21st Century Travel Ins
You are not eligible for coverage under this policy if:
- “You” are travelling against the advice of a physician;
- “You” have been diagnosed with a terminal illness with less than two (2) years to live; and /or
- “You”have been diagnosed with or received treatment within the last two (2) years for pancreatic, lung, brain, or liver cancer; or any type of cancer that has spread from one part or organ of the body to another not directly connected with it;
- “You” have had or are waiting for an organ or bone marrow transplant (excluding corneal transplant);
- “You” have a kidney condition requiring dialysis; and/or
- “You” you have used home oxygen during the 12 months prior to the date of application
- “You”reside in a nursing home, home for the aged, other long term care facility or rehabilitation centre
Under 60 years of age – you’re automatically covered for pre-existing medical conditions as long as they have been stable in the 180 days before the policy starts.
Between the ages of 60 and 85 – complete a Medical Declaration to see if you are eligible to buy our “Stable Chronic Condition” (SCC) Option to cover stable pre-existing conditions. If you are ineligible or decide to waive the SCC option, you will pay a lower premium but will NOT be covered for any pre-existing conditions – stable or unstable. Note: The SCC option is not available if you are over age 85.
Stable Chronic Condition means a pre-existing medical condition for which, in the 180 days prior to your effective date of insurance:
• there have been no new symptoms or change in
• existing symptoms have not become more frequent or
• aphysician has not found that the medical condition
has become worse;
• no test findings have shown that the medical condition
may be getting worse; and
• a physician has not provided, prescribed, or
recommended any new medication, or any change
in medication; and
• a physician has not provided, prescribed, or
recommended any new treatment, or any change
in treatment; and
• there has been no hospitalization or referral to a
specialist or specialty clinic; and
• aphysician has not advised referral to a specialist or
further testsing, and there has been no testing for which
results have not yet been received the results.
No waiting if the policy is purchased before your arrival in Canada
a. Within 30 days: effective 72 hours after purchase
b. After 30 days: effective 7 days after purchase
1. Expenses to receive emergency medical attention
–Reasonable and customary charges for medical care received from a physician in or out of a hospital,
the cost of a hospital room (semi-private room when available or an intensive care unit when medically
necessary); tests that are needed to diagnose or find out more about your condition; and drugs that are prescribed for you and are available only by prescription from a physician. Follow-up visits are covered until the attending physician or our medical advisors declare the end of the medical emergency. Note: This policy does not cover cardiac catheterization, angioplasty, and/or cardiovascular surgery including any associated test(s) or charges, magnetic resonance imaging (MRI),
computerized axial tomography (CAT) scans, sonograms, ultrasounds or biopsies unless such services are approved in advance by the Assistance Centre.
2. private duty registered nursing or licensed home care providers and rental of a hospital bed, wheelchair, crutches, splints, canes, slings, trusses or braces or other prosthetic appliance up to $5,000 following emergency insured services when prescribed in writing by a physician. The use of any licensed home care provider must be authorized in advance by the Assistance Centre.
3. services provided by a health-care practitioner, up to a combined total of $1,000 for a covered emergency, when you have received prior written referral from a physician.
4. the use of a licensed local ambulance service for emergency transportation.
5. prescription medications up to $500 and not exceeding a 30-day supply when these medications are prescribed any medications that can be purchased over-thecounter without a prescription.
6. in the event of your death, up to $7,500 for the combined cost of preparing your body for burial
or cremation, transportation (including a standard shipping container normally used by the airlines) to your place of burial, and the cost of preparing related legal documentation. In no event will we pay for the cost of a coffin or urn. This benefit must be authorized and arranged by the Assistance Centre.
7. If your treating physician and our medical advisors recommend that you return to your country of origin because of your emergency or after your emergency treatment, we will pay for one or more of the following:
• the extra cost of an economy class fare via the most cost-effective itinerary;
• a stretcher fare on a commercial flight via the most cost-effective itinerary, if a stretcher is medically necessary;
• the return economy class fare of a qualified medical attendant via the most cost-effective itinerary to accompany you, and the attendant’s reasonable fees and expenses, if this is medically necessary or required by the airline; or
• the cost of air ambulance transportation, if it is medically necessary.
This benefit must be authorized and arranged by the Assistance Centre.
8. up to $4,000 for treatment to natural teeth and repairs to dentures or other dental devices if such treatment is necessitated by a direct unintended or unexpected blow to your face.
9. obtaining hospital, medical or health-care practitioner records, or a medical report from a physician or healthcare practitioner provided we request the record or report. Under no circumstances will we reimburse you for the cost of completing the claim form.
a) Before the policy goes into effect will be available for either a declined or withdrawn Visa application or the death of the insured.
b) After the policy goes into effect (early return to home country) can be obtained with proof of travel and/or a copy of the Super Visa showing any conditions stipulated at the time of entry into Canada.
However, we recommend that the policy be kept in force if the insured will return to Canada shortly after they leave, as proof of insurance may be required at the time of re-entry.
If your visa application is denied by the Government of Canada, or you formally withdraw your visa application and your coverage under this policy has not been activated, 21st Century will refund any premium paid. Proof of the denial or withdrawal of your application for a visa must be provided to 21st Century with your written request for a refund.
If the Government of Canada issues you an entry permit that is different than the one you applied for, you may request a refund of any premium paid or change from a monthly payment plan to payment in full as long as we receive your request prior to your entry into Canada. Proof of the change in entry permits will be required. Once you enter Canada, your deposit premium becomes nonrefundable. The $50 Policy Fee for any cancellation of, or change from the Monthly Payment Option is non-refundable.
The two month deposit premium and the $50 Policy Fee for the Monthly Payment Option are non-refundable in any circumstance where the entry permit is approved and issued by the Government of Canada and you have arrived in Canada without proper Activation of your policy.
The two month deposit premium and the $50 Policy Fee for the Monthly Payment Option are non-refundable on any activated policy or policy that is terminated mid-term by you or us. Only full monthly premiums will be refunded. Partial months will not be refunded.
After you have activated your coverage under this policy, subject to all other policy terms, your insurance will terminate on the date that:
– you return to your country of origin in the event of your death under Insured Service benefit #6, or
following emergency treatment of your medical condition under Insured Service benefit #7; or
– the Assistance Centre specified when advising you to return to your country of origin due to your medical condition, even if you choose to remain in Canada; or
– we receive proof that you are eligible and covered under a Canadian government health insurance plan; or
– you return to your country of origin and submit a written request to cancel your policy.
IN THE EVENT OF AN EMERGENCY
YOU MUST CALL CALL OUR ASSISTANCE CENTRE AT
toll-free from the USA and Canada
If unable to use the toll-free number, call collect to Canada: +1 519-251-7856
Our Assistance Centre can also be contacted through its ACM TravelAid™ mobile application.
Visit http://Active-Care.ca/TravelAid to download the app. You must contact the Assistance Centre prior to receiving any medical treatment. If you fail to contact the Assistance Centre, you will have to pay 20% of the medical expenses we would normally pay under this insurance.
If it is medically impossible for you to call when the emergency happens, the 20% co-insurance will not apply. In this case, we ask that you contact the Assistance Centre as soon as you can or that someone call on your behalf. Our Assistance Centre is there to help you 24 hours a day, 365 days a year.
The ACM TravelAid™ mobile application can also provide you with directions to the nearest medical facility, local emergency telephone numbers (such as 911 in North America), and pre-and post-departure travel tips.
To make a claim, you will need to complete a claim form and submit the following:
a) policy number;
b) proof of all travel dates (airline ticket, passport or visa);
c) original itemized medical bills, receipts and invoices;
d) proof of payment if you have paid the expense;
e) complete medical and/or hospital records including diagnosis, X-ray, lab or other diagnostic testing results, which confirm that the treatment was medically necessary; and
f) copy of police report (in the case of a motor vehicle accident);
g) if a claim is made under Accidental Death and Dismemberment, we will need: a) police, autopsy or
coroner’s report; b) medical records; and c) death certificate, as applicable.
Attach all documentation requested in the claim form, and send it to:
21st Century Visitors Claims
c/o Active Care Management
P.O. Box 1237, Stn. A
Windsor, ON N9A 6P8 Canada
To enquire about the status of your claim call
1-855-297-4379 from 8:00AM to 8:00PM ET
21st Century Travel Ins Useful Forms
Complete for any applicant age 60 to 85 who is applying for the Stable Chronic Condition Option.Complete for all applicants age 86 or over.
Form must be completed in full by Insured OR Sponsor (incomplete forms will be returned)
A $25 processing fee will be deducted from any amount refundable
To pre-authorize credit card charges on the Super Visa monthly payment option
This summary is meant to be a “help guide” and does not exonerate you from the responsibility of reading the detailed terms, conditions, definitions and exclusions of the policy wording. In all instances, the official policy wording will prevail.
To view 21st Century Travel Ins policy wording click the PDF button
Super Visa Insurance
Visitors To Canada
Ideal if you are:
- Temporary resident of Canada
- Returning Canadian resident
- Work permit holder