Common questions
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GMS Eligibility Summary
If You Are Under 55 Years Old, You are NOT eligible if:
-
You have any reason to seek medical treatment,
. Exception: routine care of a chronic condition or travel visa medical evaluations. - You're already in Canada and have ever been denied similar coverage by another Canadian insurer
- You're already in Canada and have had over $5,000 in medical treatment in the past 12 months.
If You Are 55 to 79 Years Old, You are NOT eligible if:
- You will be 80 or older on the policy effective date.
-
You have any reason to seek medical treatment
. Again, routine chronic care and visa evaluations are excluded - You're already in Canada and have been denied similar insurance by another Canadian insurer.
- You've had more than $5,000 in medical treatment in the last 12 months while in Canada.
- You're expecting treatment for heart disease.
- You're waiting for tests related to a suspected heart condition
- You're on prescription drugs for heart disease and taking insulin for diabetes.
- You have an implantable cardioverter defibrillator (ICD).
- You've fainted or fallen more than once without diagnosis.
- You use home oxygen for any medical condition.
- You take oral steroids for a lung condition.
- You're being treated for cancer or have metastatic cancer
- You have an untreated vascular aneurysm.
-
You've ever had:
. a heart valve replacement,
. kidney dialysis, or
. an organ transplant. -
You've been diagnosed, treated, or changed treatment in the past 12 months for:
. a heart valve replacement,
. Congestive heart failure
. Atrial flutter/fibrillation
. Peripheral vascular disease
. Stroke/TIA
. AIDS
. Terminal illness
. Blood clots
. Gastrointestinal bleeding - You are 70 or older and need help with activities of daily living (ADLs).
📌 Important Note:
If any of these conditions apply, you’re not eligible, and GMS must be contacted immediately. Also, if
your health changes after applying, you must inform GMS to avoid denial of coverage.
Eligibility
If you are under 55 years of age you are NOT eligible if you:
- have any reason to seek medical treatment, excluding the regular care of a chronic condition or medical evaluation required to satisfy travel visa requirements;
- are currently in Canada, and have ever been denied similar coverage offered by another Canadian insurer; and
- are currently in Canada, and had more than $5,000 in medical treatment in the last 12 months while in Canada.
If you are 55 years of age and older you are NOT eligible if you:
- are 80 years of age or older on the policy effective date;
- have any reason to seek medical treatment, excluding the regular care of a chronic condition or medical evaluation required to satisfy travel visa requirements;
- are currently in Canada, and have ever been denied similar coverage offered by another Canadian insurer;
- are currently in Canada, and had more than $5,000 in medical treatment in the last 12 months while in Canada;
- are expecting medical treatment for heart disease;
- are waiting for test(s) for a suspected heart condition;
- are taking prescription drugs for heart disease while taking insulin to treat diabetes;
- have an implantable cardioverter defibrillator (ICD);
- fainted or fell more than once without medical diagnosis (syncope);
- use home oxygen for a medical condition;
- take oral steroids to treat a lung condition;
- are being treated for cancer or have Metastatic Cancer;
- have a vascular aneurysm that is surgically untreated;
-
have ever had:
a. a valve replacement;
b. kidney (renal) dialysis; or
c. an organ transplant; -
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 conditions in the last 12 months:
a. congestive heart failure;
b. atrial flutter;
c. atrial / ventricular fibrillation;
d. peripheral vascular disease;
e. stroke / transient ischemic attack (TIA);
f. acquired immune deficiency syndrome (AIDS);
g. terminal illness;
h. blood clots; or
i. gastrointestinal bleeding; and - require assistance from another person(s) with activities of daily living (ADL) if you are 70 years of age or older. If any of the medical conditions listed above do apply to you, contact GMS immediately as you are not covered. Should any changes to your health occur after you applied for coverage, GMS must be notified.
GMS Travel Insurance – Key Exclusions
You will not be covered for expenses related to:
- 🌍 Location-Based Exclusions
- Medical expenses in your country of origin
- Travel to destinations with Canadian government advisories (“Avoid all” or “Avoid nonessential travel”)
-
Medical treatment or services outside Canada, unless part of:
. Automatic Policy Extensions, or
. Eligible expenses outside Canada
- 🏥 Medical Condition & Treatment Exclusions
- Pre-existing conditions not stable for 180 days
- Treatment against medical advice or GMS instructions
- Continuation or recurrence of a previous condition
-
Routine or elective care, including:
. Regular checkups
. Elective, cosmetic, or dental surgery
. Follow-ups after emergency treatment
. Non-emergency hospitalization or surgery - Diagnostic facility treatment without GMS pre-approval
- Air transportation or return travel not pre-approved by GMS
-
ravel not pre-approved by GMS 10.
. Over-the-counter
. Not approved in Canada
. Preventative or experimental
- 🚫 Activity & Behavior-Related Exclusions
- Travel for the purpose of seeking diagnosis or treatment
- Travelling against your physician’s advice
- Pregnancy-related costs, including childbirth, miscarriage, abortion, and complications
- Newborns (not covered until 48 hours post-discharge and formally added)
- Unapproved or non-emergency cardiac treatments (angioplasty, surgery, ICDs)
- Experimental treatments or surgery
- Illegal activity or criminal acts
- Substance misuse, including alcohol or drug abuse
- Motor vehicle accidents (if covered by another insurance)
-
Extreme or high-risk sports, including:
. Professional sports
. Motor racing
. Mountaineering, skydiving, bungee jumping, rodeo, etc - Air travel, unless as a passenger on a licensed commercial carrier
- ⚠️ Legal, War, and Other Exclusions
- Prohibited treatments under Canadian law
- Military service, willful exposure to danger, or relief work
- Nuclear-related incidents or radiation exposure
- War, terrorism, or foreign rebellion
This list helps ensure you’re aware of what situations, conditions, or actions will void your coverage.
Always double-check with GMS if you have any doubts about your eligibility or risk factors.
EXCLUSIONS TO COVERAGE
The following expenses are not covered by this policy.
- GMS does not cover expenses incurred in your country oforigin.
- GMS does not cover expenses incurred where you act against medical advice or the advice of GMS.
- GMS does not cover expenses resulting from the regularcare of a chroniccondition.
-
GMS does not cover any expenses that are the result of your failure, prior to arriving in Canada, 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. -
GMS does not cover expenses resulting directly or indirectly 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 which you received medical treatment or medical consultation. -
GMS does not cover expenses resulting directly or indirectly 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 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). - GMS does not cover expenses when you travel outside Canada when 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.
- GMS does not cover any medical treatment, which is a continuation of or a recurrence of a medical condition.
- GMS does not cover any expenses resulting from medical treatment that is not a medical emergency, including but not limited to: routine or general physical examinations; medical checkups; regular care of chronic conditions; elective surgery; dental or cosmetic surgery, even if recommended by a physician; and follow ups or continued services following emergency medical treatment. GMS' opinion on the issue is final and binding.
- GMS does not cover expenses that are a duplication of any service, allowance or repayment available by an existing government health plan or private plan.
- GMS does not cover medical treatment, hospitalization or surgery (including elective, non-elective, personal comfort, dental or cosmetic) which is not considered to be an emergency, even if it is recommended by a physician.
- GMS does not cover expenses for medical treatment at a diagnostic facility unless pre-approved by GMS.
- GMS does not cover emergency air transportation or return to Canada or your country oforigin, which is not arranged and pre-approved by GMS.
- GMS does not cover drugs which are commonly available without a prescription, not legally registered or approved in Canada, experimental drugs or preventative medicines or vaccines.
- GMS does not cover any expenses resulting from and/or incurred during trips undertaken for the purpose of receiving a diagnosis of medical treatment.
- GMS does not cover any expenses when you travel against the advice of a physician.
- GMS does not cover expenses related to your pregnancy, an abortion, miscarriage, childbirth or complications of any of these conditions.
- GMS does not cover a newborn until it has been released from the hospitalfor 48 hours and has been added as a dependant on your coverage.
- GMS or does not cover expenses for coronary artery angioplasty, cardiac surgery 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.
- GMS does not cover any expenses for medical treatment or surgery which is considered by GMS to be experimental. GMS' opinion on the issue is final and binding.
- GMS does not cover expenses resulting directly or indirectly from your criminal illegal acts.
- GMS does not cover expenses resulting from your sickness, injury, or death if at the time of the sickness, injury or death evidence supports that it was caused by, or in any way contributed to, by the use or abuse of prohibited drugs, alcohol, or any other intoxicant or the misuse of medication, whether prescribed or not.
- GMS does not cover expenses incurred asa result ofa motor vehicle accident, unless such services are not covered by any other private or public vehicle insurance.
-
GMS does not cover any expenses resulting from your participation in:
. a. professional sport;
. b. speed contests or racing of motorized land, water or air vehicle(s);
. c. an extreme sport, including but not limited to scuba diving (except when you are NAUI, PADI, ACUC or SSI certified), bungee jumping, parachuting, mountaineering, skydiving, participation in a rodeo, hang gliding, acrobatic or stunt flying or participating in a horse race as a jockey. - GMS does not cover expenses resulting from air travel unless riding as a passenger on a common carrier.
- GMS does not cover medical treatment or services that contravene or are prohibited by provincial laws and/orthe federal laws of Canada.
- GMS does not cover expenses resulting from your service in the armed forces, willful exposure to peril, and/or relief work.
-
GMS does not cover expenses for medical treatment and services provided outside Canada except as provided under the following sections in this policy:
. a. Automatic Policy Extensions; or
. b. Eligible expenses outside Canada. - GMS does not cover expenses resulting from any nuclear reaction, radiation or radioactive contamination or occurrence, where the risk of the exposure was present prior to your arrival in Canada, however caused.
- GMS does not cover expenses resulting from war, terrorism or acts of foreign rebellion.