GMS Plan Details

Comprehensive emergency medical insurance for visitors, immigrants, and Super Visa applicants

Benefits

The range of coverage and services included in the policy, such as medical expenses, emergency care, trip interruption, and more.

Benefit Category	Coverage Details
In-Hospital Care	Hospital accommodations up to semi-private rooms; hospital services for medical emergencies; follow-up visits until emergency ends (if medically necessary, within 14 days of initial emergency)
Medical Services	Medical treatment by physician or surgeon
Diagnostic Services	X-rays and diagnostic tests (MRIs, CAT scans, sonograms, ultrasounds and biopsies excluded unless pre-authorized)
Out-Patient Treatment	Out-patient medical emergency room expenses
Prescription Medication	Drugs/medication on prescription, supplied by licensed pharmacist, maximum 30-day prescription (refills excluded)
Ambulance	Licensed road or air ambulance for emergency transportation (helicopter transports excluded)
Health Practitioners	Up to $500 aggregate maximum for emergency services of osteopath, optometrist, physiotherapist, chiropractor, chiropodist and/or podiatrist
Accidental Dental	Up to $2,000 for repair/replacement of natural teeth due to accidental blow; up to $300 for dental pain relief (excludes dental implants)
Return of Remains	Up to $10,000 for preparation/transportation of deceased to destination in Canada/country of origin; or up to $4,000 for cremation/burial at place of death
Child Care	Up to $500 for licensed care of dependent children if hospitalized (requires prior GMS approval)
Out-of-Pocket Expenses	Up to $150/day (maximum $1,000) for accommodations, meals, calls, transportation for accompanying family
Repatriation (Commercial Airline)	Up to $5,000 for transport by common carrier without medical attendant to country of origin (requires GMS pre-approval)
Repatriation (with Medical Attendant)	Coverage for transportation by common carrier or air ambulance with medical escort to country of origin (requires GMS pre-approval)

Specific Conditions

Any medical conditions, illnesses, or injuries that you had before purchasing the insurance policy. Coverage for these may be limited or subject to specific terms.

• Age (on application date):
• 365 days maximum for up to age 80
• Deductible: $100; $500 or $1,000 per claim.
• Waiting Period
– No waiting before arrival in Canada or extending an existing policy
– 2 days waiting for sickness if the policy has been purchased within 30 days after your arrival in Canada or after the expiry of a similar insurance plan. Injury coverage is available during the waiting period.
– 7 days waiting for sickness if the policy has been purchased after 30 days from your arrival in Canada or after the expiry of a similar insurance plan.
• Pre-existing medical conditions – 180 days look back period for stable pre-existing condition
• No coverage for recurrence or complication of already claimed medical condition

Eligibility

The criteria you must meet to purchase or be covered under the insurance plan, such as age limits, residency status, or travel requirements.

Age Group	Eligibility Requirements
Under 55 years	NOT eligible if: (1) Have reason to seek medical treatment (excluding chronic condition care/visa requirements); (2) Currently in Canada and ever denied similar coverage by another Canadian insurer; (3) Currently in Canada and had over $5,000 in medical treatment in last 12 months while in Canada
55 years and older	NOT eligible if: (1) 80+ years on policy effective date; (2) Have reason to seek medical treatment; (3) Currently in Canada and denied similar coverage by another insurer; (4) Had over $5,000 in medical treatment in last 12 months in Canada; (5) Expecting treatment for heart disease; (6) Waiting for tests for suspected heart condition; (7) Taking heart disease medication while taking insulin for diabetes; (8) Have implantable cardioverter defibrillator; (9) Fainted/fell more than once without diagnosis; (10) Use home oxygen; (11) Take oral steroids for lung condition; (12) Being treated for cancer or have metastatic cancer; (13) Have untreated vascular aneurysm; (14) Ever had valve replacement, kidney dialysis, organ transplant; (15) In last 12 months, diagnosed/treated for specific conditions including heart failure, atrial issues, stroke, AIDS, terminal illness, blood clots, GI bleeding; (16) Require assistance with daily living if 70+ years

Age Group

Eligibility Requirements

Under 55 years

NOT eligible if: (1) Have reason to seek medical treatment (excluding chronic condition care/visa requirements); (2) Currently in Canada and ever denied similar coverage by another Canadian insurer; (3) Currently in Canada and had over $5,000 in medical treatment in last 12 months while in Canada

55 years and older

NOT eligible if: (1) 80+ years on policy effective date; (2) Have reason to seek medical treatment; (3) Currently in Canada and denied similar coverage by another insurer; (4) Had over $5,000 in medical treatment in last 12 months in Canada; (5) Expecting treatment for heart disease; (6) Waiting for tests for suspected heart condition; (7) Taking heart disease medication while taking insulin for diabetes; (8) Have implantable cardioverter defibrillator; (9) Fainted/fell more than once without diagnosis; (10) Use home oxygen; (11) Take oral steroids for lung condition; (12) Being treated for cancer or have metastatic cancer; (13) Have untreated vascular aneurysm; (14) Ever had valve replacement, kidney dialysis, organ transplant; (15) In last 12 months, diagnosed/treated for specific conditions including heart failure, atrial issues, stroke, AIDS, terminal illness, blood clots, GI bleeding; (16) Require assistance with daily living if 70+ years

Refunds

The amount you may be eligible to receive back if you cancel your policy, depending on the timing and the insurer’s refund terms.

Refund Scenario	Policy
Full Refund	Available if no travel occurred when: (1) Request received before effective date; (2) After effective date if visa to Canada denied (admin fee applies)
Partial Refund	Available with admin fee when: (1) Request after effective date with no travel; (2) Return to country of origin (calculated from departure date); (3) Become eligible for government health plan; (4) Death during policy period
No Refund	When: (1) Claim reported under policy; (2) Request after policy expiry date

Extensions

The option to continue your coverage by extending the policy duration before it expires, subject to approval and conditions.

Extension Type	Details
Automatic Extensions	1. Coverage extended during hospitalization and up to 72 hours after discharge if hospitalized on expiry date 2. During transit to Canada if arrival within 48 hours of departure from country of origin 3. During transit to country of origin if arrival within 48 hours of departure from Canada
Policy Extensions	Additional days available if: (1) Contact GMS 48 hours prior to expiry; (2) No medical treatment required during coverage; (3) Total period doesn't exceed 1 year; (4) Won't be 80+ years at extension start date

Claims

The process of requesting reimbursement or payment from the insurance company for covered expenses during your policy period.

Claims Process	Requirements
Initial Notification	Contact GMS Travel Assistance within 24 hours of treatment/hospital admission (failure may limit benefits to 70% of expenses or $50,000)
Notice of Claim	Written notice within 30 days after contacting GMS Travel Assistance
Proof of Claim	Submit within 90 days: (1) Original itemized receipts; (2) Proof of payment; (3) Medical records with diagnosis; (4) Proof of accident for dental claims; (5) Travel dates proof; (6) Historical medical records if requested; (7) For death claims, may require autopsy
Limitation Period	Expenses must be submitted within 12 months from date of last eligible expense

Exclusions

Specific situations, treatments, or conditions that are not covered under the policy, which means no claim can be made for them.

Exclusion Category	Details
Location/Jurisdiction	Expenses in country of origin; services outside Canada (except as provided)
Medical Conditions	Acting against medical advice; regular care of chronic conditions; non-stable conditions for 180 days before effective date; continuation/recurrence of medical condition; non-emergency treatment; diagnostic testing without pre-approval
Specific Medical Situations	Pregnancy, abortion, miscarriage, childbirth; newborns until released from hospital for 48+ hours; coronary procedures without emergency approval; experimental treatments
Pre-existing Issues	Failure before arrival to adhere to treatment or testing; conditions not stable for 180 days
High-risk Activities	Professional sports; speed contests; extreme sports; air travel not as passenger
Behavioral/Legal	Criminal/illegal acts; drug/alcohol abuse contributing to condition; travel against advisory
Coverage Limitations	Duplication of government/private services; services prohibited by law; nuclear reactions; war/terrorism

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