Canadian Travel Insurance for Pre-Existing Conditions

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. 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 - you shouldn't assume 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 before your coverage comes into effect.

BestQuote Travel Insurance Agency carries many different travel insurance policies to use with our customers. 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 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 before departure. So, please call us if you need help looking through the various stability options on our quote engine or if you are uncertain if something means the condition is stable. 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 not to summarize coverage because that can always lead to dismissing relevant information. All policies use their definition of 'stable' and other terms that affect coverage. All policies are subject to specific 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 the 'stable' period and that the definition of 'stable', 'change in medication' etc., can affect coverage.

TuGo - Pre-Existing Medical Condition Exclusion

All Emergency Medical Insurance plans are also subject to the Emergency Medical Insurance Exclusions and to the General Exclusions shown on page 47.

The stability requirements for pre-existing medical conditions are outlined below:

Worldwide and Worldwide Excluding USA Plans
We will not be liable to provide coverage or services, or to pay claims for expenses incurred directly or indirectly as a result of the following: 

  • 59 years and under - trip 35 days or less: Any medical condition which is not stable on or within the 7 days before the date of departure.
  • 59 years and under - trip over 35 days: Any medical condition which is not stable on or within the 90 days before the date of departure. If you extend your trip and the total trip length (including the extension) exceeds 35 days, the stability for medical conditions is based on your total trip length.
  • 60 years and over - all trip lengths: Any medical condition which is not stable on or within the 180 days before the date of departure. 

If you purchased this Policy to top-up any other insurance plan, the stability for medical conditions is based on your total trip length. Medical conditions that do not meet the stability criteria set out above are not covered.

Travel Within Canada Plans
There is no stability requirement for pre-existing medical conditions.

Refer to the following definitions: alteration, medical condition, pre-existing medical condition, treatment and stable.

If you purchased the optional Unstable Pre-existing Medical Condition Coverage, refer to that section heading for coverage applicable to your pre-existing medical conditions that are not stable.

 

Relevant TuGo Definitions

Alteration 
The medication usage, dosage or type has been increased, decreased or stopped and/or a new medication has been prescribed.

Alteration does not include:

  1. Changes in brand to an equivalent name brand or to an equivalent generic brand of the same or equivalent usage or dosage; or,
  2. Routine dosage adjustments within prescribed parameters for insulin or oral diabetes medication to ensure correct blood levels are maintained; blood sugar levels must be checked regularly and the medical condition must remain unchanged; or,
  3. Routine dosage adjustments within prescribed parameters for blood thinner medication to ensure correct blood levels are maintained; blood levels must be checked regularly and the medical condition  must remain unchanged; or,
  4. A temporary stoppage of blood thinner medication up to a maximum of 24 hours if the stoppage is required for a surgery or a procedure; or,
  5. Usage changes due to the combination of several medications into one; the medical condition  must remain unchanged.

Medical condition
Any disease, illness or injury (including symptoms of undiagnosed conditions). 

Pre-existing medical condition
For Emergency Medical Insurance: Any medical condition that exists on or before the date you leave for your trip.
For Trip Cancellation & Trip Interruption Insurance and Trip Interruption Insurance Only: Any medical condition that exists on or before the date the trip is booked or the date this Insurance is purchased.

Treatment, treat, treated
A procedure prescribed, performed or recommended by a physician for a medical condition. This includes but is not limited to medication, investigative testing and surgery.

Stable
A medical condition is considered stable when all of the following statements are true:

  1. There has been no deterioration of the medical condition as determined by a physician or other registered medical practitioner, and
  2. There have been no new symptoms or findings or more frequent or severe symptoms or findings, and
  3. There has been no change in treatment by a physician or other registered medical practitioner or any alteration in any medication related to the medical condition, and
  4. There has been no new treatment received, prescribed or recommended by a physician or other registered medical practitioner.

GMS - Pre-Existing Medical Condition Exclusion

Pre-existing Medical Conditions – No coverage or reimbursement for expenses resulting from medical conditions which have not been stable for 180 days immediately prior to your departure date, including:

  1. medical conditions for which you received medical treatment or medical consultation; and/or
  2. undiagnosed medical conditions 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 conditions.

Pre-existing Medical Conditions When Topping Up Other Insurer’s Plans – No coverage or reimbursement for expenses where this policy is being used as a  top-up for another insurer’s emergency medical insurance, unless the medical conditions have been stable for 180 days prior to the effective date of the top-up.

Pre-existing Medical Conditions When Topping-Up a GMS Plan – No coverage or reimbursement for expenses where this policy is being used as a top-up to existing GMS emergency medical coverage, unless medical conditions are stable as defined by the stability period as specified within the GMS policy this policy is topping-up.

 

Relevant GMS Definitions

Stable
A medical condition is considered stable and controlled, only when all of the following statements are true.

  1. There has not been any new medical treatment prescribed or recommended, or change(s) to existing medical treatment or stopped medical treatment; and
  2. There has not been any change to any existing prescribed drug (including an increase, decrease, or stopping to prescribed dosage), except:
    a. a dosage adjustment for anti-hypertensive or cholesterol lowering medication;
    b. a change from brand name medication to generic medication and vice versa of the same dosage;
    c. Coumadin/Warfarin prescribed as an anticoagulation therapy adjusted to ensure your INR is maintained within therapeutic range as directed by your physician(s) provided there has been no other change in your condition; and
    d. insulin or oral anti-diabetic medication where blood levels are tested on a regular basis and adjustments to the dosage are made to ensure your blood glucose level is maintained within therapeutic range as directed by your physician(s) provided there has been no other change in your condition; and
  3. The medical condition has not become worse; and
  4. There have not been any new, more frequent or more severe symptoms; and
  5. There has been no hospitalization or referral to a specialist; and
  6. There has been no tests, investigation or medical treatment recommended, but not yet complete, nor any outstanding test results.

Medical Condition(s)
A disease, illness or injury including symptoms of undiagnosed conditions.

Medical Consultation
The act of meeting with a physician for the purpose of discussing and evaluating signs or symptoms in an effort to diagnose a medical condition, illness or injury; or for the purpose of evaluating your progress and medical treatment of a medical condition, illness or injury. 

Medical Treatment
A procedure prescribed, performed or recommended by a physician for a medical condition. This includes but is not limited to prescribed medication, investigative testing and surgery. 

Allianz - Pre-Existing Medical Condition Exclusion

Expenses that are due to, contributed by, or resulting from pre-existing medical conditions, may qualify for coverage, if your pre-existing medical condition meets the stability period that applies to you. All exclusions, including those for specific medical conditions, still apply.

IMPORTANT:
If you are age 64 or younger on your effective date:
Pre -existing medical conditions that are stable for 90 days before the effective date qualify for coverage, up to the Sum Insured shown on your Confirmation of Coverage.

If you are age 65 or older on your effective date:
Pre -existing medical conditions that are stable for 150 days before the effective date qualify for coverage, up to the Sum Insured shown on your Confirmation of Coverage.

To be considered stable during your stability period, your pre-existing medical condition or related conditions must not have resulted in any of the following:

  1. New treatment (including new prescriptions),
  2. Change in treatment including frequency, dosage or type (including prescriptions),
  3. Signs or symptoms,
  4. A new diagnosis,
  5. Test results showing your condition is worsening,
  6. Hospitalization,
  7. A referral to a specialist, received or recommended, or
  8. Waiting for any test results, further investigation, or surgery.

The following are considered stable:

  1. Diabetic Insulin users - Routine insulin adjustment not prescribed by your physician, as long as insulin was not first prescribed during your stability period,
  2. Coumadin, Warfarin users - Routine adjustment of these medications, as long as Coumadin or Warfarin were not first prescribed during your stability period,
  3. A change from a brand name medication to a generic medication, or
  4. Minor Ailments - a sickness or injury that ended more than 30 days prior to your effective date and did not require:
    a) treatment (including prescriptions) for more than 30 consecutive days, or
    b) more than one (1) follow-up with a physician.

 

Relevant Allianz Definitions

Injury or Injured
Physical bodily harm.

Medical condition
Any sickness (including signs or symptoms of undiagnosed conditions), injury, or condition for which you consulted a physician.

Treatment
A medical or diagnostic procedure prescribed, performed or recommended by a physician, including but not limited to, prescribed medication, investigative testing or surgery.

Sick or Sickness
Any sudden illness or disease requiring the medical care or treatment of a physician. 

Signs or Symptoms
Any abnormalities observed or uncovered in any examination, or any evidence of sickness or injury experienced by you. 

Manulife - Pre-Existing Medical Condition Exclusion

We will not pay any expenses or benefits relating directly or indirectly to:
A pre-existing medical condition. The pre-existing medical 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 medical condition” and “stable” at the end of this policy.
NOTE: For the Travel Canada Emergency Medical plan, no pre-existing medical condition exclusion applies.

Rate Category A. We will not pay any expenses relating to:

  • a pre-existing medical 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, any heart condition 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, any lung condition has not been stable or you required treatment with oxygen or Prednisone for a lung condition.

Rate Categories B and C. We will not pay any expenses relating to:

  • a pre-existing medical 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, any heart condition 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, any lung condition has not been stable or you 

 

Relevant Manulife Definitions

Change in medication 
Means the medication dosage, frequency or type has been reduced, increased or 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 medical condition
Means any medical condition that exists before your effective date.

Stable
A medical condition 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, 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 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.

Treatment
Means hospitalization, a procedure prescribed, performed or recommended by a physician for a medical condition.

This includes but is 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.

AwayCare - Pre-Existing Medical Condition Exclusion

Benefits are not payable under this policy if losses sustained or expenses incurred are the direct or indirect result of any of the following, for:

If You /Your Pre- Existing conditions do not meet the required Stability outlined on Your confirmation of benefits

  1. Stability is calculated at the departure date of your trip. For individuals 59 years or less, it can be 45 days with the option to reduce it to 7 days. 
  2. Stability is calculated at the departure date of your trip. For individuals 60 years or older, it can be 365 days with the option to reduce to 180 days, 90 days, 7 days.  

 

Relevant AwayCare Definitions

Pre-existing condition
A medical or dental condition for which treatment has been received or taken or symptoms have appeared prior to the Policy Effective Date and includes a medically recognized complication or recurrence of a medical condition.

Stable
A medical condition (other than minor ailment) for which all the following statements are true

  1. Has been no new diagnosis, Treatment or prescribed medication.
  2. No test results showing a deterioration in Your condition.
  3. No Hospitalization, referral to a specialist (made or recommended) or You are not awaiting test or Treatment.
  4. No change in Your medical Treatment and/or change in dosage of a medication (Exception: the routine adjustment to Coumadin, Warfarin or insulin to maintain optimal levels.)
    a. EXCEPTION- If You change from a brand name to a generic with the same dosage this condition will remain stable.
  5. Stability period:
    a. Stability is calculated at the departure date of your trip. For individuals 59 years or less, it can be 45 days with the option to reduce it to 7 days. 
    b. Stability is calculated at the departure date of your trip. For individuals 60 years or older, it can be 365 days with the option to reduce to 180 days, 90 days, 7 days. 

Treat/Treatment
A medical, therapeutic or diagnostic procedure ordered performed or recommended by a Physician, including but not limited to prescription medication, surgery or investigative testing that results in a diagnosis of a specific medical condition. Treatment Does not include Minor Ailment.

 

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