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Group Medical Services (GMS)

Immigrants & Visitors to Canada Medical Insurance

 

Medical health insurance for immigrants, visitors to Canada who are not covered under a provincial or territorial government plan, super visa applicants, parents and grandparents visiting Canada. Get your free online quote for this affordable health insurance plan with coverage for pre-existing conditions directly from the insurer: please, click on the link below and you will open the GMS secure website. You will also have an option to buy and get your instant policy on your email directly from the insurance company (this plan is not available in Quebec and New Brunswick) :  

 

Get your quote OR buy online

 

For assistance and to buy a policy , please call at 

416-493-0101      1-877-443-0101

What's on This Page

Policy wording

Eligibility Questionnaire

Key Features

Summary of Medical Coverage

Pre-Existing Medical Condition and

    Other Exclusions

Rates

What to do if you got sick or injured (!)

 

This insurance policy meets all requirements for parent and grandparent super visa if amount of coverage is  $100,000 or greater and period of coverage is 365 days (or 366 days for leap years): Get a Quote.

 

Who can apply? You are eligible to purchase this insurance if you are an immigrant or visitor to Canada who is not covered under a provincial or territorial government plan, super visa applicant, parent or grandparent visiting Canada on super visa. .

 

What coverage will you get

 

Eligibility.

You are not eligible to purchase this plan if:

a. you will be eighty (80) years of age or older as of the policy effective date;

b. you have any reason to see a physician; visit a hospital or clinic; obtain medical treatment ;

c. you are applying for coverage while in Canada and you have ever been denied similar coverage offered by another Canadian insurer.

d. you are applying for coverage while in Canada and you have had more than $5,000 in medical treatment in the last twelve (12) months while you are in Canada;

If you are 55 years or older, you will have to answer a number of medical questions on the application to determine your eligibility for the policy: Eligibility Questionnaire.

 

Amount of coverage: Choose coverage of: $25,000, $50,000, $100,000, or $150,000 per person.

 

Deductibles*. Choose deductible to lower premiums. Option for $0, $100, $500, or $1000 deductible.

*Deductible means the dollar amount that you are responsible to pay for each claim.

 

Waiting period.

1. There is no waiting period to obtain emergency medical treatment, if you apply for coverage prior to your arrival in Canada, or apply to continue coverage from an existing GMS policy or a policy providing similar coverage issued by an insurance company licensed in Canada (with no gap between coverages).

2. A two (2) day {48 hour) waiting period for all emergency medical conditions, except those resulting from injury, when you apply within the first thirty (30) days of your arrival in Canada and do not have a policy in effect providing similar coverage issued by an insurance company licensed in Canada.

3. A seven (7) day (168 hour) waiting period for all emergency medical conditions, including injuries, when you apply after the first thirty (30) days of your arrival in Canada and do not have a policy in effect providing similar coverage issued by an insurance company licensed in Canada.

 

Period of coverage.  

Any number of days up to the maximum of three hundred sixty-five (365) days per trip. Coverage ends when you depart from Canada to your home country  (also see Automatic Extension).

 

Travel Benefits outside Canada.  

Emergency medical coverage is included for side trips up to 30 days or less in duration, outside of Canada provided that:

a. your side trip originates and terminates in Canada;

b. your total days outside Canada are not greater than 50% of your period coverage; and

c. your side trip is not to your country of origin.

 

Refunds

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

- prior to the effective date (no administration fee); or

- after the effective date, provided GMS is notified no later than 30 days after this date, subject to a $40 administration fee.

Partial refunds are available, subject to a $40 administration fee, when:

- your request for refund is received more than 30 days after the effective date and no travel has taken place (the refund will be calculated from the date GMS was notified);

- you return to your home country . The refund will be calculated from the date you departed Canada (proof of departure will be required);

- you become covered under a government health plan during the period of coverage  coverage (the refund will be calculated from the date GMS is notified, not the effective date of the government health plan); or

- your death occurs during the policy period.

Refunds are not available:

- when you request a refund after the expiry date of your policy;

-  if a claim has been reported under this insurance policy.

 

Policy Extensions

- you contact GMS forty-eight (48) hours prior to the expiry date of the existing coverage;

- you have not required medical treatment (whether a claim was submitted or not) during your period of coverage;

- your total period of coverage (including all extensions approved or requested) will not exceed one (1) year; or

- you will not be eighty (80) years of age or older as of the start date for the policy extension.

 

Automatic Policy Extensions

Your Immigrants & Visitors plan coverage will automatically be extended at no additional cost in certain situations. The extended coverage is payable up to the maximum of your sum insured under these conditions:

1. If coverage expires while hospitalized due to a medical emergency, coverage will continue for you, your spouse and any dependants travel ling with you and are listed on your application during your hospitalization and for up to seventy-two (72) hours after discharge from hospital.

2. During your transit to Canada from your country of origin provided you:

a. purchased your coverage prior to departing your country of origin; and

b. arrive in Canada within 48 hours of departing your country of origin.

3. During your transit from Canada to your country of origin provided you;

a. have coverage on the day you depart for your country of origin; and

b. arrive in your country of origin within 48 hours of departing Canada.

If the medical emergency occurs within 48 hours of departing your country of origin for Canada or departing Canada for your country of origin, eligible expenses include all of the benefits listed under the Benefits Within Canada section of this policy.

 

Immigrants & Visitors to Canada Benefits
Emergency means a sudden or urgent happening that arose during your trip and requires immediate medical treatment.
Benefit Details

Hospitalization

Hospital accommodations up to semi-private rooms and hospital services and supplies necessary for emergency care during hospitalization.  

Medical Services

Treatment by physician or surgeon.

Diagnostic Services

X-rays and other diagnostic tests.

Out-Patient Treatment

Out-patient emergency room charges.

Prescription Drugs

Prescription drugs and medication prescribed by a physician. Maximum of a thirty (30) day prescription.

Ambulance

Covers 100% of emergency transport to a hospital. An air ambulance must be pre-approved by GMS.

Paramedical Services

Up to $300 for the emergency services of an osteopath, physiotherapist, chiropractor, chiropodist, and/or podiatrist.

Accidental Dental

Up to $2,000 per injury and up to $250 for the relief of dental pain.

Return of Remains

Preparation and transportation to your country of origin or destination in Canada to a maximum of $10,000 per person, or the cost of cremation or burial at the place of death to a maximum of $4,000 per person.

Child Care

If you are hospitalized, up to $500 for licensed child care for a dependant that is traveling with you.

Out-of-Pocket Expenses

Up-to$150 per day to a maximum of $1,000, for accommodations, meals, phone call, transportation fares for your accompanying family member, if you are hospitalized on the scheduled return date.

Out of Pocket Expenses

Accommodations, meals, phone calls and taxi or bus fares incurred by an accompanying family member in the event hospitalization continues after the policy expiry date. Must be pre-approved by GMS.

Repatriation to Country of Origin

Up to a maximum of $5,000 to transport you by common carrier back to your country of origin for further medical treatment, if found medically fit to travel. Must be pre-approved and arranged by GMS.

24-Hour Travel Assistance Services

Coordination of all medical care, transportation, and repatriation; telephone interpretation services in most languages; monitoring of progress during treatment and recovery by managed care.

Travel Benefits

When outside Canada

When eligible expenses are incurred outside of Canada, eligible expenses include all Benefits above and:

  • Air Ambulance - charges to transport you back to your province of residence for further in-hospital treatment.

  • Special Attendant - reimbursement of a one-way trip economy airfare ticket for a medical attendant to accompany you back to your province of residence or country of origin for further in-hospital treatment.

  • Escort of Insured Children - reimbursement of the cost of a one-way trip economy airfare to return an accompanying child or children and escort, when necessary, back to your original point of departure.

These benefits must have the prior approval of GMS.

This is a summary of the benefits. Please refer to the Policy wording before purchasing the policy for more details on the coverage provided, conditions, exclusions and claim procedure.    

  

Exclusions and limitations.  Visitors to Canada medical insurance does not cover everything. This insurance has exclusions, conditions and limitations (see Policy Wording, pg 2). Please read them and understand the policy before you buy this insurance.

A  Pre-Existing Medical Condition exclusion:

GMS does not cover any expenses resulting from medical condition(s) which have not been STABLE for 180 days immediately prior to your effective date, including:

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

b. undiagnosed medical conditions(s) related to symptoms for which you received medical treatment or medical consultation.

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

STABLE: a medical condition is stable if,

a.  you have no reason to expect medical treatment after your effective date for the medical condition or any symptoms ;

b.  in the 180 days before your effective date, you have not received new or different medical treatment for the medical condition;

c.  in the 180 days before your effective date, you have not had an alteration to an existing prescription drug or were prescribed a new drug for the medical condition;

d.  in the 180 days before your effective date, your medical condition has not become worse;

e.  in the 180 days before your effective date, you have not experienced new, more frequent or more severe symptoms;

f.  in the 180 days before your effective date, you have not had or needed medical consultation for undiagnosed symptoms;

g.  in the 180 days before your effective date, you have not needed in-hospital care; a referral to a specialist, or al follow-up visit; and

h.  in the 180 days before your effective date, you have not had tests or an investigation whether you know the results or not, related to the medical condition.

NOTE:  To determine your eligibility for this policy, Stability period for the conditions listed in Eligibility question 5a on the Medical Questionnaire  is 12 months before the application date.

If there are any changes in your health after your application date and before your effective date, GMS must be notified. A change in health may affect your eligibility for coverage. Changes to your health that do not affect eligibility will still constitute a change in stability and may limit your available coverage. 

 

Some other exclusions:

The following expenses are not covered by the policy and no payment for these claims will be made:
●   Expenses incurred where you act against medical advice or the advice of GMS.
●   Expenses resulting from the regular care of a chronic condition.
●   Any expenses that are the result of your failure, prior to arriving in Canada, to:

adhere to medical treatment;

obtain investigative or diagnostic tests recommended by a medical professional; and/or

 receive results from investigative or diagnostic tests.

●  Any subsequent claim for the same medical condition(s) with respect to a sickness or injury, that occurred during the period of coverage and for which a claim has already been made or is pending.

●   Expenses incurred as a result of pregnancy, abortion, miscarriage, childbirth or complications of any of these conditions.

●   Routine or general physical examinations, checkups or services of a continued nature following emergency treatment of a sickness or injury.

●   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 prior to any actions.

●   Any endovascular surgical procedures, either done individually or in combination with conventional surgical procedures unless necessary in a medical emergency and pre-approved by GMS.

Refer to the Policy wording for a  full list of exclusions (pg. 2-3) and definitions (pg. 5-6).


 

Note: The product-related information is for illustration purpose only.  For the full details of coverage, eligibility, exclusions, limitations and claims procedures, please refer to the  Policy wording

 

If you have questions, need help to complete the online application, want to purchase a policy  or to make changes to your existing policy, please call Natalia at 416-493-0101 (or 1-877-443-0101) or click here to send your question.

 

What to do if you get sick or injured.

Have your policy confirmation with you at all times. You will find emergency phone numbers on this confirmation (section IMPORTANT INFORMATION). In the event of sickness or injury which may result in claim, you, or someone on your behalf, must contact GMS assistance centre prior to treatment whenever possible. When contacting the Assistance Centre, please provide your name, your policy number, your location and the nature of your emergency.

 

Important Notice

Failure to contact GMS assistance centre within twenty-four (24) hours of receiving medical treatment or admission to hospital will limit benefits otherwise payable to 70% of eligible charges to a maximum of the sum insured.

For medical emergencies and assistance, please call:
toll-free 1-800-459-6604 (within Canada & US)

collect 905-762-5196 (from all other locations)

 

To apply for benefits under this policy, you will need to send a completed claim form (with all original bills attached) to GMS. Consult the claim guideline in your Policy wording (pg.5).

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Investments:    RESP     RRSP     TFSA     Segregated Funds

Revised: May 01, 2018

 

 

                                                       May 01, 2018