Basic Benefits

Covid-19 coverage
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
Max $3,000
Laboratory Diagnostics / X-Ray
Covered
Prescription Medications
Max $1,000 OR a 30 day Supply
Dental Pain Relief
Max $600
Emergency Dental Repair
Max $4,000
24-hour Emergency Assistance Center
Included
ambulanceTransportation
Covered
Emergency Home Return / Evacuation
Included
Repatriation of Remains
Max $12,000
Cremation / Burial
Max $5,000
Stable Pre-existing Medical Conditions Coverage
Included, if Selected
Private Duty Nurse / Medical Attendant
Up to the Coverage Amount
Rental / Purchase of Medical Appliances
Up to the Coverage Amount
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
Max $25,000
Double Dismembernent
Max $25,000
Single Dismembernent
Max $12,500
Bedside Companion Accommodation / Transportation
Included
Meals and Accommodation / Hospital Allowance / Out-of-pocket Expenses
Max $2,000/$200 Per Day
Maternity Benefits / Delivery Coverage
Max $3,000
Pregnancy Complications Coverage
Max $3,000
Physical Examination (Non-emergency)
N/A
Eye Examination (Non-emergency)
N/A
Vaccines (Non-emergency)
N/A
Child Care / Escort Expenses
$50/Day (Max $500)
Psychiatric / Psychological
N/A
Return of a Vehicle
Max $2,500
Sports Injuries Coverage
Not for Hazardous Sports
Flight / Travel Accident
Max $25,000
Trip-Break Benefit
Included

You are eligible for coverage if:

1. You are over the age of 14 days old and have not reached the age of 90 years at the time of application.

2. You are:

a) A foreign worker, or a visitor to Canada with valid legal status in Canada; or,

b) An immigrant awaiting provincial government health care coverage; or,

c) A returning Canadian not eligible for provincial government health care plan due to an extended leave.

3. The expenses you incur result from an acute, sudden and unexpected emergency

Claims Procedures and Payment of Benefits

1. Any notices of claim or correspondence concerning a claim should be promptly sent to:

Claims at TuGo

10th Floor, 6081 No. 3 Road

Richmond, BC Canada V6Y 2B2

2. Any cost incurred by Claims at TuGo in obtaining further documentation required to confirm your claim's eligibility is the responsibility of the claimant.

3. Claim forms will be provided to the claimant for completion and return to Claims at TuGo. It is the claimant's responsibility to complete and/or produce any documentation required by Claims at TuGo to enable them to process and confirm the eligibility of the claim.

4. All required documentation must be received within one year from the date of loss. Failure to do so will result in denial of the claim.

5. To qualify for reimbursement, original, itemized receipts must be provided as support for all eligible expenses. If original, itemized receipts are not provided, the expense will not be reimbursed.

6. To receive benefits, any requested supporting documentation must be submitted along with your notice of claim.

7. Only bills from physicians, hospitals and another medical care provider (s) that are original itemized and that state the insured’s name, diagnosis, date(s) of service and type of treatment or service will be considered. Only Original pharmacy prescription receipts will be considered. For all other benefits, original itemized receipts are required.

Refunds:

1. Refunds are not available if a claim has been or will be submitted.

2. When no travel has taken place and the refund request is received before the Policy's effective date, a full refund is available.

3. When no travel has taken place, and the refund request is received AFTER the effective date of the Policy:

a) A full refund is available within 10 days of the application date; or,

b) A refund less an administration fee is available when the request for refund is received more than 10 days after the application date but no later than 30 days after the effective date and before the Policy's expiry date.

c) Refunds must be requested in writing.

4. A partial refund is available if:

a) You return to your country of permanent residence and a minimum term of 45 days remains unused on the Policy; or,

b) You become eligible and/or covered under a provincial or territorial government health care plan during the period of coverage.

c) A satisfactory proof of return to the country of permanent residence or proof of the date you became eligible and/or covered under a provincial or territorial government health care plan is sent to TuGo.

d) Refunds must be requested in writing.

All refund requests must be received by TuGo no later than 30 days from the date you became eligible and/or covered under a provincial or territorial government health care plan. Refunds will be calculated from the date you return to your country of permanent residence or the date you become eligible and/or covered under a provincial or territorial government health care plan. All partial refunds will be subject to an administration fee.

Policy Exclusions are:

1. Pre-existing conditions as defined except as follows:

for persons 69 years and under, if stable in the 120 days before the effective date of this Policy; or,

for persons 70 to 79 years, if stable in the 120 days before this Policy's effective date and the applicable optional coverage was purchased.

2. Any loss incurred as a result of a sickness that originated or was symptomatic during the waiting period as follows:

the first 48 hours from the effective date of this Policy, if this Policy was purchased within 60 days of your arrival date in Canada; or,

within the first seven (7) days from this Policy's effective date, if this Policy was purchased 61 days or more after your arrival date in Canada.

3. Any subsequent claim of the same medical condition concerning a sickness or injury that occurred during a covered trip and for which a claim has already been made or is pending.

4. Conditions or any related conditions for which, before the arrival date in Canada, testing or investigative consultation took place, was scheduled to take place or was recommended, and for which results had not yet been received at the time of departure from your country of permanent residence. This includes recommended or scheduled tests before departure but had not yet taken place at the time of departure.

5. Tests and investigative consultation, including but not limited to biopsies, except when performed at the time of initial emergency sickness or injury.

6. Elective (non-emergency) treatment or surgery.

7. A trip that is undertaken:

against a physician’s advice; or,

after diagnosis of a terminal condition.

8. Any medical condition or recognized complication of a condition, where the purpose of your trip is to seek medical treatment or advice for that condition, and where the medical evidence indicates the medical treatment is related to that condition.

9. Routine pre-natal care, pregnancy, childbirth or complications thereof, occurring within the 9 weeks immediately before or after the expected delivery date except as specified under the “Maternity” Benefit.

10. Medical expenses incurred by an infant 14 days old or less.

11. Suicide or attempt thereat, self-inflicted injury, or the commission or attempted commission of any crime or offence.

12. Psychotherapeutic treatment or rehabilitative treatment, psychological-emotional or mental disorders.

13. A medical condition for which medical treatment could have reasonably been expected.

14. Air ambulance or other medical evacuation by air unless pre-approved and arranged by Claims at TuGo.

15. Treatment, services or prescriptions required for ongoing care or check-ups or provided in a psychiatric hospital, chronic care facility of a hospital or convalescent or nursing home, health spa, or rehabilitation centre.

16. Expenses incurred due to your failure to accept or follow a physician’s advice, treatment or recommended treatment.

17. The consumption or abuse of any alcohol, drugs or medication, or any event, act or omission caused or contributed to by the use or abuse of alcohol, drugs or medication.

18. Injury or sickness while participating in professional sports activities and/or scuba diving unless you are certified by an internationally recognized and accepted program (NAUI, PADI).

19. A condition arising out of or resulting from Acquired Immune Deficiency Syndrome (“AIDS”) or AIDS Related Complex (“ARC”) if the condition first manifested itself before the effective date of coverage or if the condition arose out of Human Immunodeficiency Virus (“HIV”) that had first been diagnosed or that manifested itself before the effective date.

20. a) War, civil war, riot, rebellion, insurrection, revolution, invasion, hostilities or warlike operations (whether war be declared or undeclared), civil commotion, the overthrow of the legally constituted government, military or usurped power, explosions of war weapons, utilization of nuclear, chemical or biological weapons;

b) Death or disablement in any way caused by or contributed by radioactive contamination; or

c) Any action was taken to control, prevent, or suppress any, or all of a) or b) above.

21. Unless otherwise stated in this Policy (see General Condition, no. 2), expenses incurred if other insurance policies, plans or contracts, including any private or provincial automobile insurance, cover the loss. If, however, the loss exceeds the limits of the other policies, plans or contracts, if this insurance covers losses or periods not covered by those other policies, plans or contracts, this Insurance shall then apply more than all other valid insurance.

22. Loss of or damage to eyeglasses, contact lenses, prosthetic devices, hearing aids.

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