Basic Benefits

Covid-19 coverage
Not Covered
Ambulance Services / Transportation
Covered
Emergency Hospitalization
Up to Coverage Amount
Services of a Physician, Surgeon, etc.
Up to Coverage Amount
Emergency Medical Care
Up to Coverage Amount
Walk-in Clinic Visits
Covered
Follow Up Treatment
Covered
Laboratory Diagnostics / X-Ray
Covered
Prescription Medications
Max 1 Month Supply
Dental Pain Relief
Max $250
Emergency Dental Repair
Max $2,000
24-hour Emergency Assistance Center
Included
ambulanceTransportation
Covered
Emergency Home Return / Evacuation
Max $5,000
Repatriation of Remains
Max $10,000
Cremation / Burial
Max $4,000
Stable Pre-existing Medical Conditions Coverage
Included, 180 Days Stability Required
Private Duty Nurse / Medical Attendant
Included
Rental / Purchase of Medical Appliances
N/A
Side-Trips Benefit (with in Canada and outside of Canada)
Included

Enhanced Benefits

Emergency Services of Chiropractor, Chiropodist, Physiotherapist, Osteopath, or Podiatrist
Max $300/Category
Accidental Death
N/A
Double Dismembernent
N/A
Single Dismembernent
N/A
Bedside Companion Accommodation / Transportation
N/A
Meals and Accommodation / Hospital Allowance / Out-of-pocket Expenses
Max $1,000/$150 Per Day
Maternity Benefits / Delivery Coverage
N/A
Pregnancy Complications Coverage
N/A
Physical Examination (Non-emergency)
N/A
Eye Examination (Non-emergency)
N/A
Vaccines (Non-emergency)
N/A
Child Care / Escort Expenses
Max $500
Psychiatric / Psychological
N/A
Return of a Vehicle
N/A
Sports Injuries Coverage
Not for Hazardous Sports
Flight / Travel Accident
N/A
Trip-Break Benefit
N/A

If you are under fifty-five (55) years of age, you are NOT eligible if you:

1. Have any reason to seek medical treatment, excluding the regular care of a chronic condition or medical evaluation required to satisfy travel visa requirements;

2. Are currently in Canada and have ever been denied similar coverage offered by another Canadian insurer; and

3. Are currently in Canada and had more than $5,000 in medical treatment in the last twelve (12) months while in Canada.

If you are fifty-five (55) years of age and older, you are NOT eligible if you:

1. Are eighty (80) years of age or older on the policy effective date;

2. Have any reason to seek medical treatment, excluding the regular care of a chronic condition or medical evaluation required to satisfy travel visa requirements;

3. Are currently in Canada and have ever been denied similar coverage offered by another Canadian insurer;

4. Are currently in Canada and had more than $5,000 in medical treatment in the last twelve (12) months while in Canada;

5. Are expecting medical treatment for heart disease;

6. Are waiting for the test(s) for a suspected heart condition;

7. Are taking prescription drugs for heart disease while taking insulin to treat diabetes;

8. Have an implantable cardioverter defibrillator (ICD);

9. Fainted or fell more than once without a medical diagnosis (syncope);

10. Use home oxygen for a medical condition;

11. Take oral steroids to treat a lung condition;

12. Are being treated for cancer or have Metastatic Cancer;

13. Have a vascular aneurysm that is surgically untreated;

14. Have ever had:

a. A valve replacement;

b. Kidney (renal) dialysis; or

c. An organ transplant;

15. Were diagnosed; received new medical treatment (e.g. consultation, tests or prescription drugs); or had a change in your medical treatment (e.g. a stop, start or dosage change to a prescription drug, other than a dosage change of Coumadin or Warfarin) for, any of the following conditions in the last twelve (12) months:

a. Congestive heart failure;

b. Atrial flutter;

c. Atrial/ventricular fibrillation;

d. Peripheral vascular disease;

e. Stroke / transient ischemic attack (TIA);

f. Acquired immune deficiency syndrome (AIDS);

g. Terminal illness;

h. Blood clots; or

i. Gastrointestinal bleeding; and

16. Require assistance from another person(s) with activities of daily living (ADL) if you are seventy (70) years of age or older.

If any of the medical conditions listed above apply to you, contact GMS immediately as you are not covered. Should any changes to your health occur after you applied for coverage, GMS must be notified.

For more Information, click Policy Wording.

Claim Procedure

1. Notice of Claim: In the event of a medical emergency, you must provide written notice of claim within thirty (30) days after contacting GMS Travel Assistance. Notice of claim form will be provided to you by GMS Travel Assistance on your initial contact.

2. Proof of Claim: To be eligible to claim, you must submit the following documentation to GMS as soon as possible and no more than 90 days from when the illness or injury occurred:

a. original itemized receipts for all bills and invoices;

b. proof of payment by your or any other benefit plan;

c. medical records, including a completed diagnosis by the attending physician;

d. for dental claims, proof of the accident;

e. proof of the travel dates, including your departure date from your country of origin and visa documentation, if requested by GMS;

f. your historical records, if requested by GMS; and

g. in the case of claims involving your death, GMS may require an autopsy subject to any law of the applicable jurisdiction relating to autopsies.

3. Limitation Period: Expenses must be submitted to GMS no later than 12 months from the date of the last eligible expense to be considered for reimbursement.

For more information, please review Policy Wording 

Full Refunds and Partial Refunds:

1. Full refunds are available if no travel has taken place when your request for a refund is received:

a) Before the effective date as shown on your confirmation document; or

b) After the effective date as shown on your confirmation document, if you have not travelled to Canada because your application for a visa to enter Canada was declined. An administration fee applies, and it will be deducted from the refund. A copy of the visa decline letter will be needed when requesting a refund.

2. Partial refunds are available, with an administration fee, in the following situations.

a) Your request for a refund is received after the effective date shown on your confirmation document when no travel has taken place, except if your request is the result of a declined visa application. The refund will be calculated from the date GMS was notified.

b) You return to your country of origin. The refund will be calculated from the date you departed Canada (proof of departure will be required).

c) You become eligible and covered under a government health plan during the period of coverage. The refund will be calculated from the date your government health plan takes effect.

d) Your death occurs during the policy period. The refund will be calculated from the date of your death.

3. Refunds are not available when:

a) a claim has been reported under this policy; or

b) you request a refund after the expiry date of your policy.

The following conditions apply to partial refunds issued under this policy.

1. When you apply for a refund after the date on which the coverage is to be effective, as shown on your confirmation document, the following must be provided:

a. proof of travel showing the date you departed from Canada;

b. proof of coverage under a government health plan including the effective date of coverage;

c. in the case of your death, a copy of the death certificate; or

d. proof that you did not travel from your country of origin.

Depending on the documentation provided, GMS reserves the right to limit or restrict the refund.

2. GMS considers a claim to have been reported when an insured person, or a family member, contacts GMS’ Travel Assistance. You may still be eligible for a partial refund if:

a. GMS’ Travel Assistance was only contacted once during the period of coverage; and

b. no payment for emergency medical treatment was issued or pending.

Refunds are subject to GMS’s review and approval.

3. Once a refund has been issued; you will no longer be eligible for any claim payment regardless of when the expense or claim occurred.

A refund is calculated and paid based on the following.

1. A refund is calculated using the number of unused days, and the daily rate applied based on your original trip length. The number of unused days is calculated based on your departure date unless otherwise indicated in the Requesting a Refund section above under 2. a., b., c., and d.

2. Refunds will be processed as follows:

a. Payment made by credit card will be credited to the credit card on file;

b. Payment made by cash or cheque will be payable to you unless an alternative payee has been assigned;

c. All refunds requested after the effective date shown on your confirmation document are subject to an administration fee;

d. No refund will be issued by cheque for amounts under $5.

For more information, please review the Policy Wording.

This policy does not cover the following expenses.

1. GMS does not cover expenses incurred in your country of origin.

2. GMS does not cover expenses incurred where you act against medical advice or the advice of GMS.

3. GMS does not cover expenses resulting from the regular care of a chronic condition.

4. GMS does not cover any expenses that are the result of your failure, before arriving in Canada, to:

a) Adhere to medical treatment;

b) Obtain investigative or diagnostic tests recommended by a medical professional; and/or

c) Receive results from investigative or diagnostic tests.

5. GMS does not cover expenses resulting from a medical condition(s) that have not been stable for one hundred and eighty (180) days immediately before your effective date, including:

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

b) Undiagnosed medical condition(s) related to symptoms you received medical treatment or medical consultation.

You must be stable based on the definition of stable in this policy, regardless of your physician's opinion or any other person who may provide an opinion on your medical condition(s).

6. GMS does not cover expenses when you travel outside Canada if a travel advisory has been issued by the Canadian government recommending that Canadians not travel to the country or specific regions within the country.

7. GMS does not cover any medical treatment, which is a continuation of or a medical condition's recurrence.

8. GMS does not cover any expenses resulting from medical treatment that is not a medical emergency, including but not limited to routine or general physical examinations; medical check-ups; regular care of chronic conditions; elective surgery; dental or cosmetic surgery, even if recommended by a physician; and follow-ups or continued services following emergency medical treatment. GMS’s opinion on the issue is final and binding.

9. GMS does not cover expenses that duplicate any service, allowance or repayment available by an existing government health plan or private plan.

10. GMS does not cover medical treatment, hospitalization or surgery (including elective, non-elective, personal comfort, dental or cosmetic), which is not considered an emergency, even if a physician recommends it.

11. GMS does not cover expenses for medical treatment at a diagnostic facility unless pre-approved by GMS.

12. GMS does not cover emergency air transportation or return to Canada or your country of origin, which is not arranged and pre-approved by GMS.

13. GMS does not cover drugs commonly available without a prescription, not legally registered or approved in Canada, experimental drugs or preventative medicines or vaccines.

14. GMS does not cover any expenses resulting from and/or incurred during trips undertaken to receive a diagnosis of medical treatment.

15. GMS does not cover any expenses when you travel against the advice of a physician.

16. GMS does not cover expenses related to your pregnancy, an abortion, miscarriage, childbirth or complications of any of these conditions.

17. GMS does not cover a newborn until it has been released from the hospital for forty-eight (48) hours and has been added as a dependent on your coverage.

18. GMS does not cover expenses for coronary artery angioplasty, cardiac surgery or implantable cardioverter-defibrillator (ICD) (including any associated diagnostic tests or charges) unless necessary in a medical emergency and approved by GMS before any actions.

19. GMS does not cover any expenses for medical treatment or surgery, which is considered by GMS to be experimental. GMS’s opinion on the issue is final and binding.

20. GMS does not cover expenses resulting from suicide or self-inflicted injuries.

21. GMS does not cover expenses resulting directly or indirectly from your criminal or illegal acts.

22. GMS does not cover expenses resulting from your sickness, injury, or death if, at the time of the sickness, injury or death, evidence supports that it was caused by, or in any way contributed to, by the use or abuse of prohibited drugs, alcohol, or any other intoxicant or the misuse of medication, whether prescribed or not.

23. GMS does not cover expenses incurred due to a motor vehicle accident unless such services are not covered by any other private or public vehicle insurance.

24. GMS does not cover any expenses resulting from your participation in:

a. professional sport;

b. speed contests or racing of motorized land, water or air vehicle(s);

c. an extreme sport, including but not limited to scuba diving (except when you are NAUI, PADI, ACUC or SSI certified), bungee jumping, parachuting, mountaineering, skydiving, participation in a rodeo, hang gliding, acrobatic or stunt flying or participating in a horse race as a jockey.

25. GMS does not cover air travel expenses unless riding as a passenger on a common carrier.

26. GMS does not cover medical treatment or services that contravene or are prohibited by provincial laws and/or Canada's federal laws.

27. GMS does not cover expenses resulting from your service in the armed forces, willful exposure to peril, and/or relief work.

28. GMS does not cover expenses for medical treatment and services provided outside Canada except as provided under the following sections in this policy: a. Automatic Policy Extensions; or b. Travel Benefits Outside Canada.

29. GMS does not cover expenses resulting from any nuclear reaction, radiation or radioactive contamination or occurrence, where the exposure risk was present before you arrive in Canada, however, caused.

30. GMS does not cover expenses resulting from war, terrorism or acts of foreign rebellion.

For more information, please review the Policy Wording.

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