional premium during your uninterrupted flight directly to Canada. An uninterrupted flight can include a stop-over provided you do not leave the airport.

Means sudden bodily harm that is caused directly by external and solely accidental means. Under Travel Accident Insurance, the injury must also be independent of sickness or disease.

Means sickness, injury, disease, or symptom(s); complication of pregnancy within the first 31 weeks of pregnancy.

Means a medical condition that exists before your effective date of insurance

Means illness or disease, or any symptom related to that illness and/or disease.

A stable medical condition means that all of the following apply: 1. There have not been any new symptoms; and 2..Existing symptoms have not become more frequent or severe; and 3. A physician has not found that the medical condition has become worse; and 4. No test findings have shown that the medical condition may be getting worse; and 5. A physician has not provided, prescribed, or recommended any new medication, or any change in medication; and 6. A physician has not provided, prescribed, or recommended any investigative testing, new treatment, or any change in treatment; and 7. There has been no hospitalization or referral to a specialist or specialty clinic; and 8. A physician has not advised referral to a specialty clinic or a specialist for further testing, and there has been no testing for which the results have not yet been received.

Means hospitalization, prescribed medication (including prescribed as needed), medical, therapeutic, diagnostic or surgical procedure prescribed, performed or recommended by a licensed medical practitioner. IMPORTANT: Any reference to testing, tests, test results, or investigations excludes genetic tests. “Genetic test” means a test that analyzes DNA, RNA or chromosomes for purposes such as the prediction of disease or vertical transmission risks, or monitoring, diagnosis or prognosis.

Means the 48-hour period following and including your effective date of insurance if you purchase your policy: 1. After the expiry date of an existing Manulife Visitor to Canada policy; or 2. After you arrive in Canada.

Destination Canada Visitors to Canada – 既往症に関する除外項目

This policy will not provide coverage, provide services, or pay claims for expenses incurred directly or indirectly as a result of:

1a) If at the time of application you are 79 years of age or under and selected Option 1 (with coverage for stable pre-existing conditions):

Any pre-existing medical condition unless it was stable in the 120 days immediately before the effective date.

1b) If at the time of application you are 79 years of age or under and selected Option 2 (without coverage for pre-existing medical conditions): Any pre-existing medical condition.

1c) If at the time of application you are 80 years of age or over: Any pre-existing medical condition.

Destination Canada社に基づく用語定義

Means the medication type, dosage, or frequency is reduced, increased, stopped, and/or new medications are prescribed. Exceptions: 1. Regular blood tests that result in routine adjustments of Coumadin, warfarin, or insulin as long as these medications are not newly prescribed or stopped; or, 2. Changing from a brand name medication to the same dose of a generic medication.

Means sickness, injury, disease or symptom.

Means any medical condition that exists prior to your effective date.

Means any evidence of sickness experienced by you or recognized through observation.

Means a medical condition that is considered stable when all of the following statements are true: 1.There has not been any new treatment prescribed or recommended, or change(s) to existing treatment (including a stoppage in treatment); and 2. There has not been any change in medication (including increase or decrease of dosage), or any recommendation or starting of a new prescription drug, and 3. The medical condition has not become worse, and 4. There has not been any new, more frequent or more severe signs or symptoms, and 5. There has been no hospitalization or referral to a specialist, and 6. There have not been any tests, investigation or treatment recommended, but not yet complete, nor any outstanding test results, and 7. There is no planned or pending treatment. All of the above conditions must be met for a medical condition to be considered stable.

Means medical, therapeutic or diagnostic procedure prescribed, performed or recommended by a physician including, but not limited to, prescribed medication, investigative testing and surgery. Important: Any reference to testing, tests, test results, or investigations excludes genetic tests. “Genetic test” means a test that analyzes DNA, RNA or chromosomes for purposes such as the prediction of disease or vertical transmission risks, or monitoring, diagnosis or prognosis.

Travel Shield Starr Visitors to Canada – 既往症に関する除外項目

We will not pay for any expenses relating to:

  • A Pre-existing Condition that was not Stable in the one hundred twenty (120) days before your Effective Date;

  • A heart condition, if, in the one hundred twenty (120) days before your Effective Date, any heart condition has not been Stable or you have taken any form of nitroglycerine for the relief of angina pain; or

  • A lung condition, if, in the one hundred twenty (120) days before your Effective Date, any lung condition has not been Stable or you required treatment with oxygen or prednisone for any lung condition.

Travel Shield社Starrプランに基づく用語定義

Means accidental bodily harm to you unrelated to Sickness or any other cause and which occurs during a Trip.

Means an irregularity in a person's health which required or requires medical advice, consultation, investigation, treatment, care, service or diagnosis by a Physician, and includes complications of pregnancy within the first thirty-one (31) weeks of pregnancy.

Means any procedure which is medical, therapeutic or diagnostic in nature, which is Medically Necessary and which is prescribed by a Physician. Medical Treatment includes Hospitalization, investigative testing, surgery, prescription medication or other treatment directly related to the Sickness, Injury or symptom.

Means a medical doctor, other than you or your Immediate Family Member, who is licensed to administer Medical Treatment and prescribe drugs in the place where he or she provides medical services. Naturopaths, herbalists and homeopaths are not considered to be Physicians.

Means a Medical Condition that existed before your Effective Date

Means any disease, illness, or infection of an Insured Person during a Trip that requires Emergency Medical Care.

Means that all of the following apply to your Medical Condition: 1. There has been no new symptom; 2. Any existing symptom has not become more frequent or severe; 3. There has been no new Medical Treatment or prescribed medication; 4. No test findings have shown that the Medical Condition may be getting worse; 5. There has been no change in Medical Treatment or prescribed medication (including the amount, frequency or type of medication, and the frequency or type of Medical Treatment); and 6. There has been no admission to a Hospital or specialty clinic or referral to a specialist, and there has been no testing for which the results have not yet been received.

GMS Visitors to Canada – 既往症に関する除外項目

The following expenses are not covered by this policy.

GMS does not cover expenses resulting from medical condition(s) which have not been stable for 180 days immediately prior to your effective date, including:

  1. Medical condition(s) for which you received medical treatment or medical consultation; and/or

  2. Undiagnosed medical condition(s) related to symptoms 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).

GMS社に基づく用語定義

An alteration to an existing prescription drug includes any of the following: 1. A new medication; 2. A change in medication type; 3. An increase or decrease in medication dose; 4. The discontinuation of a medication; or 5. An adjustment (stop and start) in an anticoagulation medication dosage due to surgery within 10 days prior to your effective date. The following alterations resulting from the regular maintenance of a condition where there is no change in the condition are not considered an alteration: 1. A dosage adjustment for an anti-hypertensive or cholesterol lowering medication; 2. A change from a brand name medication to a generic brand medication of the same dosage; 3. If you are taking Coumadin/Warfarin for anticoagulation therapy and are required to have your blood levels tested on a regular basis (INR) and you are adjusting the dosage of your anticoagulation medication to ensure your INR is maintained within therapeutic range as directed by your physician(s); or 4. If you are taking insulin or oral anti-diabetic medication for diabetes and are required to have your blood levels tested on a regular basis and you are adjusting the dosage of your medication to ensure your blood glucose level is maintained within therapeutic range as directed by your physician(s).

Is the impairment of your physical condition caused from a sudden and unforeseen accidental event that is independent from an illness or disease which includes but is not limited to a physical wound, fracture or blow to the body.

Are any irregularities to your health such as an illness, injury or emotional, psychological or psychiatric condition(s): 1. For which you receive medical treatment or medical consultation; 2. Related to undiagnosed symptoms for which you received medical treatment or medical consultation; or 3. Related to undiagnosed symptoms which would have caused an ordinary person to seek medical treatment or medical consultation.

A meeting with a physician to discuss and evaluate symptoms to diagnose a medical condition, illness or injury. It also includes meeting with a physician to evaluate your progress and/or medical treatment of a medical condition, illness or injury.

Any medical, therapeutic or diagnostic measure prescribed or recommended by a physician in any form, including; prescription medication; investigative testing; in-hospital care; surgery; or other prescribed or recommended action directly referable to the applicable condition, symptom or problem.

A medical condition is stable if: 1. You have no reason to expect medical treatment after your effective date for the medical condition or any symptoms; 2. You have not received new or different medical treatment for the medical condition; 3. You have not had an alteration to an existing prescription drug or were prescribed a new prescription drug for the medical condition; 4. Your medical condition has not become worse; 5. You have not experienced new, more frequent or more severe symptoms; 6. You have not had or needed medical consultation for undiagnosed symptoms; 7. You have not needed in-hospital care; a referral to a specialist, or a follow-up visit; and 8. You have not had tests or further investigation, whether you know the results or not, related to the medical condition.

保険の加入手続き方法

BestQuoteでの保険購入は、迅速かつ簡単です。当社のオンライン見積もり比較ツールを使えば、カナダの主要保険会社のプランを並べて比較でき、最適な補償を最良の価格で見つけられます。

購入の流れ:

  1. 旅行情報(目的地、日程、旅行者情報)を入力

  2. 希望する補償額と免責額を選択

  3. TuGo、GMS、Allianz、Manulife、AwayCareなどの提供会社のプランを瞬時に比較

  4. 自分に最適なプランを選び、オンラインで数分で購入

他のサイトのように、見積もり取得の際に電話番号を求めることはありません。プランの違いについて詳しく知りたい場合は、経験豊富なアドバイザーに電話やメールでいつでも相談できます。

お問い合わせ先:

  • バンクーバー: 1-604-259-2544

  • トロント: 1-647-799-2032

  • カルガリー: 1-403-800-1582

  • 北米国内フリーダイヤル: 1-888-888-0510