Seniors CAN insure almost any Pre-existing Medical Conditions
Here is a summary of some of the top Canadian travel insurance companies' pre-existing medical condition exclusions, stable periods, and definitions of medical conditions for seniors, snowbirds, parents, and retirees to quickly find the best wording that fits their medical condition.
Travel insurance is designed to help you protect against the risk of sudden, unplanned, and unforeseen circumstances such as accidental injury and unexpected illness. So medical conditions that already exist and can reasonably be expected to require medical attention during your trip will not usually be covered by any Canadian travel insurance policy. There are always exclusions described in the policy, and it's important to review which pre-existing medical conditions can be covered, or not. For example, just because you have some travel insurance coverage that comes with your credit card - don't assume that it will cover a pre-existing medical condition. Everything comes down to what is defined in the policy wording document.
Most plans may limit these exclusions according to the language of the insurance contract, so that stable pre-existing conditions can be covered. Depending on the policy you buy and the pre-existing conditions exclusion clause that comes with it (which can vary based on your answers to the medical questionnaire), your health conditions may be covered as long as they have been stable for a certain period of time prior to your coverage coming into effect.
BestQuote Travel Insurance Agency carries many different travel insurance policies to use with our customers, and we can usually always find a policy that will cover your pre-existing medical conditions, but: 1) the more serious the condition, the higher the price; and 2) the more recent the last 'change' of that condition (change of treatment or medication, new non-routine testing or new symptoms) the shorter the stability period we will need to find - and the higher the price the insurance company will ask for.
For short duration holidays (less than 35 days), we can usually find a policy that has a 90 day stability period. Longer trips will usually require a stability of 90, 180, or 365 days depending on the condition. However, we also have some extra options such as an individualized medically underwritten plan (from Manulife), that has 0 days stability - and other plans that will offer $250,000 coverage for an 'unstable' condition as long as it has been stable for the 7 days prior to departure. So, please call us if you need some help looking through the various stability options on our quote engine, or if you are uncertain if something means the condition is stable or not. We are your guide to worry-free coverage!
Below you will find the type of wording that each company offers concerning pre-existing medical conditions, and relevant definitions:
We prefer to not summarize coverage because that will always lead to dismissing relevant information. All policies use their own definition of stable and other terms that affect coverage. And all policies are subject to certain eligibility questions which may further restrict coverage. While it is beyond the scope of this page to list all the pre-existing exclusion clauses of every policy offered on this website, we list the clauses offered below for single trip emergency medical insurance to become familiar with the differences.
Please notice the differences in 'stable' period. Also, that the definitions of 'stable', 'change in medication' etc. can affect coverage.
TuGo - Pre-existing medical condition exclusion
1. Any pre-existing condition as defined, except as follows: Applicable to persons 59 years and under (on the application date)
a) On trips 35 days or less, except for conditions and/or symptoms which arose or worsened on the date of departure, or at any time within the seven days prior to the date of departure, other than a minor ailment.
b) On trips over 35 days, any condition which has remained stable in the 90 days prior to the commencement date of a covered trip.
Applicable to persons 60 to 74 years (on the application date): On all trip lengths, pre-existing conditions must be stable in the 180 days prior to the commencement date of a covered trip.
Applicable to persons 75 to 89 years (on the application date): On all trip lengths, pre-existing conditions must be stable in the 365 days prior to the commencement date of a covered trip.
Pre-existing conditions that do not meet the criteria set out above are not covered.
Refer to the following definitions: accident and injury, alteration, medical treatment, minor ailment, pre-existing condition, sickness and stable.
Relevant defintions:
Pre-existing condition
For Emergency Medical Insurance: means a medical or dental condition, illness or injury known to you, and for which you have received medical consultation, diagnosis, and/or medical treatment by a physician or dentist prior to the commencement date of a covered trip and includes a medically recognized complication or recurrence of a medical or dental condition.
For Trip Cancellation/Trip Interruption Insurance and Trip Interruption Insurance only: means a medical or dental condition, illness or injury for which medical consultation, diagnosis, and/or medical treatment has been received by a physician or dentist and includes a medical or dental condition which occurs or develops as a progressive consequence of a pre-existing condition.
Stable
For Emergency Medical Insurance: means that within the period specified in this Policy before the commencement date of a covered trip:
a) There has been no deterioration of your condition as determined by your physician, and
b) There have been no new symptoms or more frequent or severe symptoms, and
c) You have not experienced symptoms related to the condition that remain undiagnosed, and
d) There has been no change in medical treatment or no alteration in any medication for the condition, and
e) There has been no new medical treatment prescribed or recommended by a physician or received.
For Trip Cancellation/Trip Interruption Insurance and Trip Interruption Insurance only: means that within the period specified in this Policy:
a) There has been no deterioration of the condition as determined by a physician, and
b) There have been no new symptoms or more frequent or severe symptoms, and
c) There have been no symptoms related to the condition that remain undiagnosed, and
d) There has been no change in medical treatment or no alteration in any medication for the condition, and
e) There has been no new medical treatment prescribed or recommended by a physician or received.
RSA - Pre-existing medical condition exclusion:
Age 54 or under - Exclusions (below) #1, 2 and 3 with Stable period 180 days;
The following exclusions are applicable to any medical condition you have, including any medical condition you have disclosed on the Application (if applicable). This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by:
1. Any sickness, injury or medical condition (other than a minor ailment) that was not stable at any time during the applicable Pre-Existing Period prior to each departure date.
2. Your heart condition, if any heart condition was not stable at any time during the applicable Pre-Existing Period prior to each departure date.
3. Your lung condition, if:
a) Any lung condition was not stable; or
b) You have been treated with home oxygen or taken oral steroids (e.g., prednisone) for any lung condition, at any time during the applicable Pre-Existing Period prior to each departure date.
Relevant definitions:
Minor Ailment means any sickness or injury which does not require: the use of medication for a period of greater than 15 days; more than one follow-up visit to a physician, hospitalization, surgical intervention, or referral to a specialist; and which ends at least 30 consecutive days prior to the departure date of each trip. However, a chronic condition or any complication of a chronic condition is not considered a minor ailment.
Stable means any medical condition (other than a minor ailment) for which all the following statements are true:
a) There has been no new diagnosis, treatment or prescribed medication;
b) There has been no change in treatment or change in medication, including the amount of medication to be taken, how often it is taken, the type of medication or change in treatment frequency or type.
Exceptions: the routine adjustment of Coumadin, Warfarin, insulin or oral medication to control diabetes (as long as they are 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);
c) There have been no new symptoms, more frequent symptoms or more severe symptoms;
d) There have been no test results showing deterioration;
e) There has been no hospitalization or referral to a specialist (made or recommended) and you are not awaiting results of further investigations for that medical condition.
Treated means that you have been hospitalized, have been prescribed medication (including prescribed as needed), have taken or are currently taking medication, or have undergone a medical or surgical procedure. Note that aspirin/entrophen is not considered treatment.
GMS - Pre-existing medical condition exclusion:
Coverage for medical conditions that existed prior to your departure date or prior to your effective date, if used as a top-up, is subject to the following: This policy does not provide coverage for any expenses related directly or indirectly as a result of:
a) your medical condition and/or related condition and/or symptoms (whether or not the diagnosis has been determined) if at any time in the one hundred eighty (180) days preceding your departure date your medical conditions or related conditions and/or symptoms have not been stable;
b) if at any time in the one hundred eighty (180) days prior to your departure date:
i) any heart condition, has not been stable;
ii) any lung condition has not been stable.
Relevant Definitions:
Stable: any medical condition or related medical condition for which:
a) there have been no new symptoms, more frequent or more severe symptoms;
b) there has been no change in treatment or change in medication(*);
c) A dosage adjustment of an anti-hypertensive or cholesterol lowering medication done in the pre-existing timeframe does not constitute a change;
d) there has been no deterioration of your medical condition;
e) there has been no hospitalization or referrals to a specialist including initial follow-up visits, tests or investigations booked in conjunction with a medical condition/symptom;
f ) there is no further testing, treatment or investigation booked or results pending;
g) you have not experienced a symptom that remains undiagnosed;
h) no further medical treatment after departure would be anticipated
(*) Any newly prescribed medication, change in medication type, increase/decrease in dosage or discontinuation of a medication constitutes a change. It does not include a change from a brand name medication to a generic brand medication of the same dosage. If you are taking Coumadin/Warfarin for anticoagulation therapy or are insulin dependent or take oral medication for diabetes and are required to have your blood levels tested on a regular basis and your medical condition remains unchanged, yet you are required to adjust the dosage of your medication only to ensure correct blood levels are maintained,this is not considered a change in medication, except for an adjustment (stop and start) in an anticoagulation medication dosage due to surgery within ten (10) days prior to your departure date or, if used as a top-up, on the effective date,constitute a change.
Treatment: any medical, therapeutic or diagnostic measure prescribed or recommended by a physician in any form including prescription medication, investigative testing, hospitalization, surgery or other prescribed or recommended treatment directly referable to the condition, symptom or problem.
Allianz - Pre-existing medical condition exclusion:
Any sickness, injury or medical condition, that exhibited symptoms for which a diagnosis need not have been made or required any or all of, medical consultation, prescription medication, medical treatment or hospitalization, within the 180 days immediately prior to the effective date.
If the insured is age 70 and under on the effective date:
a) When coverage is purchased prior to departure:
This exclusion applies to each trip of 36 days or longer including Top-Ups starting from the day the insured leaves the province/territory of residence, unless the insured has completed a medical questionnaire, has been approved in writing by TIC and has paid any required premium.
b) When coverage is purchased after depature:
This exclusion applies starting from the 36th day of each trip including Extensions unless the insured has completed a medical questionnaire, has been approved in writing by TIC and has paid any required premium. If the insured is age 71 and over on the effective date:
This exclusion applies to each trip including Top-Ups and Extensions of any duration unless the insured has completed a medical questionnaire, has been approved in writing by TIC and has paid any required premium.
Relevant Definitions:
Medical consultation means any medical services obtained from a licensed medical practitioner for an ailment, sickness or medical condition, including but not limited to any or all of: history taking, medical examination, investigative testing, advice or treatment, and for which a diagnosis of the condition need not have been definitively made. This does not include regular medical checkups where no medical signs or symptoms existed or were found during the check-up.
Treatment means a medical, therapeutic or diagnostic procedure prescribed, performed or recommended by a physician including, but not limited to, prescribed medication, investigative testing and surgery.
Manulife - pre-existing medical condition exclusion:
We will not pay any expenses or benefits relating to:
1. A pre-existing condition. The pre-existing condition exclusion that applies to you depends on the Rate Category you qualified for when you purchased this policy. Please see the definition of “pre-existing condition” and “stable” at the end of this policy booklet.
Rate Categories A+ and A. We will not pay any expenses relating to:
• a pre-existing condition that is not stable in the three (3) months before your effective date; and/or,
• your heart condition if, in the three (3) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the three (3) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.
Rate Category B. We will not pay any expenses relating to:
• a pre-existing condition that is not stable in the six (6) months before your effective date; and/or,
• your heart condition if, in the six (6) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the six (6) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.
Rate Category C. We will not pay any expenses relating to:
• a pre-existing condition that is not stable in the twelve (12) months before your effective date; and/or,
• your heart condition if, in the twelve (12) months before your effective date, it has not been stable or you have taken any form of nitroglycerine for the relief of angina pain; and/or,
• your lung condition if, in the twelve (12) months before your effective date, it has not been stable or you required treatment with oxygen or Prednisone for your lung condition.
Relevant Definitions:
Change in medication means the medication dosage or frequency 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.
Pre-existing condition means a medical condition that existed before your effective date.
Stable means a medical condition for which:
• there have been no new symptoms, and existing symptoms have not become more frequent or more severe or there have been no test results showing deterioration; and/or
• a physician has not determined that the condition has become worse; and/or
• a physician (or other medical professional) has not prescribed or recommended a change in medication taken for that condition; and/or
• a physician (or other medical professional) has not prescribed or recommended a change in treatment for that condition; and/or
• there has been no admission to a hospital and/or you are not awaiting results of further investigation for that medical condition.
Treatment means a medical, therapeutic or diagnostic procedure prescribed, performed or recommended by a licensed medical practitioner, including but not limited to prescribed medication, investigative testing and surgery related to any sickness, injury or symptom.
Travel Guard - Pre-existing medical condition exclusion:
You may have qualified for any one of four rate classifications (check your quote presentation for details):
If your exclusion identifier is “GE” only the exclusions set out in the General Exclusions Section of this policy apply to your Emergency Medical and Dental Coverage.
Pre-Existing Condition Medical Exclusion for Identifier ME#1
If your exclusion identifier is ME#1 your Emergency Medical and Dental Coverage is subject to all of the exclusions set out in the General Exclusions Section of this policy and the following exclusion:
ME#1. We do not cover any loss or expense related directly or indirectly to:
a. Your medical condition or any related condition if in the 90-day period immediately preceding your effective date that condition has not been stable and controlled.
b. Your heart condition if in the 90-day period immediately preceding your effective date:
i. you have had any heart condition that has notbeen stable and controlled; or
ii. you have been required to use, take, or been prescribed to take nitro-glycerine in any form, more than once per a 7 day period.
c. Your lung condition if in the 90-day period immediately preceding your effective date:
i. you have had any lung condition that has not been stable and controlled; or
ii. you required the use of home oxygen or had to take oral steroids; for example prednisone or prednisolone.
Pre-Existing Condition Medical Exclusion for Identifier ME#2
If your exclusion identifier is ME#2 your Emergency Medical and Dental Coverage is subject to all of the exclusions set out in the General Exclusions Section of this policy and the following exclusion:
ME#2. We do not cover any loss or expense related directly or indirectly to:
a. Your medical condition or any related condition if in the 180-day period immediately preceding your effective date that condition has not been stable and controlled.
b. Your heart condition if in the 180-day period immediately preceding your effective date:
i. you have had any heart condition that has not been stable and controlled; or
ii. you have been required to use, take, or been prescribed to take nitro-glycerine in any form, more than once per a seven day period.
c. Your lung condition if in the 180-day period immediately preceding your effective date:
i. you have had any lung condition that has not been stable and controlled; or
ii. you required the use of home oxygen or had to take oral steroids; for example prednisone or prednisolone.
Pre-Existing Condition Medical Exclusion for Identifier ME#3
If your exclusion identifier is ME#3 your Emergency Medical and Dental Coverage is subject to all of the exclusions set out in the General Exclusions Section of this policy and the following exclusion:
ME#3. We do not cover any loss or expense related directly or indirectly to:
a. 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 effective date and this exclusion applies whether or not the condition has been stable and controlled;
b. Your heart condition if in the 180-day period immediately preceding your effective date you have taken medication, been prescribed medication, received treatment, experienced a deterioration of the condition or had cause to seek treatment for any heart condition; or
c. Your lung condition if in the 180-day period immediately preceding your effective date you have taken medication, been prescribed medication, received treatment, experienced a deterioration of the condition or had cause to seek treatment for any lung condition.
Relevant Definitions:
Expected medical treatment: Medical consultation or hospitalization that your prior medical history indicates as being probable or certain to occur.
Medical condition: An injury or sickness, including but not limited to disease, acute psychoses, and complications of pregnancy occurring within the first 31 weeks.
Medical consultation: Any investigative medical service, including history-taking, examination, testing, advice, or treatment by a physician for a symptom, sickness, illness, or disease that may or may not have been definitively diagnosed.
Prescription medication: A drug, medicine or medication only obtainable by the prescription of a licensed physician or dentist due to a medical emergency, and dispensed by a licensed pharmacist. Provider: The hospitals, clinics, physicians, and other medical service providers, the use of which must be approved by us at the time of the emergency.
Recurrence: The appearance of symptoms caused by or related to a medical condition that was previously diagnosed by a physician or for which treatment was previously received.
Stable and controlled: Any medical condition for which there has been no new treatment or newly prescribed medication; no change in treatment or change in prescribed medication; no new, more frequent or more severe symptom; no test results showing deterioration; no investigations initiated for symptoms whether or not your diagnosis has been determined; no hospitalization and no referral to a specialist.
Treatment: A medical, therapeutic or diagnostic procedure prescribed, performed or recommended by a licensed physician, including but not limited to prescription medication, investigative testing, and surgery.