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 (Pre-approval required)
Prescription Medications
30 day Supply
Dental Pain Relief
Max $500
Emergency Dental Repair
Max $3,000
24-hour Emergency Assistance Center
Included
ambulanceTransportation
Covered
Emergency Home Return / Evacuation
Included
Repatriation of Remains
Max $10,000
Cremation / Burial
Max $4,000
Stable Pre-existing Medical Conditions Coverage
Included, if Selected
Private Duty Nurse / Medical Attendant
Included
Rental / Purchase of Medical Appliances
Minor appliances such as crutches, casts, splints, canes, slings, trusses, braces, walkers and/or the temporary rental of a wheelchair do not exceed the purchase price.
Side-Trips Benefit (with in Canada and outside of Canada)
Included

Enhanced Benefits

Emergency Services of Chiropractor, Chiropodist, Physiotherapist, Osteopath, or Podiatrist
Max $500/Category
Accidental Death
Coverage Amount OR Max $150,000
Double Dismembernent
Coverage Amount OR Max $150,000
Single Dismembernent
Coverage Amount OR Max $75,000
Bedside Companion Accommodation / Transportation
N/A
Meals and Accommodation / Hospital Allowance / Out-of-pocket Expenses
N/A
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
N/A
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

Eligibility Requirements

To be eligible for coverage under this plan, the applicant must:

1.be a visitor to Canada, a person with a Canadian work visa or super visa, an immigrant to Canada or a Canadian resident, who is not eligible for a provincial or territorial government health insurance plan in Canada;

2.be at least 15 days of age on the date of purchase;

3. not be travelling against the medical advice of a physician and/or have been diagnosed with a terminal illness. A terminal illness means that you have a medical condition that is cause for a physician to estimate that you have less than 6 months to live or for which palliative care has been received.

4.not have a kidney disease requiring dialysis;

5.not have Congestive Heart Failure, AIDS or require the use of home oxygen;

6.not be experiencing new or undiagnosed symptoms and/or know of any reason to seek medical attention.

Note: Your spouse and/or child(ren) must also meet all the criteria to be eligible for family coverage under this plan.

Make a Claim:

1. You must substantiate your claim by providing all documents listed below. (The insurer, Administrator Company or Ontime Care are not responsible for charges levied in relation to any such documents.)

a) A completed Claim Form (provided by Ontime Care or Administrator Company upon notification of claim).

b) Original itemized bills from the licensed medical provider(s)stating the patient’s name, diagnosis, date and type of treatment, and the name, address and telephone number of the provider, as well as the original transaction documents proving that payment was made to the provider.

c) Original prescription drug receipts from the pharmacist, physician or hospital indicating the name of the prescribing physician, prescription number, name of preparation, date, quantity and total cost.

Note: If you refuse or fail to sign the medical authorization form or refuse to provide any information pertinent to your claim, it may result in a delay in processing your claim. (Please refer to SECTION XI - STATUTORYCONDITIONS#5.)

2. Payment of Benefits

All payments are payable to you or on your behalf. Benefits for loss of life are made to your estate unless another beneficiary is designated in writing to Ontime Care or the Administrator Company. Any claims paid to you will be payable in Canadian funds. If you have paid a covered expense, you will be reimbursed in Canadian currency at the prevailing rate of exchange on the date that the claim payment is made to you. No sum payable shall bear interest.

3. Sendall pertinent documentsto:

Ontime Care Worldwide Inc.

15 Wertheim Court, Suite 512,

Richmond Hill, ON L4B 3H7

Indicate your policynumber on all correspondence

Premium Refunds:

All refunds and cancellations are a subject to $25 policy administration fee.

You can request a Full Refund of the insurance premium in case:

– You have applied for Super Visa, and it was rejected. All other requests for premium refunds due to not traveling to Canada should be submitted for approval by 21 Century office.

Requests for Partial Refunds are only issued, if:

– You return to your country of origin before the insurance policy expires. – You become eligible to receive health care insured under the Provincial Medical Plan.

If you are applying for a Partial Refund and:

– Have a claim that has been paid or has been reported but not yet paid. – The total amount of all reported eligible expenses will not exceed the Deductible Amount.

You may apply to have such claim(s) withdrawn, subject to a file handling fee of $250 per claim.

Once these claims have been withdrawn in order to apply for a premium refund, no further expenses for your medical care will be accepted for consideration, regardless of the date the expense was incurred. Moreover, the file handling fee will be deducted from any amount to be refunded. In order to request a Premium Refund, please contact our Insurance Advisors.

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