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"NO WORRY.
BE SAFE."
Emergency Hospital & Medical for Canadians
Includes Travel Worldwide
Eligibility
1. Coverage is NOT AVAILABLE to any individual who:
a) has been diagnosed with a terminal illness;
b) has been diagnosed with or has had an episode of congestive heart failure;
c) has Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV);
d) has Alzheimer’s disease or any other type of dementia;
e) has received any type of treatment for pancreatic cancer, liver cancer or any type of cancer that hasmetastasized;
f) has been prescribed or used home oxygen treatment in the last 12 months;
g) has had a major organ transplant (heart, kidney, liver,lung); or
h) has received kidney dialysis treatment in the last 12 months.
2. To be eligible for coverage a person must:
a) be at least 15 days old; and
b) be insured for benefits under a Canadian government health insurance plan during the entire period of coverage; and
c) be currently in good health and know of no reason to seek medical consultation during the period of coverage; and
d) not reside in a nursing home and receive nursing care; and
e) not reside in a convalescent home or rehabilitation centre; and
f) not require assistance with activities of daily living.
Important notes
* Minimum premium 3 days per person with the minimum being $25 per policy.
• Use the applicant’s age on the effective date.
• The family rate applies to a maximum of 5 persons and includes the applicant and their spouse under age 61 and
their dependent children under age 22.
Summary of Coverage per Insured Person
Hospital confinement and Medical Services ....... $5 million
The following benefits are included in the overall maximum of $5 million.
Accidental Dental .....................................................$3,000
Ambulance Services .......................up to overall maximum
Attendant .........................................up to overall maximum
Chiropractor .................................................................$500
Cremation at Place of Death .................................... $4,000
Dental Emergency ...................................................... $500
Emergency Transportation ..............up to overall maximum
Meals and Accommodation ......................................$3,000
Out-of-pocket Expenses ...................... $50/day up to $500
Pet Return (dog or cat) ................................................$500
Physiotherapist ............................................................$500
Prescription Medication ...............................................$500
Return of Deceased ............................................... $10,000
Return to Original Trip Destination ........................... $5,000
Return of Travelling Companion ..... up to overall maximum
Return of Vehicle or Watercraft ................................ $3,000
Terrorism ............................ aggregate limit (refer to policy)
When is a medical questionnaire required?
0 – 60 Years of Age
Standard Eligibility
Any trip length
Not required
Client is covered for medical conditions that are stable for 90 days immediately prior to effective date
61 – 84 Years of Age
1-60 days of travel
Not required*
Issue standard policy
61+ days of travel
Required
Complete Basic Medical Questionnaire through quicktic
85+ Years of Age
1-60 days of travel
Not required*
Issue standard policy
61+ days of travel
Required
Complete Detailed Medical Questionnaire form and submit to Allianz Global Assistance
*Clients wanting coverage for pre-existing conditions have the option to complete a basic medical questionnaire through quicktic.
All information above is for reference only. All explanation reserved by the licensed travel insurance agent.