TuGo: Visitors To Canada Health Insurance

An Overview of Benefits

Maximum limit—$5,000,000
The wording in this section applies to Emergency Medical:
● Multi Trip Annual and Single Trip Worldwide
● Multi Trip Annual and Single Trip for Travel within Canada
● Single Trip Worldwide excluding USA
The company will pay the actual, reasonable and customary medical and related expenses up to the coverage limits for acute, sudden and unexpected emergency sickness or accidents, incurred while you are travelling outside your home province. Eligible medical and related expenses are described below

Emergency Medical Treatment
● HOSPITAL SERVICES
Hospitalization services (limited to a semi-private room) . Any coverage related to hospitalization terminates upon release from the hospital other than what is specified under the Follow-up Visit Benefit.
● Out-patient medical treatment provided by a hospital.
● PHYSICIAN
The services of a physician.
● AMBULANCE SERVICES
The services of a licensed ground, air or sea ambulance and paramedics from the scene of the accident or place of onset of the sickness to the nearest hospital . Fire rescue expenses are also covered if a fire rescue team is dispatched in response to your medical emergency. If an ambulance is medically required but is unavailable, the company will reimburse you for taxi expenses, but the taxi receipt is required.
● X-RAY EXAMINATIONS
X-ray examinations and diagnostic laboratory procedures when performed at the time of the initial emergency.
● PRESCRIPTION DRUGS
Prescription drugs (excluding over the counter medicine, vitamins, minerals and dietary supplements) that require a physician’s written prescription (original pharmacy prescription receipts indicating the medication name, quantity, dosage, prescribing physician and cost are required) . Coverage is available for a maximum supply of 30 days, for prescription drugs that are purchased within the 30-day period following the initial emergency consultation. While you are confined to hospital, the company will pay the total cost of all prescription drugs, in addition to the 30-day maximum supply of related prescriptions that are filled within the 30-day period following release from the hospital.
● ESSENTIAL MEDICAL APPLIANCES
The cost to rent or purchase essential medical appliances, including but not limited to, wheelchairs, crutches and canes. When appliances are purchased, the reimbursement will not exceed the total cost that would have been incurred if the appliance had been rented.
● PRIVATE DUTY NURSING
Private duty nursing services, performed by a registered nurse (R. N.) other than a family member, when ordered in writing by the attending physician.

Follow-up Visit
One follow-up visits within the 14 days after the initial emergency medical treatment, provided the follow-up visit is required as a direct result of the initial emergency.

Fracture Treatment
Following the initial emergency treatment and the one follow-up visit, the company will pay up to a maximum of $1,000 for the following treatments related to fractures:
● X-ray examinations following the initial casting until the cast is permanently removed; and,
● Re-examination physician visits following a casting until the cast is permanently removed; and,
● Re-casting and new cast, if medically necessary; and,
● Cast removal; and Physiotherapy treatment
- When this benefit is used for physiotherapy treatment, there is no further coverage for physiotherapy treatment under the Other Professional Medical Services Benefit.
- Eligible expenses must be incurred during the same trip and prior to your return to your home province.

Other Professional Medical Services
Up to a maximum of $500 for any one emergency, per practitioner for the services of the following licensed practitioners to relieve an acute emergency:
(a) Physiotherapist
(b) Osteopath
(c) Chiropractor
(d) Chiropodist
(e) Optometrist

Dental Services:
The services of a licensed dentist or dental surgeon for emergency dental treatment, including the cost of prescription drugs and x-rays, as follows: br>(a) Up to a maximum of $4,000 for dental expenses you incur while on your trip, for an accidental blow to the face requiring the repair or replacement of sound natural teeth or permanently attached artificial teeth, including crowns, bridges, and dental implants. All continuous treatment must be initiated within 48 hours from the time the emergency began and completed no later than 90 days after the treatment began and prior to your return to your home province. This benefit does not cover dental treatment for veneers, caps or dentures. br>(b) Up to a maximum of $500 for dental expenses you incur while on your trip for any dental emergencies other than pain caused by an accidental blow to the face. All continuous treatment must be initiated within 48 hours from the time the emergency began and completed no later than 90 days after the treatment began and prior to your return to your home province.

Hospital Allowance
Up to $75 per day to cover incidental hospital charges, which are billed by the hospital, such as TV rental and telephone charges.

Emergency Air Transportation THIS BENEFIT IS PAYABLE ONLY WHEN PRE-APPROVED AND ARRANGED BY CLAIMS AT TUGO
(a) At the time of hospitalization, medical air evacuation for return to Canada or medical air evacuation between medical facilities when the first medical facility is not equipped to provide the required medical treatment; or,
(b) The cost of stretcher fare or one-way economy airfare on a commercial flight via the most direct route to return to your home province for immediate medical treatment as a result of an emergency providing the medical treatment is sought within 48 hours of arrival to your home province and that the attending physician providing treatment outside your home province recommends it in writing; and,
(c) The cost of an airline seat upgrade when medically necessary if the attending physician providing treatment outside your home province recommends it in writing

Medical Attendant:
THIS BENEFIT IS PAYABLE ONLY WHEN PRE-APPROVED AND ARRANGED BY CLAIMS AT TUGO
If you are returned under the Emergency Air Transportation Benefit, the company will pay:
(a) The cost of a round trip economy airfare on a commercial flight via the most direct route for a qualified medical attendant (or travelling companion in lieu) to accompany you if the attending physician providing treatment outside your home province recommends it in writing and it’s medically necessary and;
(b) The cost of an airline seat upgrade for the medical attendant (or travelling companion in lieu) if the attending physician providing treatment outside your home province recommends it in writing and when it’s medically necessary.

Pre-Existing condition Coverage:

Worldwide and Worldwide Excluding USA Plans In addition to the Emergency Medical Insurance Exclusions below and to the General Exclusions shown on page 42, the company will not be liable to provide coverage or services, or to pay claims for expenses incurred directly or indirectly as a result of any pre-existing condition, except as follows:
APPLICABLE TO INSUREDS 59 YEARS AND UNDER (ON THE APPLICATION DATE)
(a) On trips 35 days or less, except for any condition or symptom (other than a minor ailment):
i . That arose or worsened on the date of departure or at any time within the 7 days before the date of departure; or,
ii . For which medical treatment was obtained on the date of departure or at any time within the 7 days before the date of departure; or; That developed before departure and was undiagnosed at the time of departure.
(b) On trips over 35 days, any condition which has remained stable in the 90 days before the date of departure.
If you extend your trip and the total trip length (including the extension) exceeds 35 days, paragraph b) applies. APPLICABLE TO INSUREDS 60 TO 74 YEARS (ON THE APPLICATION DATE) On all trip lengths, any pre-existing condition which has remained stable in the 180 days before the date of departure.

APPLICABLE TO INSUREDS 75 YEARS AND OVER (ON THE APPLICATION DATE)
On all trip lengths, any pre-existing condition which has remained stable in the 365 days before the date of departure.
If you purchased this Policy to top-up any other insurance plan, the stability for pre-existing conditions is based on your total trip length.
Pre-existing conditions that do not meet the criteria set out above are not covered.
Refer to the following definitions: accident and injury, alteration, medical treatment, minor ailment, pre-existing condition, sickness and stable.

Travel Within Canada Plans
Pre-existing conditions are not excluded; however, the Emergency Medical Insurance Exclusions and the General Exclusions still apply. Refer to those headings for details.

Exclusions:

In addition to the General Exclusions shown on page 42, the company 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 medical treatment, recurrence or complications related directly or indirectly to a sickness or injury which was diagnosed or for which symptoms first occurred, or medical treatment was received after the date of departure but prior to the effective date of this Insurance, unless this Policy is purchased to top-up any other insurance plan.
2 . A medical condition for which symptoms were present or medical treatment was received during a temporary visit to your home province during the period of coverage or any condition wholly or partly, directly, or indirectly, related thereto.
3 . Any expenses incurred as a result of sickness that originated or was symptomatic during the waiting period. This exclusion does not apply when this Policy is purchased to top-up any other insurance plan.
4 . A trip that is undertaken against a physician’s advice.
5 . A trip that is undertaken after the diagnosis of a terminal condition.
6 . Conditions or any related conditions for which, prior to departure, testing or investigation took place, was scheduled to take place, or was recommended (not including tests for routine check-up or routine monitoring for a medical condition), and for which results had not yet been received at the time of departure. This includes tests or investigation that were recommended or scheduled prior to departure, but had not yet taken place at the time of departure.
7. Tests and investigation except when performed at the time of initial emergency sickness or injury.
8 . Any condition(s) for which you are registered on a waiting list in Canada for treatment or diagnosis.
9 . Any medical treatment, other than continuous treatment as specified in the Dental Services Benefit, which is a continuation of or subsequent to an emergency sickness or accident during the same trip, including its recurrence or any complications related directly or indirectly thereto, unless you are declared by an attending physician medically unfit to return to your home province because the emergency had not ended.
10. Expenses incurred once the emergency ends and in the opinion of the attending physician or dentist, you are able to travel to your home province for any further treatment relating to the sickness or accident that led to the emergency (other than specified under the Follow-up Visit Benefit).
11. Loss, theft, or breakage of prescription glasses contact lenses, prosthetic devices, hearing aids and dentures.
12. Expenses incurred after emergency air transportation, when the emergency air transportation was not arranged by Claims at TuGo .
13. Expenses incurred and trips when coverage is purchased after departure, unless authorized in advance by TuGo .
14. Any eligible medical and related expenses in excess of $50,000, if you are not covered by a provincial or territorial government health care plan at the time of your claim .
15 . Emergency sickness or injury incurred if you choose to travel to a destination after a formal written travel advisory and/or travel warning has been issued by Global
Affairs Canada or Public Health Agency of Canada (PHAC) recommending that you avoid all or non-essential travel to that destination during your trip. This exclusion applies if the advisory/warning is issued before the date you leave for your trip and the expenses are directly or indirectly caused by the reason for the travel advisory/warning.
16 . Your coaching, teaching, participating, practicing, or training for any of the sports listed in the optional Contact Sports Coverage, the optional Adventure Sports Coverage, or the optional Extreme Sports Coverage. If you have purchased the optional Contact Sports Coverage, the optional Adventure Sports Coverage, or the optional Extreme Sports Coverage, refer to those section headings.

Refunds:

Applicable to Multi Trip Annual and Single Trip
1 . Refunds are not available if a claim has been or will be submitted.
2 . When the request for refund is received PRIOR to the effective date of the Policy, a full refund is available.
3 . When no travel has taken place and the request for refund is received AFTER the effective date of the Policy:
(a) A full refund is available within 10 days of the application date; or,
(b) A refund less an administration fee is available when the request for refund is received more than 10 days after the application date but no later than one year from the expiry date of the Policy.
(c) Refunds must be requested in writing.

Applicable to Single Trip Only In the case of early return to your home province, partial refunds may be available provided:
(a) A satisfactory proof of return to your home province is sent to TuGo .
(b) The request is received by TuGo no later than one year from the expiry date of the Policy. Refunds will be calculated from the date of. All partial refunds will be subject to an administration fee.
(c) Refunds must be requested in writing.

Eligibility:
You are eligible for coverage if:
1 . You know of no reason for which you may seek medical attention.
2 . You are:
(a) A foreign worker, or a visitor to Canada with valid legal status in Canada; or,
(b) An immigrant awaiting provincial or territorial government health care coverage; or,
(c) A returning Canadian not eligible for a provincial or territorial government health care plan due to an extended leave.
3 . The expenses you incur result from an acute, sudden, and unexpected emergency.
4 . You are not travelling against a physician’s advice; or,
5 . You have not been diagnosed with a terminal condition.

Refunds:
Refunds are not available if a claim has been or will be submitted.
2 . When no travel has taken place and the request for refund is received PRIOR to the effective date of the Policy, a full refund is available.

3 . When no travel has taken place and the request for refund is received AFTER the effective date of the Policy:
(a) A full refund is available within 10 days of the application date; or,
(b) A refund less an administration fee is available when the request for refund is received more than 10 days after the application date but no later than one year from the expiry date of the Policy.
(c) Refunds must be requested in writing. A partial refund is available if:

4. You return to your country of permanent residence; or,
(a) You become eligible and/or covered under a provincial or territorial government health care plan during the period of coverage.
(b) A satisfactory proof of return to your country of permanent residence or proof of the date you became eligible and/or covered under a provincial or territorial government health care plan, is sent to TuGo .
(c) Refunds must be requested in writing.

All refund requests must be received by TuGo no later than one year from the date you became eligible and/or covered under a provincial or territorial government health care plan. Refunds will be calculated from the date you return to your country of permanent residence or the date you become eligible and/or covered under a provincial or territorial government health care plan. All partial refunds will be subject to an administration fee.

5. Applicable to 365-day Policies with a sum insured of $100,000 or more (Super Visa Policies):
(a) A refund is available, subject to a $250 cancellation fee, provided no travel has taken place. For cancellation after the effective date of the Policy, the request must be received no later than one year from the expiry date of the Policy; or,
(b) If a Super Visa application was denied, a full refund is available prior to the effective date of the Policy, or a refund less an administration fee is available after the effective date of the Policy, provided the request is received no later than one year from the expiry date of the Policy. Supporting documentation must be sent to TuGo .
(c) Refunds must be requested in writing.
Note: If your Super Visa application is delayed, please contact your designated representative prior to your Policy effective date to change the coverage dates of your Policy

Rates: