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Sunday, April 30th, 2017

GMS
Visitors Insurance

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Benefits
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Administrated by: GMS Insurance Inc.
Underwritten by: GMS Insurance Inc.
24 hours Emergency Assistance Center: GMS Travel Assistance.

IMPORTANT NOTE: The product-related information on this website is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please see the policy booklet at the download section below. Please read and understand your policy before you travel.

Note: This plan is NOT available for purchase in the provinces of Quebec and New Brunswick.

BENEFITS:
  - Emergency Medical Expenses maximum benefits: $25,000; $50,000; $100,000 and $150,000.
  - Hospital Room - semi-private.
  - Physicians or surgeons.
  - Diagnostic Treatments: Lab tests and X-ray examinations ordered by a physician. Magnetic resonance imaging, computerized axial tomography scans, sonograms, ultrasounds, and biopsies have to be pre-authorized by GMS.
  - Ambulance Transportation: Licensed local air or land ambulance, when necessary, to the nearest hospital. This benefit excludes helicopter transportation.
  - Prescription drugs or medicines, 30 day supply.
  - Professional Medical Services - care received from a licensed physiotherapist, chiropractor, osteopath, chiropodist, and/or podiatrist, up to $300 per category of practitioner.
  - Return of Remains: In the event of death from covered condition, up to $10,000 is provided to return the body home, or up to $4,000 for cremation or burial at the place of death.
  - Accidental Dental: Up to $2,000 for repair or replacement of natural teeth or permanently attached artificial teeth, damaged by an accidental blow to the face.
  - Dental Emergencies: Up to $250 for treatment or relief of acute dental pain.
 - Follow-up visits are covered up to 14 days after the initial medical emergency when deemed medically necessary.
  - Child Care - up to $500, with prior GMS approval, for licensed care of dependant, should you be hospitalized for forty-eight (48) hours or more due to a medical emergency.
  - Out of pocket expenses - up to $150 per day to a maximum of $1,000 for accommodations, meals, necessary telephone calls and taxi or bus fares incurred by an accompanying family member in the event that you are hospitalized. 
  - Repatriation to Country of Origin: up to maximum of $5,000 to transport you back to your country of origin for further medical treatment, if found medically fit to travel. This benefit must be pre-approved by GMS.
 - Parent and Grandparent Super Visa holders will be deemed to have coverage for a full 365 days, without limitation as to the number of departures and re-entries into Canada.
 - Coverage while in-transit between Canada and the country of origin - limited up to 48 hours after your initial departure.

EXCLUSIONS: Your coverage is subject to various exclusions, which are completely set out in the Exclusions section of the policy document. The following, although not an exhaustive list, are some of these exclusions:
ELIGIBILITY: 
1. You are not eligible to purchase this plan if:
   a) you are covered under a government health plan;
   b) you are age 80 years of age or older as of the effective date;
   c) you have reason to seek medical attention.
   d) you are applying for coverage while in Canada and;
      - have incurred medical treatment (where a claim was submitted or not) in excess of $5,000 in the 12 months immediately prior to applying;
      - have been refused coverage by any other insurer who provides similar coverage.
2. You are not eligible for coverage if you are 55 years of age or older and:  
  a) within the 12 months prior to applying you have been diagnosed with any of the following conditions or you have any of the following conditions which have not been stable for 12 months prior to applying:
      - Congestive heart failure
      - Atrial flutter
      - Atrial/ventricular fibrillation
      - Peripheral vascular disease
      - Stroke/transient ischemic attack (TIA)
      - Acquired Immune Deficiency Syndrome (AIDS)
      - Terminal illness (A disease that cannot be cured and is reasonably expected to result in death.)
      - Blood clot(s)
      - Gastrointestinal bleeding
  b) you are expecting tests or medical treatment for heart disease (Any medical, therapeutic or diagnostic measure prescribed or recommended by a physician in any form, including: prescription medication; investigative testing; in-hospital care; surgery; or other prescribed or recommended action directly referable to the applicable condition, symptom or problem); and/or
  c) you are taking prescription drugs for heart disease; while taking insulin to treat diabetes (heart disease is any disease of the heart including, but not limited to: angina, irregular heartbeat, heart attack, congestive heart failure, ischemic heart disease, valvular heart disease, and myocardiopathy)
  d) you have an Implantable Cardioverter Defibrillator (ICD)
  e) you have fainted or fallen more than once without medical diagnosis (syncope)
  f) you use home oxygen for a medical condition
  g) you take oral steroids for a lung condition (Oral steroids are steroids that are swallowed to treat a lung condition. They do not include steroids that are inhaled to prevent asthma attacks or to temporarily treat and relieve inflammation of the airway)
  h) you have been diagnosed with metastatic cancer
  i) you are under active medical treatment for cancer
  j) have a vascular aneurysm that is surgically untreated
  k) you have undergone renal dialysis, valve replacement or organ transplant
  l) you are 70 years of age or older and require assistance from another person(s) with activities of daily living (ADL) which include, but are not limited to, personal hygiene and grooming; dressing and undressing; self-feeding; functional transfers (getting into and out of bed or a wheelchair, getting onto or off the toilet, etc.); bowel and bladder management; and/or medication management. 

WAITING PERIOD:
- There is no waiting period if you apply for coverage before arriving in Canada, or purchase to continue coverage without a gap from another policy, that is providing similar coverage from a Canadian insurance company.
- 2 days (48 hours) waiting period for medical conditions, other than injury, if uninsured and apply within the first 30 days of arriving in Canada.      
- 7 days (168 hours) waiting period for medical conditions, other than injury, if uninsured and apply more than 30 days of arriving in Canada.   
- The maximum number of days coverage may be purchased for is three hundred sixty-five (365) days per trip.

The following expenses are not covered by the policy and no payment for these claims will be made:

PRE-EXISTING CONDITIONS for Visitors to Canada:
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 condition(s) related to symptoms for which you received medical treatment or medical consultation.
You must be STABLE based on the definition of "stable" (see below), 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 themedical condition or any symptoms; 
   b) if in the 180 days before your effective date, you have not received new or different medical treatment for the medical condition;
   c) if in the 180 days before your effective date you have not had an alteration to an existing prescription drug or were prescribed a new prescription drug for the medical condition;
   d) if in the 180 days before your effective date your medical condition has not become worse;
   e) if in the 180 days before your effective date you have not experienced new, more frequent or more severe symptoms;
   f) if in the 180 days before your effective date you have not had or needed medical consultation for undiagnosed symptoms;
   g) if in the 180 days before your effective date you have not needed in-hospital care; a referral to a specialist, or a follow-up visit; and
   h) if in the 180 days before your effective date you have not had tests or further investigation, whether you know the results or not, related to the medical condition.

OTHER EXCLUSIONS:
   - GMS does not cover any expenses resulting from and/or incurred during trips undertaken for the purpose of receiving a diagnoses or medical treatment.
   - Expenses resulting from the regular care of a chronic condition.
   - Expenses incurred as a result of pregnancy, abortion, miscarriage childbirth or complications thereof.
   - Routine or general physical examinations, check-ups, or services of a continued nature following emergency treatment of a sickness or injury.
   - Expenses resulting directly or indirectly from the commission or attempted commission of any criminal, criminal-like, or illegal activity; intentional self-injury, suicide, or attempted suicide; the abuse of medication, drugs, or alcohol; any participation in the armed forces; or any wilful exposure to peril.
   - Expenses resulting from participation in professional sports, any speed contest or racing of motorized land, water or air vehicle(s), extreme sports including but not restricted to scuba diving (except when you are NAUI, PADI, ACUC or SSI certified), bungee jumping, parachuting, mountaineering, skydiving, rodeo, hang gliding, acrobatic or stunt flying or participating in a horse race as a jockey.
   - Expenses resulting from air travel unless riding as a passenger on a common carrier.
   - Treatment or services that contravene or are prohibited by the provincial laws of your province of residence and the federal laws of Canada that applies in your province of residence.
  - Services provided for persons working in hazardous occupations.

CLAIMS:

Regardless of your plan deductible, in the event of a medical emergency, you are required to contact GMS within twenty-four (24) hours of receiving medical treatment or admission to hospital. Failure to do so may limit benefits to the lesser of 70% of reasonable and customary expenses or $50,000. Emergency phone numbers: Toll free within Canada and the USA: 1-800-459-6604 and Collect call from all other locations: 905-726-5196.

Claims Instructions:
   1. Complete a claim form and attach all original itemized medical bills and prescription receipts.
   2. Sign and date completed form and return package to:
                          Group Medical Services
             150 Commerce Valley Drive W. 9th floor
                          Thornhill, ON, L3T 7Z3
For claims inquiries, please contact:
Toll Free 1-800-459-6604(within Canada and the USA) or
Collect (905) 726-5196 (from all other locations)

Please keep a copy of all the submitted correspondence for your records.

FAQ:

POLICY EXTENSIONS:
1. You may extend your coverage subject to GMS's approval if:
  a) you contact GMS 48 hours prior to the expiry date of the existing coverage
  b) you have not required medical treatment (whether a claim was submitted or not) during your period of coverage;
  c) your total period of coverage (including all extensions approved or requested) will not exceed 1 year; or
  d) you will not be 80 years of age or older as of the start date for the policy extension; 

SIDE TRIPS: Emergency medical coverage is included for side trips up to 30 days outside of Canada provided that:
   - Your trip originates and terminates in Canada;
   - You spend 50% or greater of your period of coverage in Canada; and
   - Your temporary visit is not to your country of origin.

A temporary visit to the US or Mexico during your trip is permitted provided that:
- Your trip originates and terminates in Canada;
- You spend 50% or greater of your total trip duration in Canada; and
- Your temporary visit is not to your country of origin. 

REFUNDS:
1. Full refunds are available if no travel has taken place, when your request for a refund is received:
  a) prior to the effective date as shown on your confirmation document; or
  b) after the effective date as shown on your confirmation document if you have not travelled to Canada because your application for a visa to enter Canada was declined.
  A $40 administration fee applies and it will be deducted from the refund. A copy of the visa decline letter will be needed when requesting a refund.              
2. Partial refunds are available, with a $40 administration fee, in the following situations.
  a) Your request for a refund is received after the effective date shown on your confirmation document when no travel has taken place, except if your request is the result of a declined visa application. The refund will be calculated from the date GMS was notified;
  b) you return to your country of origin. The refund will be calculated from the date you departed Canada (proof of departure will be required);
  c) you become eligible and covered under a government health plan during the period of coverage. The refund will be calculated from the date GMS was notified, NOT the effective date of the government health plan; or
  d) your death occurs during the policy period.
3. Refunds are NOT available when:
  a) a claim has been reported under this policy; or
  b) you request a refund after the expiry date of your policy. 

The following conditions apply to partial refunds issued under this policy:
1. When you apply for a refund after the date on which the coverage is to be effective as shown on your confirmation, the following must be provided:
  a) proof of travel showing the date you departed from Canada.
  b) proof of coverage under a government health plan including effective date of coverage;
  c) in case of a your death, a copy of the death certificate; or
  d) proof that you did not travel from your country of origin.
Depending on the documentation provided GMS reserves the right to limit or restrict the refund.
2. GMS considers a claim to have occurred when an insured person, or a family member, contacts GMS' Travel Assistance regarding the intent, or need to seek medical treatment regardless of whether a claim is actually filed with GMS for reimbursement. You may still be eligible for a partial refund if:
  a) GMS Travel Assistance was only contacted once during the period of coverage; and
  b) no payment for emergency medical treatment was issued or pending. 
Refunds are subject to GMS' review and approval. A file handling fee of $300 will be deducted from the refund amount owned. Once a refund is issued, future expenses or additional claims will not be accepted, regardless of when the expense or claim occurred.
3. Once a refund has been issued, you will no longer be eligible for any claim reimbursement.
A refund is calculated and paid based on the following.
1. A refund is calculated using the number of unused days and the daily rate applied based on your original trip length. The number of unused days is calculated based on your departure date unless otherwise indicated in the Requesting a Refund section above under 2.a.,b.,c., and d.
2. Refunds will be processed as follows:
  a) payment made by credit card will be credited to the credit card on file;
  b) payment made by cash or cheques will be payable to you unless an alternative payee has been assigned;
  c) all refunds requested after the effective date shown on the confirmation document are subject to a $40 administration fee;
  d) no refund will be issued for amounts under $5. 

About GMS
Group Medical Services (GMS) has been providing health and travel insurance coverage since 1949. GMS is expert in emergency medical coverage and offer a wide range of flexible plans at competitive rates. GMS is a non-profit corporation based in Regina, Saskatchewan.

RATES:

Daily premium per person with a $1,000 DEDUCTIBLE.

Age/Sum

$25,000

$50,000

$100,000

$150,000

Under 18

$1.58

$1.81

$2.40 $3.05

18-34

$1.73

$1.99 $2.62 $3.31

35-54

$1.99

$2.26 $3.48 $4.08

55-59

$2.16

$2.40 $3.50 $4.22

60-64

$2.89

$3.24 $4.14 $4.86
65-69 $3.35 $3.85 $4.85 $5.92
70-74 $5.32 $6.32 $7.52 $9.09

75-79

$6.17

$7.14 $8.81 $10.70

   - To determine rates for a $500 deductible, add 15% to the $1,000 deductible premium above.
   - To determine rates for a $100 deductible, add 30% to the $1,000 deductible premium above.
   - To determine rates for a $0 deductible, add 45% to the $1,000 deductible premium above.

Dependant: any unmarried child of you or your spouse (including step-child or adopted child) who is chiefly dependent upon you or your spouse for support and maintenance, and is 18 years of age or under.

IMPORTANT NOTE: The product-related information on this website is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please see the policy booklet at the download section below. Please read and understand your policy before you travel.

 

DOWNLOADS:

GMS Visitors Insurance POLICY PDF

GMS Visitors Insurance CLAIM FORM PDF

GMS Visitors Insurance REFUND Policy Reference

 

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