Visitors Insurance: Compare pre-existing medical conditions & stable periods

Summary of all top Canadian visitor insurance company's pre-existing medical condition exclusions, stable periods, and definitions of changes for visitors 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 be reasonably expected to require medical attention during your trip will be excluded from coverage under your visitors to Canada health insurance. Simply put, medical expenses for ongoing maintenance, monitoring or treatment of an ongoing (chronic) condition will not be covered - by any of the policies offered by any Canadian insurance company. If we could provide the option for some customers to choose that kind of coverage we would (even though it would be quite expensive), but Canadian companies don't provide that type of coverage.

However, some plans may limit these exclusions according to the language of the insurance contract, so that STABLE pre-existing conditions can be covered. Listed below are the exclusions for pre-existing medical conditions offered by the six Canadian insurance companies offered here.

We do not prefer to 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. Please look at the short summary here for a quick reference, before looking at the specific wording below:

• Manulife Plan B gives coverage for illnesses related to conditions stable for 180 days prior to effective date up to age 85; Manulife Plan A does not provide coverage for pre-existing conditions;

• GMS gives coverage for illnesses related to conditions stable for 180 days prior to effective date up to age 79;

• TIC gives coverage for illnesses related to conditions stable for 180 days prior to effective date up to age 69;

• Travel Guard gives coverage for illnesses related to pre-existing medical conditions stable for 90 days prior to effective date up to age 50;

• ETFS Medi-Select Advantage does not provide coverage for illnesses related to pre-existing conditions;
  

• Travel Underwriters Freedom does not provide coverage for illnesses related to pre-existing conditions;

• ETFS Hospital Medical Care gives coverage for illnesses related to conditions stable for 120 days prior to effective date, up to age 69; or up to age 79 if the extra fee is paid (automatic setting for BestQuote);

• Travel Underwriters Platinum policy gives coverage for illnesses related to pre-existing medical conditions up to age 69, or even between age 70-79 if the 'pre-existing coverage option' is purchased.

Manulife Visitors to Canada
The pre-existing condition exclusion that applies depends on your age and the plan you have qualified for as determined by the answers to the medical questions.
Plan A
Up to age 85: We will not pay any expenses relating to a pre-existing condition for which medication has been taken, received or prescribed and/or treatment has been received in the 180 days before your effective date of insurance; any heart condition if, in the 180 days before the effective date, you require any form of nitroglycerine for the relief of angina pain; any lung condition if, in the 180 days before the effective date, you require treatment with oxygen or prednisone for a lung condition.
Plan B
Up to age 85: We will not pay any expenses relating to a pre-existing condition that is not stable in the 180 days before your effective date; any heart condition if, in the 180 days before the effective date, you require any form of nitroglycerine for the relief of angina pain; any lung condition if, in the 180 days before the effective date, you require treatment with oxygen or prednisone for a lung condition.
ALL PLANS & ALL AGES
Hospitalization for a pre-existing condition. We will not pay any expenses relating to a pre-existing condition for which you are hospitalized either more than once or for at least 2 consecutive days in the 12 months before your effective date.
Definitions:
Please refer to these definitions when completing the Medical Questionnaire.
Change in medication means the medication dosage or frequency has been reduced, increased, stopped and/or new medications have been prescribed. We do not mean a change from a brand-name drug to an equivalent generic drug of the same dosage, and a routine adjustment in the dosage of your medication, as a result of your blood levels only, if you are taking Coumadin (warfarin) or insulin and are required to have your blood levels tested on a regular basis and your medical condition remains unchanged.
Effective Date means the date on which your coverage starts.
Hospital means a facility that is licensed as a hospital where in-patients receive medical care and diagnostic and surgical services under the supervision of a staff of physicians with 24-hour care by registered nurses. A clinic, an extended or palliative care facility, a rehabilitation establishment, an addiction centre, a convalescent, rest or nursing home, home for the aged or health spa is not a hospital.
Medical condition means accidental bodily injury, illness or disease; symptom(s); complication of pregnancy within the first 31 weeks of pregnancy; a mental or emotional disorder that requires admission to a hospital, or acute psychosis.
Pre-existing condition means a medical condition that exists before your effective date.
Stable – a medical condition for which:
1. 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
2. A physician has not determined that the condition has become worse; and/or
3. A physician (or other medical professional) has not prescribed or recommended a change in medication taken or medical care received for that condition; and/or
4. A physician (or other medical professional) has not prescribed or recommended a change in treatment for that condition; and/or
5. 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 illness, injury or symptom.

Travel Gaurd Canada
If you are under 50 years of age when your insurance starts your policy includes Medical Exclusion #1.
If you are 50 years of age or older when your insurance starts your policy includes Medical Exclusion #3.

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 not been stable and controlled; or
ii. you have been required to use, take, or been prescribed to take nitroglycerin in any form, more than once per a seven 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. required the use of home oxygen or had to take oral steroids; for example prednisone or prednisolone.
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.
Definition:
Medical condition: An injury or sickness, including but not limited to disease, acute psychoses, and complications of pregnancy occurring within the first 31 weeks.
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.

GMS Visitors to Canada
Coverage for medical condition(s) that existed prior to your effective date 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 effective 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 effective date:
i) any heart condition has not been stable;
ii) any lung condition has not been stable.
Definition
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 medications;
c) there has been no deterioration of your medical condition;
d) 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;
e) there is no further testing, treatment or investigation booked or results pending;
f ) you have not experienced a symptom that remains undiagnosed;
g) no further medical treatment after departure would be anticipated.

Travel Underwriter Freedom
Excluded from coverage:
A medical condition which existed prior to the effective date of the Policy or any condition wholly or partly, directly or indirectly, related thereto. Conditions or any related conditions for which, prior to the arrival date in Canada, testing or investigative consultation took place, was scheduled to take place or was recommended (not including routine check-up or routine monitoring for a medical condition), and for which results had not yet been received at the time of departure from country of permanent residence. This includes tests that were recommended or scheduled prior to departure but had not yet taken place at the time of departure.

TIC Visitors to Canada
Benefits are not payable for costs incurred for or as a result of:
a) If you are 69 years of age or under on the effective date:
Any pre-existing medical condition unless it was stable in the 180 days immediately before the effective date.
b) If you are 70 to 79 years of age on the effective date:
i. Any of the following pre-existing medical conditions, unless you have completed a Medical Questionnaire, have been approved in writing by TIC and have paid the required premium: • cardiovascular; • cerebrovascular; • respiratory; or
ii. Any other pre-existing medical condition not listed under “b) i.” unless it was stable in the 180 days immediately before the effective date;
c) If you are 80 years of age or over on the effective date:
Any pre-existing medical condition unless you have completed a Medical Questionnaire, have been approved in writing by TIC and have paid the required premium.
Definition:
Pre-existing medical condition means: Any sickness, injury or medical condition that has showed symptoms or required a medical consultation (even if the condition wasn’t diagnosed), or that you’ve been treated, hospitalized or prescribed medication for.
A medical consultation includes services performed by a physician for an ailment, sickness or medical condition, which may include taking a history of the problem, examining you, advising or treating you, or ordering tests to confirm a diagnosis or find out more.
Stable means a pre-existing medical condition that:
a) did not require, or was not referred for any medical consultation;
b) did not require a change in type or dosage of medication.

ETFS Medi-Select Advantage
This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by:
1. Any sickness or symptoms which manifested or were contracted or treated within the first 48 hours following the effective date if you purchase this policy after your arrival in Canada.
2. Pre-existing Condition:
a) Any sickness, injury or medical condition for which:
i. you have had symptoms;
ii. you have been hospitalized;
iii. you have been prescribed medication (including prescribed as needed);
iv. you have taken medication; or
v. you have undergone a medical or surgical procedure, at any time in the 180 days prior to your effective date.
b) Your heart condition if, for any heart condition:
i. you have had symptoms;
ii. you have been hospitalized;
iii. you have been prescribed medication (including prescribed as needed);
iv. you have taken medication; or
v. you have undergone a medical or surgical procedure, at any time in the 180 days prior to your effective date.
c) Your lung condition if, for any lung condition:
i. you have had symptoms;
ii. you have been hospitalized;
iii. you have been prescribed medication (including prescribed as needed);
iv. you have taken medication;
v. you have undergone a medical or surgical procedure; or
vi. you have been treated with home oxygen or taken oral steroids (e.g. Prednisone), at any time in the 180 days prior to your effective date.
3. For insured children under two years of age: Any sickness or medical condition arising from or related to a birth defect.

ETFS Hospital Medical Care
Pre-Existing Medical Condition Coverage
a) Stable pre-existing medical condition(s) are covered for insureds age 69 or younger.
b) Stable pre-existing medical condition(s) are covered for insureds age 70 to 79 if you paid the required premium on the date of purchase for the stable pre-existing medial condition coverage option.
c) Stable Pre-existing medical condition(s) are not covered for insureds age 70 to 79 if you did not purchase the optional coverage for stable pre-existing medical condition(s) on the date of purchase.
d) Pre-existing medical condition(s) are not covered for insureds age 80 or older.

This insurance does not cover losses or expenses caused directly or indirectly, in whole or in part, by:
1. a) if you are age 86 or older, any sickness or symptoms which manifested or were contracted or treated within 15 days following the effective date, if you purchased this policy after your arrival in Canada;
b) if you are age 85 or younger, any sickness or symptoms which manifested or were contracted or treated within the first 48 hours following the effective date, if you purchased this policy after your arrival in Canada.
2. Pre-existing medical condition(s)
Any sickness, injury or medical condition for which at any time prior to your effective date:
a) you have experienced symptoms;
b) you have received medical care, advice, investigation or medical treatment;
c) you have been hospitalized;
d) you have been prescribed (including prescribed as needed) or have taken medication; or
e) you have undergone a medical or surgical procedure.
This exclusion does not apply to your stable pre-existing medical condition(s) as defined in SECTION II - DEFINITIONS:
i. if you are age 69 or under; or
ii. if you are age 70 to 79 and purchased the Stable Pre-Existing Medical Condition Coverage Option.

SECTION II : Stable Pre-Existing Medical Condition means:
a) A condition which is under treatment and has been controlled by diet or consistent use of medication prescribed by a physician and for which in the 120 days prior to the effective date of this policy there has been:
i. no hospitalization; and
ii. no change in treatment, medication or dosage.
Exceptions: a reduction in dosage or an elimination of medication resulting from an improved health condition, approved by a physician, does not constitute a change in medication or dosage. A reduction or elimination of treatment resulting from an improved health condition, approved by a physician, does not constitute a change in treatment.
b) A condition that existed more than 120 days prior to the effective date and which did not require treatment, as determined by a physician, during the 120 days prior to the effective date of this policy.

Travel Underwriters Platinum
The Company will not provide coverage, provide services, or pay claims for expenses incurred directly or indirectly as a result of:
1. Pre-existing Conditions as defined except as follows:
a) for persons 69 years and under, if Stable in the 120 days prior to the effective date of this Policy; or,
b) for persons 70 to 79 years, if Stable in the 120 days prior to the effective date of this Policy and the applicable optional
coverage was purchased.
“Pre-existing Condition” means a medical condition, illness or Injury known to You and for which You have received medical consultation, diagnosis and/or Medical Treatment by a Physician prior to travel.
“Medical Treatment” means any reasonable medical, therapeutic or diagnostic measure prescribed by a Physician in any form including prescribed medication, reasonable investigative testing, hospitalization, surgery or other prescribed or recommended treatment directly referable to the condition, symptom or problem. Medical Treatment does not include either:
a) the unchanged use of prescribed drugs or medication for a Stable condition, symptom or problem; or
b) a check-up where the Physician observes no change in a previously noted condition, symptom or problem.
“Physician” means a Physician, surgeon, radiologist, anaesthesiologist, who is registered and licensed to practice his or her medical profession in accordance with the regulations applying in the jurisdiction where the person practices.
“Stable” means the medical condition is not worsening and there has been no alteration* in any medication for the condition or its usage or dosage, nor any Medical Treatment prescribed or recommended by a Physician or received, within the period specified in this Policy before the commencement date of a covered trip.
* Alteration includes an increase or decrease in medication dosage, usage or a change in medication type, but does not include changes in brand due solely to the availability of Your usual brand or due to government regulations regarding reference-based pricing.

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