GMS Travel Insurance

Administrated by: GMS Insurance Inc.
Underwritten by: GMS Insurance Inc.
24 hours Emergency Assistance Center: World Travel Protection (WTP)

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 in Quebec, New Brunswick and Nunavut.

BENEFITS: 
 - Emergency Medical Expenses: maximum benefit: $5,000,000
 - Hospital Room: ward or semi-private.
 - Physician Services
 - Diagnostic Services: basic diagnostic tests ordered by a physician (advanced diagnostics require pre-approval) *
 - Prescription drugs or medicines - 30-day supply per prescription
 - Medical Appliances - rental of essential medical appliances (wheelchair, crutches, canes etc.) when needed. *
 - 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 mouth.
 - Dental Emergencies: Up to $250 for treatment or relief of acute dental pain.
 - Private Duty Nursing – up to $5,000. *
 - Professional Medical Services – care received from a licensed physiotherapist, chiropractor, osteopath, chiropodist, or podiatrist, up to $300 per specialty.
 - Ambulance Transportation: Licensed local road ambulance, when necessary, to the nearest hospital. 
 - Air Ambulance & Remote Evacuation – up to $20,000 for the use of a helicopter air ambulance in a medical emergency involving life threatening circumstances where you require immediate transport to the nearest hospital.
 - Repatriation – expenses to transport you by air ambulance (excluding helicopters) and Attendant (if necessary) or regularly scheduled common carrier back to your province of residence for further in-hospital medical treatment. *
 - Return of Family Member - up to $1,000 for one-way air transportation to return of one covered family member and/or insured dependent (including escort when required), if you are repatriated to your province of residence for further in-hospital medical treatment or in the event of your death. *
 - Family/Friend to Bedside up to $3,000 to bring family member or a close friend, and reimbursement of up to $150 per day to a maximum of $750 for reasonable expenses incurred by the transported person, once they arrive if you have been hospitalized for more than 3 consecutive nights. * 
 - Return of Remains In the event of death from covered condition, up to $7,000 for the preparation and transport of your remains, or up to $3,000 for cremation or burial at the place of death. (This benefit does not cover the cost of a burial casket or urn). *
 - Return of Vehicle – up to $2,000, for returning your vehicle, to your province of residence if you have been transferred to Canada due to covered illness or injury.
 - Return of Cat or Dog – Reimbursement up to $300 to return your cat or dog to your province of residence if you have been transferred to Canada due to covered illness or injury.
 - Child Care - up to $500 for licensed care of dependent, should you be hospitalized due to a medical Emergency. *
 - Out of pocket expenses – expenses up to a maximum of $1,000 incurred by insured travelling companion in the event you are in hospital receiving care on your return date. This benefit includes coverage for up to $150/day for accommodations, which shall form part of the $1,000 limit. *

* Some of the benefits must be pre-approved and arranged by GMS. Please read the insurance policy (attached below) for full descriptions and condition of the insurance benefits. 

OTHER PLANS (additional rates apply)
- Baggage Loss, Damage & Delay – up to $1,500 per person
- Trip Cancellation & Interruption – before departure: up to $20,000 and after departure: $10,000

ELIGIBILITY:
You must purchase the plan prior to your departure date from your province of residence.
You must have valid provincial health coverage for the entire duration of your trip.
You are NOT eligible for coverage if you:
1. are awaiting tests or medical treatment for a heart condition;
2. have a surgically untreated vascular aneurysm;
3. have been diagnosed with Congestive Heart Failure (CHF);
4. have an Implantable Cardioverter Defibrillator (ICD);
5. were diagnosed; received new medical treatment (e.g. consultation, tests or prescription drugs); or had a change in your medical treatment (e.g. a stop, start or dosage change to a prescription drug, other than a dosage change of Coumadin or Warfarin) for, any of the following heart or vascular conditions in the last twelve (12) months:
a. heart transplant;
b. atrial flutter;
c. atrial/ventricular fibrillation;
d. peripheral vascular disease;
e. stroke/TIA; or
f. blood clots;
6. have diabetes that is treated with insulin AND take prescription medication for a heart condition (excluding medication to treat high cholesterol or high blood pressure);
7. use home oxygen or take an oral steroid to treat a lung condition;
8. are currently being treated for cancer, excluding breast or prostate cancer treated exclusively with hormone therapy;
9. were diagnosed; received a new medical treatment (e.g. consultation, tests or prescription drugs); or had a change in your medical treatment (e.g. a stop, start or dosage change to a prescription drug) for, any of the following conditions in the last twelve (12) months:
a. liver failure;
b. GI bleed;
c. AIDS; or
d. terminal illness;
10. have had any of the following procedures in the last twelve (12) months:
a. valve surgery or replacement;
b. kidney dialysis;
c. organ, stem cell or bone marrow transplant;
11. require assistance from another person(s) with activities of daily living (ADL) if you are seventy (70) years of age or older;
12. are not a Canadian resident with a valid provincial/territorial government health plan; and
13. have not purchased prior to departing on your trip, unless purchased as a top-up to an existing GMS policy.

PRE-EXISTING CONDITIONS:
No coverage or reimbursement for expenses resulting from medical condition(s) which have not been stable for one hundred and eighty (180) days immediately prior to your departure 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 in the insurance policy, regardless of the opinion of your physician or any other person who may provide an opinion on your medical condition.

Stable: a medical condition is considered stable and controlled, only when all of the following statements are true.
1. there has not been any new medical treatment prescribed or recommended, or change(s) to existing medical treatment or stopped medical treatment; and
2. there has not been any change to any existing prescribed drug (including an increase, decrease, or stopping to prescribed dosage), except:
a. a dosage adjustment for anti-hypertensive or cholesterol lowering medication;
b. a change from brand name medication to generic medication and vice versa of the same dosage;
c. Coumadin/Warfarin prescribed as an anticoagulation therapy adjusted to ensure your INR is maintained within therapeutic range as directed by your physician(s) provided there has been no other change in your condition; and
d. insulin or oral anti-diabetic medication where blood levels are tested on a regular basis and adjustments to the dosage are made to ensure your blood glucose level is maintained within therapeutic range as directed by your physician(s) provided there has been no other change in your condition; and
3. the medical condition has not become worse; and
4. there have not been any new, more frequent or more severe symptoms; and
5. there has been no hospitalization or referral to a specialist; and
6. there has been no tests, investigation or medical treatment recommended, but not yet complete, nor any outstanding test results.

EXTENSIONS:
Your Single-Trip plan may be extended by purchasing additional days while outside your province of residence if you:
1. notify GMS two (2) business days prior to the expiry date of your policy; and
2. have not incurred a claim, required medical treatment or medical consultation during your trip; 

REFUNDS:
1. Prior to your effective date you are eligible for a full refund.
2. After your effective date, a partial refund is available for unused days upon return to your province of residence except if:
a. the insured person requesting the refund has incurred a claim under the policy; or
b. if a family rate was applied, any person covered under the plan has incurred a claim.
Written notice with supporting documentation is required within 30 days of your early return to your province of residence.
Once you have received a refund, you will no longer be eligible for reimbursement of expenses for any medical emergency.

CLAIMS: 
You must contact GMS Travel Assistance where possible before you seek medical treatment. Failure to contact GMS within twenty-four (24) hours of receiving medical treatment or admission to hospital may limit benefits, otherwise payable to you, 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:
World Travel Protection
901 King Street West, Suite 300, Toronto, ON, M5V 3H5
For online Claims Submission visit www.gms.ca/emergency-medical-claims
In the event of a claim, a claim form must be submitted to GMS within ninety (90) days of the illness or injury.
Please keep a copy of all the submitted correspondence for your records.

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.

EXCLUSIONS: 
1. Pre-existing Medical Conditions - No coverage or reimbursement for expenses resulting directly or indirectly from medical conditions which have not been stable for 180 days immediately before your departure date, including:
a. medical conditions for which you received medical treatment or medical consultation; and/or
b. undiagnosed medical conditions 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 conditions.
2. Pre-existing Medical Conditions When Topping Up Other Insurer’s Plans - No coverage or reimbursement for expenses resulting directly or indirectly from medical conditions that have not been stable for 180 days before the effective date of the top-up when this policy is being used as a top-up for another insurer's emergency medical insurance. 
3. Pre-existing Medical Conditions When Topping Up a GMS Plan - No coverage or reimbursement for expenses resulting directly or indirectly from medical conditions that have not been stable as defined by the stability period specified within the GMS policy this policy is being used to top-up.   
4. Recurrence of a Medical Condition - No coverage or reimbursement for the continued medical treatment of a medical condition or related condition, following emergency medical treatment during your trip, if GMS determines that your emergency has ended.
5. Non-Emergency Treatment - No coverage or reimbursement for non-emergency, experimental or elective medical treatment (e.g. cosmetic surgery, chronic care, rehabilitation) including any expenses for related complications.
6. Travel for Diagnosis or Treatment - No coverage or reimbursement for any claim if the purpose of your trip is to obtain or receive a diagnosis, medical treatment, surgery, investigation, palliative care or therapy.
7. Travel When Treatment Expected - No coverage or reimbursement if it was reasonable, prior to your departure date, to expect medical treatment or hospitalization during your trip, including any symptoms evident that it would be reasonable to expect you to investigate prior to your departure date.
8. Delayable Treatment - No coverage or reimbursement for expenses for medical treatment that can be reasonably delayed until you return to your province of residence.
9. Transplants - No coverage or reimbursement for transplants, including but not limited to organ transplants, or bone marrow or stem cell transplants which may be required as part of your medical treatment provided at your trip destination.
10. Refusal of Transfer - If GMS medical advisors determine that you should transfer to another facility for emergency medical treatment or return to your province of residence, and you choose not to, benefits will not be paid for further medical treatment and the policy will be null and void.
11. Refusal to Follow Medical Advice - No coverage or reimbursement for expenses that result from you not following medical treatment as prescribed to you, including prescribed medication.
12. Non-Adherence - No coverage or reimbursement for expenses that result from your failure, prior to departure, to:
a. adhere to medical treatment;
b. obtain investigative or diagnostic tests recommended by a medical professional; and/or
c. receive results from investigative or diagnostic tests.
13. Acting Against Physician’s Advice - No coverage or reimbursement for expenses incurred after your physician advised you not to travel.
14. Maintaining Valid Government Health Insurance – No coverage or reimbursement for any expense that would have been covered under your government health plan, if you fail to maintain valid coverage within your province of residence for the entire duration of your trip. It is your responsibility to check that you have this coverage.
15. Pregnancy Related Matters - No coverage or reimbursement for expenses related to routine pre-natal or post-natal care and pregnancy, delivery or complications of either the pregnancy or delivery, which occur nine (9) weeks before the expected date of delivery or anytime after.
16. Child Born During Trip - No coverage or reimbursement for expenses related to your child born during the trip.
17. Cardiac Procedures and Devices - No coverage or reimbursement for expenses for cardiac catheterization, angioplasty or cardiovascular surgery or insertion of an implantable cardioverter defibrillator (ICD) or pacemaker including all associated diagnostic expenses, unless necessary in a medical emergency. Pre-approval by GMS required.
18. Risky Activities - No coverage or reimbursement for expenses resulting from your participation in:
a. professional sport;
b. speed contests or racing of motorized land, water or air vehicle(s); or
c. any extreme sport or activity involving a high level of risk, including but not limited to: scuba diving (except when you are NAUI, PADI, ACUC or SSI certified); bungee jumping; parachuting; mountaineering; skydiving; hang gliding; acrobatic or stunt flying; or participating in a rodeo or horse race as a jockey.
19. Non-Common Carrier Air Travel - No coverage or reimbursement for expenses resulting from air travel unless riding as a passenger on a common carrier.
20. Common Carrier Air Travel - No coverage or reimbursement for expenses resulting from air travel unless riding as a passenger on a common carrier.
21. Work - No coverage or reimbursement for expenses for work related accidents.
22. Risky Work or Volunteer Activities - No coverage or reimbursement for expenses resulting from your service in the armed forces, willful exposure to peril, work within a hazardous occupation, or mission and/or relief work.
23. Result of Conflict - No coverage or reimbursement for expenses resulting from war, terrorism or acts of foreign rebellion.
24. Travel Advisory - No coverage or reimbursement for expenses that occur where, before your departure date, an official travel advisory is issued by the Canadian Government stating "Avoid non-essential travel" or "Avoid all travel" for the country, region, city, or other destination (including cruise ships) that are part of your travel arrangements.
To view travel advisories, visit the Government of Canada Travel site: https://travel.gc.ca/travelling/advisories.
25. Criminal or Illegal Activity - No coverage or reimbursement for expenses that result from or are related to your involvement in the commission, or attempted commission, of a criminal offence or illegal act.
26. Drugs & Alcohol - No coverage or reimbursement for
a. expenses for any medical condition, including symptoms of withdrawal, arising from, or in any way related to, your use of alcohol, drugs or other intoxicants (including cannabis)  whether prior to or during your trip; and
b. out-of-pocket expenses arising from or in any way related to alcohol, drugs, or other intoxicants (including cannabis).
27. Misuse of Medication - No coverage or reimbursement for expenses resulting from the misuse of a medication, whether prescribed or not.
28. Motor Vehicle Accident - No coverage or reimbursement for expenses resulting from a motor vehicle accident, unless not covered by any other policy.
29. Failure to Obtain GMS Pre-Approval - No coverage or reimbursement for expenses where pre approval by GMS is required and not obtained.
30. Unapproved Treatment - No coverage or reimbursement for expenses for medical treatment or services that contravene or are prohibited by the provincial laws of your province of residence or the federal laws of Canada.
31. Pre-Existing Nuclear Issues - No coverage or reimbursement for expenses resulting from any nuclear reaction, radiation or radioactive contamination or occurrence, where the risk of the exposure was present prior to your departure, however caused.
32. Experimental Treatment - No coverage or reimbursement for expenses for any medical treatment which is considered by GMS to be experimental. GMS’ opinion is final and binding.

Should any changes to your health occur after you applied for coverage, GMS must be notified and your application updated.
A change in health may:
1. affect your eligibility for coverage; or
2. increase your premium.
Changes to your health that do not affect eligibility will still constitute a change in stability and may limit your available coverage.

DOWNLOADS:

GMS Travel Insurance POLICY PDF

GMS Travel Insurance CLAIM FORM PDF