MSH Eligibility Requirements

To be eligible for coverage under MSH’s Visitors to Canada insurance policy, the following conditions must be met on the effective date of the coverage:

  • Visitor Status: You must be a visitor to Canada or a person in Canada under a valid work or student visa, or a Canadian immigrant who is not eligible for benefits under a government health insurance plan
  • Age Range: You must be at least 15 days old and no more than 90 years old.
  • Health Condition:
    1. You cannot be traveling against the advice of a physician.
    2. You must not have been diagnosed with a terminal illness, congestive heart failure, or experience new or undiagnosed symptoms.
    3. You must not know of any reason to seek medical attention at the time of purchase.
  • Daily Living: You must not require assistance with activities of daily living, such as:
    1. Eating
    2. Bathing
    3. Dressing
    4. Functional mobility
    5. Using the toilet

These requirements are essential to determine eligibility for the policy, ensuring coverage applies only to individuals who meet the health and status criteria.

ELIGIBILITY

To be eligible for coverage, on the effective date, you must:
  • Be a visitor to Canada or a person in Canada under a valid work or student visa, a Canadian or an immigrant not eligible for benefits under a government health insurance plan; and
  • Be at least 15 days of age and no more than 90 years of age; and
  • Not be travelling against the advice of a physician and/or have not been diagnosed with a terminal illness or congestive heart failure or be experiencing new or undiagnosed symptoms and/or know of any reason to seek medical attention; and
  • Not require assistance with the activities of daily living (eating, bathing, dressing, functional mobility, using the toilet).

MSH Travel Insurance Exclusions

The following are the key exclusions from the MSH travel insurance policy, meaning that the insurer will not cover expenses related to:

  • Pre-existing Medical Conditions:
    • Any sickness, injury, or medical condition that existed before the effective date, unless:
      1. Age 70 or younger: Condition was stable for 90 days prior to the effective date.
      2. Ages 71–80: Condition was stable for 180 days prior to the effective date.
  • Sickness or Injury:
    • Conditions that would have prompted a reasonably prudent person to seek medical attention within 90 days before the effective date.
  • Elective or Cosmetic Surgery:
    • Any elective or cosmetic surgery unless required due to a covered injury.
  • Prior to Effective Date:
    • Any sickness or injury that occurred before the effective date of coverage, even if coverage was extended after arrival in Canada.
  • Travel Against Medical Advice:
    • Costs incurred due to travel against the advice of a physician or due to a terminal illness diagnosed before the effective date.
  • Delaying Treatment:
    • Emergency medical treatment that can reasonably be delayed until return to your home country.
  • Ongoing Treatment:
    • Treatment for chronic conditions, rehabilitation, or ongoing care after the emergency has ended.
  • Non-Compliance with Medical Treatment:
    • Failure to follow prescribed medical treatment.
  • Travel for Medical Treatment:
    • If the policy was purchased specifically to obtain medical treatment outside your home country, regardless of physician recommendation.
  • Medical Treatment in Your Country of Origin:
    • Any treatment received in your country of origin.
  • Transplants and Prosthetics:
    • Costs related to organ or bone marrow transplants, artificial joints, prosthetic devices, and implants.
  • Prescription Replacement:
    • The replacement of existing prescriptions due to loss, inadequate supply, or renewal.
  • Pregnancy:
    • Pregnancy that commences prior to the effective date, including childbirth or complications during the trip.
  • Congenital Defects for Children Under 2:
    • Any condition related to a congenital defect for children under 2 years old.
  • Prescription Replacement:
    • Any replacement of lost, stolen, or forgotten prescriptions.
  • Treatment Requiring Prior Approval:
    • Medical treatment that requires prior approval but was not obtained.
  • Mental or Emotional Disorders:
    • Any emotional, psychological, or mental disorder, except if hospitalized or as specified in the psychiatric/psychological benefit.
  • Intoxication:
    • Loss or injury caused by alcohol, prohibited drugs, or other intoxicants.
  • Illegal Acts:
    • Injury or loss resulting from the commission of or attempt to commit a criminal act.
  • Self-Inflicted Injury:
    • Suicide, attempted suicide, or self-inflicted injuries, regardless of mental state.
  • Dangerous Sports:
    • Participation in high-risk activities like rock climbing, parachuting, skydiving, motor racing, or professional sports, unless proper certification is met (e.g., scuba diving).
  • Aircraft Operations:
    • Death or injury while piloting or learning to operate any aircraft as a pilot or crew member.
  • Travel Warnings:
    • Travel to regions where the Canadian Government has issued a warning against all travel or non-essential travel before departure.
  • War and Civil Unrest:
    • Losses due to war, civil war, rebellion, revolution, or military power.
  • Terrorism:
    • Terrorism-related losses unless directly caused by fire or explosion.
  • Nuclear or Chemical Contamination:
    • Contamination from radioactive materials or mass destruction weapons (nuclear, chemical, biological).
  • Military Service:
    • Expenses related to service in or training for military or armed forces.
  • Motor Vehicle Accident:
    • Any motor vehicle accident where you are covered under another insurance policy, except when that coverage is exhausted.

These exclusions highlight the conditions under which you would not be covered by the policy. It’s important to carefully review the full list of exclusions and any specific conditions mentioned in your insurance agreement.

Exclusions

This policy does not cover any expenses related in whole or in part, directly or indirectly, to any of the following:
  1. Any sickness, injury or medical condition (other than a minor ailment) that existed prior to the effective date other than:
    • a. Up to age 70: Any sickness, injury or medical condition that was stable in the 90 days prior to the effective date.
    • b. Age 71–80: Any sickness, injury or medical condition that was stable in the 180 days prior to the effective date.
  2. Expenses related to a sickness or injury that would have caused an ordinarily prudent person to seek medical treatment, advice, diagnosis or care during the 90 day period immediately prior to the effective date.
  3. Elective and/or cosmetic surgery or treatment unless required as the result of a covered injury.
  4. Any sickness or injury which occurred prior to the effective date of your policy when coverage has been extended after your arrival in Canada.
  5. Any costs incurred due to your travelling against the advice of a physician or any loss resulting from your sickness or medical condition that was diagnosed by a physician as a terminal illness prior to the effective date.
  6. Any emergency medical treatment which can reasonably be delayed until you return to your country of origin by the next available means of transportation, whether you intend to or not.
  7. Any medical treatment of an ongoing condition, regular care of a chronic condition, health care, investigative testing, rehabilitation or ongoing care or medical treatment of an acute sickness and/or injury after the initial emergency.
  8. Non-compliance with any prescribed medical therapy or medical treatment.
  9. Expense incurred whereby this policy was purchased specifically to obtain medical treatment outside your country of origin, whether or not recommended by an attending physician.
  10. Any medical treatment in your country of origin.
  11. Transplants including, but not limited to, cornea or organ transplants or bone marrow transplants, artificial joints, prosthetic devices or implants including any associated charges.
  12. The replacement of an existing prescription whether by generic or brand-name drugs (as specified elsewhere in this policy), renewal or ongoing refill or the purchase of drugs and medications (including vitamins) which are commonly available without a prescription or which are not legally verified in Canada and which are not required as a result of an emergency.
  13. Loss or damage to hearing devices, eyeglasses, sunglasses, contact lenses, or prosthetic teeth, limbs or devices and resulting prescriptions.
  14. Pregnancy that commences prior to the effective date; a child born during your trip; pregnancy, miscarriage, childbirth or termination of pregnancy or complications thereof, except as provided under Benefit #15 – Maternity.
  15. For children under 2 years of age any sickness or medical condition resulting from or related to a congenital defect.
  16. Expenses for any benefit or medical treatment that requires prior approval by Intrepid 24/7™ if such approval was not provided, except in extreme circumstances where such medical treatment is performed on an emergency basis immediately upon admission to hospital.
  17. A disorder, disease, condition or symptom that is emotional, psychological or mental in nature unless you are hospitalized or as provided in Benefit #16 – Psychiatric/Psychological.
  18. Loss, death or injury, if at the time of the loss, death or injury, evidence supports that you were affected by, or the medical condition causing the loss was in any way contributed to by, the use of alcohol, prohibited drugs or any other intoxicant.
  19. Your commitment of or attempt to commit an illegal act or a criminal act.
  20. Your suicide, attempted suicide or self-inflicted injury, whether you are sane or insane.
  21. Rock or mountain climbing, hang gliding, parachuting, bungee jumping, or skydiving; participation in any motor sport or motor racing; participation in any sport as a professional athlete for which you are remunerated; or scuba diving (except if certified by an internationally recognized and accepted program such as NAUI or PADI, or if diving depth does not exceed 30 metres).
  22. Death or injury sustained while operating or learning to operate any aircraft as pilot or crew.
  23. Travel to, from or through any country, region or city for which, prior to your departure date, the Canadian Government, or any department thereof, has issued a warning to avoid all travel or non-essential travel during the time of your trip if the loss is the result of the reason for which the warning was issued.
  24. War, invasion, act of a foreign enemy, declared or undeclared hostilities, civil war, riot, rebellion, revolution or military power or your unlawful visit in any country.
  25. Terrorism or by any activity or decision of a government agency or other entity to prevent, respond to or terminate terrorism. Loss or damage which results directly or indirectly from such events is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss or damage.
  26. Contamination resulting from radioactive material or nuclear fuel or waste or the release of weapons(s) of mass destruction (nuclear, chemical or biological).
  27. Any service, treatment or supplies provided by armed forces, national guard or organized reserve corps of any country or international authority.
  28. Any expenses resulting from a motor vehicle accident where you are covered under any other insurance policy, including motor vehicle insurance, except when such other insurance coverage is exhausted.