TuGo Visitors to Canada Insurance – Eligibility Requirements

To be eligible for coverage under TuGo’s Visitors to Canada Insurance, you must meet the following conditions at the time of application:

  1. No Known Medical Need
    You must not be aware of any reason that may cause you to seek medical attention during your trip.
  2. Legal Status in Canada
    You must belong to one of the following groups:
    • A visitor to Canada, international student, or foreign worker with valid legal status in Canada.
    • An immigrant awaiting coverage under a provincial or territorial health care plan.
    • A Canadian returning from extended travel who is eligible for provincial/territorial health care but not yet covered.
  3. Traveling With Medical Approval
    You must not be travelling against the advice of a physician or registered medical practitioner.
  4. No Terminal Illness
    You must not have been diagnosed with a terminal condition or be receiving or advised to receive palliative care.
  5. No High-Risk Health Conditions
    Coverage is not available if you have any of the following:
    1. Chronic Obstructive Pulmonary Disease (COPD) or emphysema requiring home oxygen.
    2. Pancreatic cancer, liver cancer, or any cancer that has metastasized or required a bone marrow transplant.
    3. Kidney disease requiring dialysis.
    4. You’ve had or are waiting for an organ transplant.
    5. You have been diagnosed with congestive heart failure (pulmonary edema).

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
  • You have not been diagnosed with a terminal condition.
  • You are not receiving palliative care or palliative care has not been recommended.
  • You do not have Chronic Obstructive Pulmonary Disease (COPD), including emphysema, requiring home oxygen.
  • You do not have pancreatic cancer, liver cancer or any type of cancer that has metastasized or that required a bone marrow transplant
  • You do not have kidney disease requiring dialysis.
  • You have not had or are not waiting for an organ transplant.
  • You have not been diagnosed with congestive heart failure also known as pulmonary edema.

TuGo Visitors to Canada Insurance – What’s Not Covered (Exclusions)

This insurance will not cover claims that fall under the following conditions:

1. Pre-existing Conditions

  1. Any complication from a pre-existing medical condition that was not stable before the policy began.
  2. Stability periods vary by age and whether optional coverage was purchased.
  3. Claims also won’t be paid if:
    1. You were advised not to travel by a doctor or healthcare provider.
    2. You were diagnosed with a terminal illness or are receiving palliative care.
    3. You had pending test results or recommended tests, procedures, or surgeries before your policy started.

2. Mental and Emotional Health

  1. Mental or emotional disorders unless they led to hospitalization.
  2. Drug- or alcohol-induced psychosis.

3. Cancer Treatment

  1. No coverage if you had active cancer treatment (except for skin cancers in remission) within 90 days before the policy began.

4. Diagnostic and Ongoing Treatment

  1. Costs for non-emergency diagnostic tests or follow-ups after your emergency ends unless pre-approved.
  2. No coverage for treatment that can wait until you return home.

5. Substance Use

  1. Any condition related to:
    1. Chronic alcohol or drug use.
    2. Intoxication (including a blood alcohol level over 0.08%).
    3. Misuse or abuse of medication or substances.

6. Travel Advisory Restrictions

  1. No coverage if a Canadian government travel advisory (e.g. “avoid non-essential travel”) was issued before you arrived in Canada.
    1. If the advisory is issued after you arrive, coverage is limited to 30 days, unless extended by TuGo.
    2. This exclusion does not apply to COVID-19 or unrelated emergencies.
    3. Applies similarly to travel outside Canada.

7. Travel to/from Home Country

  1. No coverage if:
    1. A condition worsened or developed during a temporary visit to your home country.
    2. Treatment is received in your home country (with limited exceptions).

8. Other Exclusions

  1. Routine checkups, continuing care, rehab, or home care.
  2. Costs from unauthorized air transportation.
  3. Loss or damage to glasses, contacts, hearing aids, or prosthetics.
  4. Any treatment that breaches Canadian laws or health regulations.

9. Sports and Activities

Coverage is excluded unless you purchase additional coverage for:

  1. Extreme sports (e.g. skydiving, rock climbing, backcountry skiing, etc.).
  2. High-contact sports (e.g. football, hockey, rugby) if you’re 21 or older and playing competitively.

EXCLUSIONS

In addition to the General Exclusions shown on page 31, we will not be liable to provide coverage or services, or to pay claims for expenses incurred directly or indirectly as a result of:

  1. Any complications that develop after departure, related to a pre-existing medical condition that was not stable on or before the effective date of the Policy.
    If you are 79 years and under and have purchased the optional Unstable Pre-existing Medical Condition Coverage, refer to that section heading for stability requirements.
  2. Any claim incurred after a physician advised you not to travel.
  3. Any claim incurred after any other registered medical practitioner advised you not to travel.
  4. A trip that is undertaken after the diagnosis of a terminal condition.
  5. A trip that is undertaken while you are receiving palliative care or after palliative care has been recommended.
  6. Medical conditions or any related medical conditions for which, before the effective date of the Policy, diagnostic tests took place, were scheduled to take place or were recommended and for which results had not yet been received on or before the effective date of the Policy.
    This includes diagnostic tests that were scheduled or were recommended on or before the effective date of the Policy but had not yet taken place on or before the effective date of the Policy.
    This exclusion does not apply to:
    • a. Tests to monitor an existing medical condition if there have been no new or more frequent symptoms, whether or not results have been received; or
    • b. Screening tests intended to prevent illness or to detect medical conditions before symptoms are noted, whether or not results have been received.
  7. The cost of any medication not required for travel.
  8. Medical conditions or any related medical conditions for which, on or before the effective date of the Policy, follow-up on the effectiveness or response to a procedure, surgery or hospitalization are scheduled to take place or are recommended.
    This includes tests that were scheduled or recommended on or before the effective date of the Policy but had not yet taken place on or before the effective date of the Policy.
  9. Medical conditions or any related medical conditions for which before the effective date of the Policy, major procedures, surgeries and/or referrals to a specialist were scheduled to take place or were recommended but had not yet taken place at the time of the effective date of the Policy.
  10. Emotional or mental disorders, unless they result in hospitalization.
  11. Acute psychosis unless hospitalization occurs.
  12. Any cancer (other than basal cell or squamous cell skin cancer and/or cancer that is in remission) for which you received or were recommended to receive treatment on or before the effective date of the Policy.
    This includes active cancer treatment that you were recommended to receive but chose to decline.
  13. Tests and investigation except when performed at the time of initial emergency medical condition.
  14. Any expenses incurred as a result of a disease or illness that originated or was symptomatic during the waiting period.
  1. The continued treatment, recurrence or complication of a medical condition or related condition, following emergency treatment during your trip, if we determine that your emergency has ended, unless otherwise specified in a benefit.
  2. Any medical condition, including symptoms of withdrawal, arising from, or in any way related to, your chronic use of alcohol, drugs or other intoxicants whether prior to or during your trip.
    • a. Any medical condition arising during your trip from, or in any way related to, the misuse or abuse of drugs or other intoxicants, or to the use or abuse of alcohol when you have reached a blood alcohol level of 80 milligrams of alcohol per 100 millilitres of blood or when records indicate you were intoxicated and no blood alcohol level is specified.
  3. Expenses incurred for emergency air transportation and any expenses incurred after emergency air transportation, when the emergency air transportation was not arranged by us.
  4. Any medical condition or related expenses if we determine that you should transfer to another facility or could return to your country of permanent residence for treatment, and you choose not to, benefits will not be paid for further treatment related to the medical condition.
  5. An official travel advisory issued by a Canadian government stating to avoid optional, discretionary, or non-essential travel into Canada, before the date you arrive in Canada.

    If an official travel advisory is issued for a province/territory, region or city within Canada after you have already arrived to that province/territory, region or city, your coverage for an emergency or medical condition related to the travel advisory in Canada will be limited to a period of 30 days from the date the travel advisory was issued. We may extend this coverage beyond 30 days if authorized at our sole discretion.

    To view the travel advisories, visit the Government of Canada Travel site.

    This exclusion does not apply to claims for an emergency or a medical condition unrelated to the travel advisory or to claims incurred for COVID-19.

    If you are a foreign worker, international student studying in Canada, an immigrant awaiting provincial government health care coverage or a Canadian returning to Canada, coverage for an emergency or a medical condition related to the travel advisory will remain in place until your policy expires.

    For Travel Outside of Canada:
    An official travel advisory issued by a Canadian government stating to “avoid all travel” or “avoid non-essential travel” regarding the country, region, or city of your destination, before the date you arrive at the destination (including any stopovers, layovers or any other destination you are transiting through).

    To view the travel advisories, visit the Government of Canada Travel site.

    If an official travel advisory is issued while you are travelling outside of Canada for the country, region or city of your destination or for any part of the country through which you are transiting and you choose to remain in that country or region despite the advisory, your coverage for an emergency or a medical condition related to the advisory will be limited to a period of 30 days from the date the travel advisory was issued. We may extend this coverage beyond 30 days if authorized at our sole discretion.

    This exclusion does not apply to claims for an emergency or a medical condition unrelated to the travel advisory or to claims incurred for COVID-19.
  1. A medical condition for which symptoms arose or worsened or for which treatment by a physician or other registered medical practitioner was received during a temporary visit to your country of permanent residence during the period of coverage or any medical condition wholly or partly, directly or indirectly, related thereto. This exclusion does not apply if the treatment was for either:
    • a. The unchanged use of prescribed drugs or medication for a stable medical condition, symptom or problem; or,
    • b. A check-up where the physician or other registered medical practitioner observes no change in a previously noted medical condition, symptom or problem.
  2. Treatment by a physician or other registered medical practitioner and expenses incurred while in your country of permanent residence or the country you were travelling or residing in before arriving in Canada.
    This exclusion does not apply to a returning Canadian.
  3. Loss, theft, breakage of prescription glasses, contact lenses, prosthetic devices, hearing aids and dentures.
  4. Your participating, training, or practicing for the following sports or activities (except when coaching and/or officiating as a referee or sports official) unless you have paid the applicable surcharge(s) for the Sports & Activities Coverage as shown on your Policy declaration:
    1. Backcountry skiing/snowboarding
    2. Base jumping
    3. Boxing
    4. Downhill freestyle skiing/snowboarding in organized competitions
    5. Downhill mountain biking
    6. Hang gliding/paragliding
    7. High risk motorized speed contests
    8. High risk snowmobiling and motorized snow biking
    9. Ice climbing
    10. Mixed martial arts
    11. Mountaineering over a 6,000-metre elevation
    12. Mountaineering up to a 6,000-metre elevation
    13. Parachuting/skydiving/tandem skydiving
    14. Rock climbing
    15. Scuba diving or free diving over 40 metres
    16. White water sports – Class VI
    17. Wingsuit flying
  5. Your participating, training, or practicing as part of a professional sports team, league, association or club; or while competing in a registered tournament, competition or sporting event for the following sports or activities (except when coaching and/or officiating as a referee or sports official), if you are 21 years of age or over at the time of application, unless you have paid the applicable surcharge(s) for the Sports & Activities Coverage as shown on your Policy declaration:
    1. Football (American and Canadian)
    2. Ice hockey
    3. Rugby