Medipac Travel Insurance Guide

Transcription

2016-2017 MEDIPAC
Travel Insurance Guide
Save up to 18%
Details on Page 9
Great Reasons to Buy
Short Term Travel
Hopping across the border for a little shopping or taking a 10-day cruise? Do not
take a chance by travelling without Medipac insurance! Check out our Short Term
Rates beginning on page 43.
Medipac Annual Plan
The 23-day Annual Add-on is perfect if you plan on taking
two or more trips this year. Simply add it to your single
trip plan. Save time and money!
See page 12 for details.
MedipacPLUS
This popular endorsement, now with 7 benefits, only
costs $59. It protects your Claim-Free Discount and more
than doubles your maximum policy benefit, PLUS more!
A must-have option! See page 13 for details.
Medipac Rewards
Premium Credits are your reward for loyalty. You will save 1% for each consecutive
year you travel with Medipac, to a maximum of 8%. Also, Medipac clients who have
no claims deserve even better rates; reduce your premium by up to 10% more with
our Claim-Free Discount. See page 9 for details.
Worldwide Emergency Assistance
Medipac’s trained medical professionals are only a phone call away,
24 hours a day, seven days a week. Medipac Assist is your lifeline to
information, service and advice when travelling in a foreign country.
Read what our satisfied clients say about Medipac on page 15.
Medipac and Canadian Snowbird Association are Registered Trademarks
the Medipac Program!
®
Superannuate Special
Retired civil servants, military personnel and retired RCMP officers who participate
in the Public Service Health Care Plan can receive a premium credit and an
upgraded 40-day annual plan at no extra cost.
Pre-Existing Condition Coverage
Most clients with stable and controlled medical
conditions can purchase Medipac and have full
coverage for ALL such conditions.
Read the enclosed policy for details.
New Client Incentives
Join the tens of thousands of seasoned
travellers who choose Medipac every year. First time
clients can earn up to 5% as a Claim Free Discount.
Easy Payment Option
Spread your premium over two easy, automatic payments directly
from your bank account. Pay 50% of your premium when you apply
and 50% one month later. Only available with cheque payments for
trips of more than 41 days.
Endorsed by the CSA and the Royal Canadian Legion
Medipac has been chosen as the exclusive Travel
Insurance Partner of both the Canadian Snowbird
Association and the Royal Canadian Legion. We’re proud
to have earned their trust, and we hope to earn yours!
© Medipac International Inc. 2016
Congratulations! You have made a very wise decision to consider Medipac’s Travel Medical Insurance
Program. We are all looking ahead to a great travel season and our Canadian dollar appears to have
settled down.
This Travel Insurance Guide has been designed to help you make several important choices regarding
your coverage and to provide you with a strong understanding of your benefits. Your complete travel
insurance policy is found later in these pages, and we recommend that you read it thoroughly. We have
also highlighted several of our policy features in easy-to-understand language, and have provided two
pages of Travel Tips to assist you.
The rate tables in this guide are the base rates for Medipac's comprehensive coverage. You will be
pleasantly surprised to learn that you are immediately eligible for substantial discounts on these base
rates. Our returning clients are already aware of Medipac’s substantial savings through our Loyalty
Credits (up to 8% off) and Claim Free Discounts (up to an additional 10% off). Certain discounts also
may apply if your province or territory is complying with the Canada Health Act. Even our brand new
clients who have been claim free can receive a discount (up to 5%).
Medical insurance, by its very nature, has exclusions, conditions and other clauses that may limit
your coverage, and it is important that you understand them before you travel. With the complexity of
today’s travel insurance policies, it is reassuring to know that the program you have in your hands is
recommended by Canada’s largest group of long-term travellers, the Canadian Snowbird Association.
Medipac has earned their coveted endorsement for 24 consecutive years. The Royal Canadian Legion
has also designated Medipac as its exclusive travel insurance benefits partner.
We have exceptional benefits, no age limits, full coverage for most stable medical conditions, and we
automatically provide 24-hour access to our own dedicated medical professionals. Medipac Assist is
your lifeline in the event of any emergency and we will help you to navigate foreign medical systems
and protocols should you ever need us.
Medipac is more than just an insurance policy…much, much more!
I would like to personally thank all of our thousands of returning clients and, if this is your “first time,”
we welcome you to the Medipac family. You will be in great company and you are certainly making the
right choice for your travel insurance needs.
Sincerely,
John Ross Quigley, CEO
P.S.: Have a look at our Annual Add-on and the MedipacPLUS Endorsement. Both of these offer excellent
value and provide very strong coverage options.
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www.medipac.com
Table of Contents
Great Reasons to Buy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Important Insurance Tips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Medipac Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Discounts - Save With Medipac. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Existing Insurance? Reduce Your Cost. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Save with Federal Superannuate Credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Annual Add-on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
MedipacPLUS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Individual Underwritten Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Medipac Assist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Preferred PLUS Rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Preferred Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Standard Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Policy Text. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Underwritten by Old Republic Insurance Company of Canada.
In Quebec underwritten by Reliable Life Insurance Company.
Period of coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
What should I do in a medical emergency?. . . . . . . . . . . . . . . . . . . . . . . . . . . .29
The definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
The benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
What is not covered
Pre-existing conditions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
General exclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
General limitations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Change in departure date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Is there anything else I need to know?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
What happens to my insurance coverage if I am hospitalized
and cannot return on my scheduled return date?. . . . . . . . . . . . . . . . . . . . . . . 38
How do I present my claim?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Policy extensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Refund policy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
MedipacPLUS Endorsement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Notice on Privacy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Administration Fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Short Term Rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Trip Days – Quick Calculator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
1-888-MEDIPAC (1-888-633-4722)
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Important Insurance Tips
"Coverage for out-of-country health care services is limited;
-Ministry of Health
1.
Always read your Travel Insurance Policy (TIP) before making your purchase decision, and
ensure that you understand the coverages being offered, as well as the policy limitations
and exclusions.
At Medipac, we’re proud of our Travel Insurance Policy (TIP) and always include it in
our Guide so that clients have the opportunity to review it before buying. Do not buy
any plan without reading, and understanding, its policy first.
2.
Before you purchase a travel insurance plan, ask about the assistance services – most
assistance companies are disinterested third parties that route medical emergency calls
to call-centre clerks, rather than to medical professionals.
At Medipac Assist, medical professionals will answer your calls – much more
expensive, of course, but we take our responsibilities seriously! Minutes can save
lives.
3.
Every TIP has limitations and conditions. Ensure that you understand the pre-existing
condition clause of your TIP, and note that these conditions usually apply as of your
departure date, not when you purchased the policy. If you purchase an annual plan, these
conditions apply to the departure date of each and every trip.
Medipac’s 90-day stability period is one of the fairest and most liberal pre-existing
condition clauses* in the industry.
4.
The “definitions” section of some TIPs defines “treatment” as including “taking ANY
medication.” So if you ARE taking a medication, you will NOT meet the requirements
of their pre-existing clause and no coverage is provided for your condition, or anything
related to it. Stability really does not matter in these TIPs, so beware!
The Medipac policy covers most stable and controlled conditions*, including those for
which you take medication, provided they have been stable during the 90 days prior
to your effective date. Make sure you buy insurance that covers your medical
condition.
5.
Many TIPs have different deductible choices. Deductibles are a good way in which to
reduce your premium cost. However, only choose a deductible that you can afford.
6
Medipac offers deductibles from $0 to $10,000 USD, with substantial savings! See
the other sections of this Guide for details, but always choose a deductible that you
can afford.
*See Pre-Existing Conditions starting on policy page 5
www.medipac.com
Important Insurance Tips
you should purchase supplementary [travel medical] insurance..."
and Long-Term Care
6.
If you plan to take more than one trip during the upcoming year, consider purchasing an
annual plan, rather than applying for travel insurance before each trip. You can save time
and money.
Medipac’s 23-day Annual Add-on is perfect for seasoned and regular travellers who
plan to travel more than once during the year, and the savings can be significant!
7.
If your upcoming birthday places you in the next-higher age band, your premium can
increase.
You can save money by departing earlier than planned, prior to your birthday. Even
if you purchase a longer trip, your premium may be lower because you are now in a
less costly age band.
8.
A dangerous practice is to refuse treatment or not change a drug, despite your doctor’s
recommendation, because you think that it may affect your insurance.
This does not work. If a doctor recommends a change in drugs and you do not
accept that change, the insurance company will treat this as an unstable pre-existing
condition. A claim will not be paid for that condition. Please, just do what your doctor
recommends and do not sacrifice your health for insurance reasons. Medipac
can often provide full coverage if you contact us and explain your situation. See page
14 for information on Individual Underwritten Insurance.
9.
Some travellers leave a few days earlier or return home a few days later than they
originally expected, without advising their insurance company. What they do not realize is
that statistically, the two highest incidences of claim are at the beginning and the end of
trips.
This means no insurance protection when it is needed the most. Many insurance
plans will void your insurance if such information is withheld. Call your insurance
company if you have a change of plans.
10.
Many TIPs require proof of departure and return. Purchases at “duty free” and using credit
cards on your last day at home and first day away are convenient ways of establishing a
record that can be retrieved later.
Medipac recommends using a passport for all of your travels, and asking that it be
stamped upon entering and leaving any country. That’s indisputable proof!
Safe Travelling!
1-888-MEDIPAC (1-888-633-4722)
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Medipac Benefits
vMedipac Assist
• 24-hour, toll-free advice from our experienced medical professionals
• Caring assistance throughout any medical emergency
• Hospital, clinic and physician referrals
v Benefits up to $2,000,000 USD including:
• Hospital and Emergency Room Expenses
• Doctor’s, Physician’s, Chiropractor's and other Practitioner’s Care
• Air Ambulance, Ground Ambulance and Paramedic Fees
• Emergency Prescription Drug Coverage
• Return of Your Vehicle (including your trailer or motor home)
• Emergency Dental Coverage
• Travel Expenses to Bring a Relative to Your Bedside
• Return of Your Spouse and/or Dependent Children to Canada
• Return to Destination Benefit
v Claim Free Discount (see page 9)
• Available to new purchasers as well as existing clients
v Loyalty Credit (see page 9)
v Top-Ups Available (see page 10)
vCo-Insurance (see page 10)
v Credits for Federal Superannuates (see page 11)
v 23-Day Annual Add-on (see page 12)
• now 90 days within Canada
NEW
vMedipacPLUS (see page 13)
• Claim forgiveness
• Medical evacuation benefit
• Return to Canada benefit
• Increase policy maximum to $5,000,000 USD
• Accidental death benefit
• Pet benefit
• Excess Luggage benefit NEW
v Individualized Underwritten Insurance (see page 14)
• For individuals not eligible for Medipac's regular travel insurance plan
• To cover pre-existing conditions that do not meet our stability requirements
Underwritten by Old Republic Insurance Company of Canada
In Quebec underwritten by Reliable Life Insurance Company
8
www.medipac.com
Discounts - Save with Medipac
Loyalty Credit – Save up to 8%
Medipac is continually working to save money for our clients. As one of our loyal
Medipac clients, you can now save up to 8% off your travel insurance. You will receive
a 1% premium credit for each consecutive year in which you purchase Medipac, up to
eight years for a total credit of 8%.
Note: If you were unable to travel due to personal reasons in any particular year,
please advise us in writing. Medipac may still allow a Loyalty Credit.
Claim-Free Discount – Save up to 10%
Each year, thousands of Medipac clients qualify for substantial savings under our
Claim-Free Discount program – saving hundreds, if not thousands of dollars! Our
Claim-Free Discount recognizes up to 10 years of claim-free travelling. Medipac
clients who have been Claim-Free for the past three consecutive years initially qualify
for a 3% discount. For each additional and consecutive claim-free year, the discount
increases by 1%, to a maximum of 10%.
Note: A claim less than your deductible is not considered a claim for discount purposes.
Combine the above discounts to save up to 18%.
Save up to 23% in PEI, Nunavut, the Northwest Territories and the Yukon,
under our provincial discount program.
NEW to Medipac? You can save up to 5%, too!
As a NEW Medipac client, you may be eligible for Medipac’s Claim-Free Advantage
Discount.
If you have not been hospitalized, and/or have not made a travel medical insurance
claim for the past three consecutive years, then you may be entitled to savings under
this unique program.
Your discount will be based on the number of consecutive years in which you have not
made a claim (with a minimum of three years), receiving 1% for each year for which
you qualify, to a maximum of 5%. You must provide Medipac with a written statement
confirming the number of years you have not been hospitalized and have remained
claim-free.
Discounts do not apply to Annual Add-on Rates and/or MedipacPLUS.
1-888-MEDIPAC (1-888-633-4722)
9
Existing Insurance? Reduce Your Cost
If you are one of the many travellers who already have some form of travel medical insurance, but
with limited coverage (perhaps through a former employer), you can choose to modify your plan with
Medipac Travel Insurance.
Co-insurance – If your existing policy provides coverage for your whole trip, but includes a coinsurance feature that requires you to pay a percentage of any bill (typically 20%), Medipac may be
able to pass on significant savings with our Co-insurance Program. Call Medipac and request a special
Co-insurance Application Supplement.
Lifetime Maximum – Many retirees have medical plans with limited lifetime maximums. If you have
such a plan, you may choose to use a portion of your benefits under the plan to pay your Medipac
deductible and, by choosing a $5,000 or $10,000 deductible, you can substantially reduce your
premium.
Note: In order to process your claim, Medipac will require payment of your deductible up front (usually
by credit card). Medipac will assist you later in recovering your deductible from your other plan.
Top-up Options – If you have an existing policy that provides for a limited number of travel days,
you can have your Medipac policy begin on the day your other coverage expires. Simply select the
Effective Date on which you want your Medipac policy to begin and pay the premium for the extra
number of days you need to complete your trip. This is called “topping up,” and Medipac offers this
feature with NO ADDED ADMINISTRATION FEE.
WARNING: In all top-up plans, eligibility conditions and pre-existing conditions will
apply as of the effective date of your Medipac Travel Insurance Policy, NOT on your date
of departure. If you have a change in your health status prior to Medipac’s Effective Date of
Insurance, you must contact Medipac for a full review.
We cannot advise you on your non-Medipac plan. However, we strongly recommend that you carefully
review and understand your other coverage.
· M
any group and employer plans renew annually, and coverage may change. Recently
insurance companies have introduced pre-existing condition exclusion clauses on a number
of these plans with their renewal. Each year, make sure that your plan continues to provide
adequate coverage.
· V ery low policy maximums of $100,000, with some as low as $10,000, are common. Do not
rely on these low-limit plans. Make sure that your other plan provides adequate coverage
with a minimum benefit of $1,000,000 USD. Otherwise, purchase Medipac coverage for your
entire trip.
·M
any other policies restrict your number of travel days to 10 days, 14 days,
40 days or 60 days. Make sure that you will be covered for your entire trip.
· M
any annual policies, and almost all credit card plans, DO NOT allow topping up. They also
may terminate ALL coverage if you go on a longer trip. It is your responsibility to ensure that
your other coverage is adequate for your needs.
Medipac provides coverage for emergencies that happen on the dates on which your Medipac policy is
in effect, and not for any other period of time.
10
www.medipac.com
Save with Federal Superannuate Credits
Retired federal civil servants, military personnel and retired RCMP officers who
participate in the Public Service Health Care Plan (PSHCP) are normally provided with
up to $500,000 CAD in basic travel medical benefits, for the first 40 days of any trip.
Medipac cautions that this is a limit which may not provide the necessary protection in
the event of a major accident or illness while travelling.
“Do not rely on your provincial health plan to cover costs if you get sick
or are injured while abroad.”
– Department of Foreign Affairs, Trade and Development Canada
Why thousands of Superannuates choose Medipac...
✔✔
✔✔
✔✔
✔✔
✔✔
✔✔
Four times the Federal Superannuate benefit
Premium discounts for existing coverage
Coverage from day one of your trip
40-day, out-of-country annual plan at no extra cost
Additional benefits not provided by PSHCP
24-hour emergency assistance from Medipac Assist
When Superannuates purchase Medipac for the entire duration of their trip with a
$500,000 deductible* for the first 40 days, they are covered from their date of departure
with Medipac’s maximum policy benefit of $2,000,000 USD and receive a Federal
Superannuate Coverage Credit towards their premium; in addition, they receive an
out-of-country, 40-day annual plan at no extra cost. The annual plan begins on the
Effective Date of Insurance. Credits can be found at the bottom of each rate table.
We are aware that many Superannuates choose to “take a chance” during the first 40
days of their trip and buy Medipac only as top-up coverage. This is usually cheaper, but
you lose the protection of Medipac’s $2,000,000 USD maximum policy benefit and the
emergency assistance services offered through Medipac Assist (see page 15 for details)
for the first 40 days. The Medipac plan would be effective on the 41st day of your trip,
when the PSHCP coverage ends. In addition, you would need to ensure that you remain
eligible for the Medipac plan and that any new or existing conditions were stable up to
and including Medipac’s Effective Date of Insurance.
For greater coverage, we at Medipac recommend that you purchase Medipac Travel
Insurance for the entire duration of your trip, and use our Superannuate Credit to reduce
your premium.
Whether you choose the Superannuate Credit or the Top-Up option, Medipac’s discount
programs continue to apply (see page 9 for details).
* Each trip under your annual plan will be subject to the same deductible.
1-888-MEDIPAC (1-888-633-4722)
11
23-Day Annual Add-on
Save time and money with Medipac’s 23-day Annual Add-on
When you purchase any Medipac Travel Insurance policy that is greater than 22 days in length, you
can save time when you upgrade your policy with Medipac’s 23-day Annual Add-on by only having
to apply once for travel insurance to cover all of the short trips you take during the year.
When you purchase the Annual Add-on, you will also save money! Coverage is for an unlimited
number of trips outside Canada for up to 23 days in length, and up to 90 days in length within
Canada, outside of your home province.
Need Separate Annual Coverage?
Simply buy a 22-24 day Medipac Travel Insurance Plan (see page 43 for short term rates), add the
Annual Add-on rate and indicate the date on which you wish your annual coverage to begin. It’s
that simple!
Did You Know that our provincial health insurance plans DO NOT COVER many emergency
expenses incurred in Canada (outside your province of residence), such as medication, ambulance,
paramedical services or air evacuations? Medipac does! Your Medipac policy also covers additional
non-medical costs for all of your trips, including return of your vehicle, bringing a family member to
your bedside, out-of-pocket expenses and emergency dental expenses.
Convenient Features
·
You can choose to have your Annual Add-on begin
at any time between your purchase date and your
Effective Date.
·
Extensions and top-ups are available for trips under
your Annual Add-on.
·
You are not required to notify Medipac before you
depart on any short trip covered under your 23-day
Annual Add-on. You are, however, required to provide
proof of your trip start date, in the event of a claim.
Please remember that the Pre-Existing Condition clause*
applies prior to each and every trip, so be certain that you
are in compliance prior to travelling.
You must buy a minimum 22-24 day Single Trip Plan in order to purchase the Annual Add-on.
Annual Add-on rates can be found on all rate tables. The Annual Add-on can be used alone, extended or topped up for every
other trip but cannot be used in combination with the Single Trip with which it is purchased.
12
*See Pre-Existing Conditions starting on policy page 5
www.medipac.com
MedipacPLUS
SEVEN GREAT FEATURES!
ONE LOW PRICE!
For the last few years clients have saved thousands of dollars by protecting their Claim Free
Discount when they upgraded to the MedipacPLUS plan for only $59.
Many Medipac clients have already earned up to a 10% Claim-Free Discount; with the
MedipacPLUS plan, that valuable discount can be protected in the event of a claim. Without
MedipacPLUS, should you experience a claim, your discount will be reduced significantly.
Why take the chance? Upgrade to our MedipacPLUS plan!
Protect Your Claim-Free Discount
Return To Canada Benefit
MedipacPLUS protects your Claim-Free
Discount by forgiving the first claim that
causes you to exceed your deductible during
your trip – a small price to pay to extend your
savings year after year.
MedipacPLUS provides coverage for
economy-class return airfare to a maximum
of $2,000 to fly you from your vacation
destination to Canada and back. In addition,
this benefit provides coverage for ground
transportation expenses:
Medical Evacuation Benefit
MedipacPLUS pays you $100 CAD per day
to a maximum of 10 days, if Medipac returns
you to Canada for medical reasons and you are
hospitalized within three days of your return to
Canada.
$5,000 Accidental Death Insurance
MedipacPLUS includes a $5,000 CAD death
benefit that will be paid to your estate if you
die as a result of accidental injury while you
are on your MedipacPLUS-insured trip.
Pet Benefit
MedipacPLUS will reimburse you up to
$750 to return your pet(s) to Canada if
Medipac returns you to Canada for medical
reasons, or if you have a claim under the
MedipacPLUS Return to Canada benefit, you
will be reimbursed the cost of boarding your
pet(s) for one week to a maximum of $500
while you are in Canada.
· If a member of your immediate family* who
is not travelling with you dies after you
leave your home, or
· If a natural disaster causes your principal
residence to become uninhabitable after
you leave home.
*see definition page 40
Policy Benefit Maximum Increases to
$5,000,000 USD
MedipacPLUS increases the coverage
amount of your Medipac policy from
$2,000,000 to $5,000,000. Certain provisions
and exclusions apply. See Endorsement
wordings for details.
Excess Luggage Benefit
NEW
MedipacPLUS will reimburse up to
$500 for the cost to return your excess
luggage if Medipac returns you to Canada for
medical reasons and you are unable to return
your luggage to Canada by any other means.
If topping up another insurance policy, MedipacPLUS does not
provide coverage until your Medipac Policy Effective Date.
1-888-MEDIPAC (1-888-633-4722)
$ 59
13
Individual Underwritten Insurance
For Applicants NOT Eligible for the Medipac Plan
As most of you know, Medipac is continuously searching for new ways in which to make
comprehensive travel insurance available to everyone.
Some of Medipac’s clients have also found it difficult, if not impossible, to purchase
proper travel health insurance due to a recent change in their medication, a change in
their health status or because of hospitalization during the past year.
Medipac may be able to help – ask about our Individual Underwritten Insurance.
If you do not qualify for the Medipac plan, or if you want coverage for a “pre-existing
condition” that would otherwise be excluded, we invite you to call our Specialty
Services department at 1-877-888-5259 and ask for our Individual Underwritten
Application. Once your completed application and medical questionnaire have been
received by Medipac, either by fax or mail, our medical staff will assess your medical
information and, if approved, provide you with an individual quotation.
Our Individual Underwritten Insurance has brought the Medipac plan to thousands of
snowbirds and travellers who were previously unable to purchase insurance anywhere.
For those of you who must apply for our Individual Underwritten Insurance, your
Claim-Free Discount and Loyalty Credit still apply.
14
www.medipac.com
Medipac Assist
Peace of mind is a phone call away
The Medipac Assistance “hotline” is a very important service for our clients. Should you ever need to
call, you will speak directly with one of our medical professionals who are trained and experienced in
critical care. Often, all that is required is some reassurance and help with setting up a doctor’s appointment. On many occasions, our medical staff has persuaded clients to seek immediate emergency
medical attention and not to “wait until the weekend is over.” Our medical professionals can also help
you deal with a sometimes intimidating foreign medical system and help prevent unnecessary expenses
when you have a large deductible.
Some of your comments about our Medipac Program
“I would like to take this time to thank all of
the staff at Medipac. It’s a great feeling to
know that the staff took their time to ensure
that my wife and I were insured properly.
We can travel with ease of mind.”
Freddy
“I am grateful to all of your associates
for so ably and promptly attending to my
unfortunate claim…thank you.”
Wake
“I would also like to thank the wonderful and
friendly staff at Medipac. They were always in
touch and I never felt alone. I will encourage
any of our friends to use this service.”
Terry
1-888-MEDIPAC (1-888-633-4722)
“I have found my experience at Medipac to
be pleasurable, fast, and easy. I approached
the company not really knowing what I
needed or what was necessary for me to
have, and the staff were ready to assist me.
I was able to explain my needs and they
were able to match me with the package
that worked best for my life without over
charging me. The staff at Medipac were
extremely knowledgeable and informative.
I would recommend them to any of my
friends and family.”
Ashley
15
Preferred PLUS Rates - $ 99 USD Deductible
Zero Deductible add
10% to $99 Deductible
Rates
For Short Term rates see page 43
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
156 $
218 $
241 $
265 $
371 $
556 $ 1,014 $ 1,654
51-60
184
258
275
317
445
670
1,179
1,798
61-66
217
306
335
385
510
799
1,316
2,039
67-75
255
370
387
455
599
915
1,577
2,299
76-82
288
399
419
499
665
999
1,791
2,515
83-90
320
428
439
555
720
1,115
1,950
2,697
91-96
345
458
479
607
781
1,258
2,079
2,855
97-105
381
499
510
677
880
1,404
2,267
3,199
106-112
414
535
547
740
953
1,525
2,436
3,474
113-120
455
588
608
784
1,034
1,626
2,603
3,829
121-126
494
655
689
831
1,099
1,735
2,833
4,055
127-135
535
725
777
917
1,215
1,854
3,087
4,413
136-142
565
788
842
973
1,299
1,972
3,325
4,794
143-150
588
825
881
1,034
1,376
2,075
3,499
5,100
151-156
625
865
948
1,095
1,491
2,208
3,655
5,414
157-165
673
919
1,005
1,176
1,594
2,323
3,818
5,666
166-175
729
965
1,045
1,244
1,690
2,445
4,013
5,988
176-183
759
999
1,099
1,299
1,785
2,555
4,190
6,230
184-190
835
1,076
1,177
1,377
1,893
2,677
4,396
6,801
191-200
920
1,195
1,270
1,476
2,132
2,884
4,812
7,447
201-212
1,065
1,391
1,452
1,678
2,459
3,204
5,391
8,355
Trips in excess of 183 days are available to residents of all provinces and territories except QC, PEI and NU.
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
$
56 to 60
65 $
61 to 65
80 $
66 to 70
71 to 75
76 to 79
105 $
127 $
149 $
212 $
FEDERAL SUPERANNUATE CREDIT
80 to 85
327 $
86 PLUS
408
TRIP
LENGTHS Up to 55 56 to 60 61 to 65 66 to 70 71 to 75 76 to 79 80 to 85 86 PLUS
OVER 41
33 $
67 $
84 $
117 $
154 $
229 $
341 $
500
DAYS $
16
www.medipac.com
Preferred PLUS Rates - $ 1,000 USD Deductible
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
136 $
199 $
222 $
249 $
329 $
497 $
899 $ 1,422
51-60
158
218
235
270
376
589
1,013
1,545
61-66
186
256
284
326
430
711
1,130
1,757
67-75
232
308
327
399
508
812
1,325
1,999
76-82
252
339
355
449
585
896
1,499
2,175
83-90
268
349
368
481
618
976
1,655
2,307
91-96
296
379
393
513
675
1,095
1,779
2,499
97-105
326
404
432
578
745
1,216
1,952
2,755
106-112
355
439
455
625
810
1,327
2,093
2,984
113-120
389
487
509
663
883
1,417
2,255
3,233
121-126
424
543
599
704
930
1,516
2,440
3,444
127-135
461
608
675
773
999
1,616
2,662
3,761
136-142
487
656
705
824
1,088
1,710
2,865
4,099
143-150
507
680
741
882
1,168
1,795
3,028
4,388
151-156
535
694
788
927
1,255
1,919
3,159
4,645
157-165
578
758
841
989
1,359
2,055
3,281
4,891
166-175
627
784
873
1,029
1,445
2,135
3,428
5,167
176-183
659
806
915
1,075
1,488
2,222
3,599
5,399
184-190
700
878
968
1,138
1,602
2,332
3,776
5,863
191-200
791
998
1,076
1,250
1,805
2,514
4,133
6,395
201-212
915
1,162
1,229
1,420
2,083
2,792
4,631
7,156
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
77 $
66 to 70
71 to 75
76 to 79
1-888-MEDIPAC (1-888-633-4722)
92 $
108 $
125 $
187 $
80 to 85
86 PLUS
355
TRIP
OVER 41
27 $
57 $
75 $
104 $
125 $
208 $
312 $
437
DAYS $
$
62 $
61 to 65
285 $
17
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
116 $
163 $
188 $
215 $
279 $
410 $
698 $ 1,157
51-60
136
195
215
248
334
487
814
1,293
61-66
163
231
242
300
382
565
955
1,472
67-75
191
269
279
355
435
645
1,106
1,687
76-82
217
288
299
395
475
709
1,225
1,807
83-90
239
315
329
425
505
788
1,333
1,899
91-96
258
341
356
462
545
868
1,445
2,044
97-105
284
369
385
509
599
955
1,562
2,377
106-112
309
389
415
543
660
1,038
1,680
2,499
113-120
333
438
455
583
720
1,115
1,813
2,754
121-126
355
479
525
615
777
1,197
1,953
2,882
127-135
375
517
559
645
854
1,279
2,115
3,174
136-142
395
550
587
679
905
1,360
2,265
3,463
143-150
419
571
615
718
959
1,435
2,399
3,673
151-156
443
588
654
756
1,029
1,516
2,499
3,894
157-165
471
625
699
803
1,099
1,610
2,615
4,096
166-175
505
655
720
855
1,149
1,681
2,755
4,318
176-183
537
678
748
892
1,215
1,755
2,890
4,489
184-190
575
737
788
939
1,305
1,846
3,034
4,910
191-200
644
837
858
1,018
1,471
1,990
3,321
5,351
201-212
702
974
985
1,158
1,693
2,210
3,720
6,005
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
18
66 $
66 to 70
71 to 75
76 to 79
76 $
88 $
103 $
149 $
80 to 85
86 PLUS
287
TRIP
OVER 41
21 $
45 $
57 $
82 $
102 $
150 $
229 $
333
DAYS $
$
55 $
61 to 65
219 $
www.medipac.com
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
103 $
149 $
169 $
191 $
239 $
376 $
644 $
995
51-60
121
169
186
209
267
434
715
1,123
61-66
136
185
211
241
317
510
823
1,279
67-75
159
199
229
299
375
584
987
1,466
76-82
179
225
248
333
419
642
1,099
1,583
83-90
199
249
269
355
459
698
1,198
1,742
91-96
219
278
288
389
499
779
1,298
1,890
97-105
238
299
309
421
551
878
1,396
2,073
106-112
258
325
338
458
598
955
1,523
2,205
113-120
285
366
389
491
651
1,017
1,642
2,393
121-126
308
407
432
525
699
1,084
1,774
2,529
127-135
329
451
479
572
765
1,159
1,935
2,670
136-142
349
475
519
608
829
1,228
2,055
3,010
143-150
369
499
554
650
875
1,297
2,177
3,191
151-156
389
519
585
685
933
1,373
2,286
3,384
157-165
411
555
620
729
997
1,455
2,388
3,551
166-175
445
587
651
765
1,056
1,529
2,507
3,761
176-183
479
615
671
799
1,099
1,596
2,625
3,873
184-190
510
658
702
835
1,183
1,673
2,747
4,271
191-200
579
746
794
922
1,333
1,803
3,006
4,654
201-212
666
869
907
1,049
1,538
2,002
3,370
5,223
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
59 $
66 to 70
71 to 75
76 to 79
1-888-MEDIPAC (1-888-633-4722)
67 $
76 $
88 $
125 $
80 to 85
86 PLUS
229
TRIP
OVER 41
15 $
33 $
46 $
59 $
71 $
104 $
167 $
250
DAYS $
$
50 $
61 to 65
183 $
19
Preferred Rates - $99 USD Deductible
Zero Deductible add
Rates
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
274 $
342 $
368 $
555 $
666 $ 1,013 $ 1,525 $ 2,285
51-60
355
403
443
658
779
1,175
1,732
2,637
61-66
378
445
495
717
872
1,318
2,021
2,953
67-75
417
515
565
799
975
1,458
2,316
3,315
76-82
488
555
605
853
1,065
1,616
2,626
3,647
83-90
538
599
645
911
1,135
1,793
2,866
3,999
91-96
570
642
699
995
1,235
1,992
3,235
4,408
97-105
626
718
790
1,099
1,384
2,182
3,572
4,835
106-112
664
798
888
1,188
1,525
2,379
3,851
5,214
113-120
715
899
999
1,277
1,640
2,565
4,203
5,590
121-126
765
981
1,129
1,369
1,799
2,707
4,553
5,976
127-135
835
1,072
1,235
1,475
1,953
2,935
4,899
6,379
136-142
900
1,185
1,336
1,578
2,092
3,131
5,199
6,725
143-150
947
1,288
1,464
1,685
2,217
3,341
5,555
7,277
151-156
1,000
1,401
1,569
1,788
2,357
3,542
5,788
7,820
157-165
1,075
1,525
1,676
1,888
2,514
3,755
6,118
8,253
166-175
1,158
1,635
1,780
1,979
2,675
3,955
6,399
8,699
176-183
1,229
1,735
1,888
2,099
2,826
4,155
6,655
9,144
184-190
1,348
1,858
2,013
2,222
3,047
4,448
7,014
9,592
191-200
1,508
2,054
2,182
2,414
3,441
4,805
7,735
10,402
201-212
1,748
2,328
2,546
2,736
3,842
5,191
8,636
11,627
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
20
106 $
66 to 70
71 to 75
76 to 79
143 $
198 $
231 $
331 $
80 to 85
86 PLUS
571
TRIP
OVER 41
37 $
74 $
93 $
130 $
171 $
254 $
379 $
555
DAYS $
$
91 $
61 to 65
463 $
www.medipac.com
Preferred Rates - $ 1,000 USD Deductible
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
238 $
299 $
319 $
444 $
578 $
866 $ 1,296 $ 1,984
51-60
302
349
384
555
655
1,017
1,470
2,261
61-66
325
379
429
630
756
1,125
1,727
2,559
67-75
362
445
502
701
846
1,243
1,978
2,877
76-82
413
499
524
745
936
1,380
2,243
3,199
83-90
455
525
547
789
991
1,532
2,502
3,467
91-96
489
556
578
846
1,048
1,696
2,762
3,821
97-105
535
604
625
957
1,199
1,884
3,049
4,187
106-112
565
655
699
1,043
1,321
2,031
3,290
4,518
113-120
599
725
845
1,125
1,421
2,199
3,588
4,844
121-126
635
782
949
1,166
1,559
2,355
3,888
5,179
127-135
678
871
1,005
1,275
1,691
2,508
4,268
5,527
136-142
730
965
1,089
1,385
1,809
2,645
4,553
5,827
143-150
770
1,046
1,186
1,471
1,922
2,845
4,807
6,307
151-156
825
1,131
1,283
1,562
2,037
3,024
4,993
6,664
157-165
875
1,262
1,380
1,635
2,182
3,230
5,192
7,152
166-175
933
1,334
1,463
1,699
2,325
3,396
5,530
7,596
176-183
991
1,410
1,522
1,760
2,455
3,555
5,660
7,984
184-190
1,094
1,509
1,626
1,901
2,642
3,755
5,990
8,313
191-200
1,221
1,669
1,758
2,092
2,942
4,028
6,481
9,016
201-212
1,397
1,893
2,036
2,370
3,328
4,433
7,377
10,075
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
$
56 to 60
74 $
61 to 65
85 $
66 to 70
71 to 75
76 to 79
125 $
161 $
186 $
261 $
80 to 85
377 $
86 PLUS
497
TRIP
OVER 41
30 $
63 $
83 $
116 $
139 $
231 $
347 $
486
DAYS $
1-888-MEDIPAC (1-888-633-4722)
21
Preferred Rates - $5,000 USD Deductible
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
190 $
237 $
267 $
366 $
455 $
689 $ 1,043 $ 1,610
51-60
240
274
305
455
544
803
1,200
1,821
61-66
261
303
342
503
605
913
1,361
2,023
67-75
284
354
381
553
675
1,011
1,604
2,336
76-82
337
385
405
594
749
1,107
1,818
2,610
83-90
372
409
433
624
792
1,243
1,971
2,803
91-96
393
444
475
675
832
1,379
2,242
3,101
97-105
426
496
548
763
955
1,520
2,454
3,401
106-112
456
549
632
827
1,049
1,647
2,666
3,651
113-120
495
625
725
885
1,130
1,765
2,899
3,933
121-126
527
679
799
952
1,245
1,874
3,173
4,205
127-135
563
744
856
999
1,351
2,040
3,460
4,488
136-142
622
830
948
1,085
1,440
2,168
3,691
4,732
143-150
655
891
1,012
1,176
1,534
2,316
3,899
5,120
151-156
692
967
1,090
1,247
1,630
2,453
4,050
5,502
157-165
745
1,074
1,189
1,291
1,743
2,618
4,294
5,808
166-175
794
1,145
1,266
1,375
1,874
2,760
4,465
6,168
176-183
845
1,198
1,325
1,435
1,927
2,888
4,599
6,463
184-190
932
1,285
1,415
1,518
2,108
3,041
4,855
6,742
191-200
1,042
1,420
1,535
1,671
2,354
3,324
5,253
7,316
201-212
1,208
1,610
1,749
1,826
2,657
3,524
5,978
8,135
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
22
83 $
66 to 70
71 to 75
76 to 79
103 $
131 $
151 $
216 $
80 to 85
86 PLUS
399
TRIP
OVER 41
23 $
50 $
63 $
91 $
113 $
167 $
254 $
370
DAYS $
$
62 $
61 to 65
308 $
www.medipac.com
Preferred Rates - $10,000 USD Deductible
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
172 $
211 $
229 $
320 $
417 $
633 $
949 $ 1,432
51-60
214
235
249
404
503
725
1,083
1,648
61-66
235
274
285
455
560
811
1,263
1,846
67-75
261
299
315
506
610
911
1,447
2,075
76-82
305
355
365
537
676
1,011
1,643
2,318
83-90
336
375
399
570
716
1,121
1,791
2,502
91-96
365
401
465
610
777
1,245
2,022
2,756
97-105
392
449
525
683
865
1,379
2,232
3,022
106-112
416
503
545
753
954
1,487
2,407
3,259
113-120
446
570
625
798
1,025
1,599
2,626
3,493
121-126
477
613
699
842
1,125
1,699
2,846
3,735
127-135
521
670
773
933
1,221
1,842
3,122
3,987
136-142
553
735
849
998
1,308
1,957
3,333
4,244
143-150
591
799
913
1,064
1,385
2,086
3,499
4,548
151-156
625
876
988
1,126
1,473
2,213
3,654
4,887
157-165
674
945
1,067
1,165
1,573
2,364
3,861
5,158
166-175
717
1,015
1,149
1,255
1,677
2,488
4,025
5,479
176-183
765
1,077
1,199
1,313
1,766
2,599
4,142
5,758
184-190
843
1,161
1,269
1,371
1,906
2,746
4,384
5,996
191-200
943
1,284
1,388
1,510
2,125
3,003
4,742
6,503
201-212
1,093
1,455
1,591
1,709
2,397
3,245
5,397
7,266
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
73 $
66 to 70
71 to 75
76 to 79
1-888-MEDIPAC (1-888-633-4722)
89 $
112 $
129 $
183 $
80 to 85
86 PLUS
326
TRIP
OVER 41
17 $
37 $
51 $
65 $
79 $
116 $
185 $
278
DAYS $
$
55 $
61 to 65
255 $
23
Standard Rates - $99 USD Deductible
Zero Deductible add
Rates
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
385 $
452 $
555 $
699 $
899 $ 1,296 $ 1,998 $ 2,885
51-60
406
605
655
826
1,086
1,566
2,329
3,265
61-66
483
699
725
928
1,262
1,773
2,604
3,768
67-75
514
775
815
1,077
1,451
1,955
2,902
4,284
76-82
589
889
915
1,167
1,655
2,233
3,172
4,756
83-90
661
955
981
1,296
1,775
2,507
3,560
5,240
91-96
698
999
1,045
1,395
1,894
2,721
3,853
5,792
97-105
775
1,099
1,199
1,607
2,171
2,956
4,244
6,455
106-112
861
1,216
1,299
1,773
2,409
3,204
4,558
6,982
113-120
904
1,327
1,399
1,892
2,529
3,437
4,901
7,514
121-126
963
1,445
1,515
2,003
2,655
3,667
5,314
7,869
127-135
1,030
1,525
1,683
2,199
2,899
3,907
5,760
8,565
136-142
1,127
1,586
1,794
2,337
3,138
4,141
6,231
9,131
143-150
1,180
1,675
1,911
2,515
3,447
4,376
6,639
10,028
151-156
1,225
1,745
2,013
2,643
3,737
4,664
7,142
10,613
157-165
1,309
1,924
2,229
2,784
4,110
4,969
7,815
11,487
166-175
1,406
2,044
2,441
2,955
4,253
5,297
8,405
12,240
176-183
1,471
2,206
2,640
3,177
4,484
5,691
8,805
12,674
184-190
1,572
2,428
2,900
3,509
5,004
6,248
9,598
13,339
191-200
1,834
2,731
3,291
3,847
5,775
6,964
10,727
14,852
201-212
2,137
3,033
3,761
4,483
6,692
7,933
12,325
16,491
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
24
171 $
66 to 70
71 to 75
76 to 79
208 $
263 $
360 $
546 $
80 to 85
86 PLUS
1,152
TRIP
OVER 41
37 $
74 $
93 $
130 $
171 $
254 $
379 $
555
DAYS $
$
154 $
61 to 65
768 $
www.medipac.com
Standard Rates - $1,000 USD Deductible
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
303 $
429 $
475 $
555 $
788 $ 1,135 $ 1,756 $ 2,444
51-60
333
499
555
689
945
1,355
2,012
2,742
61-66
364
562
635
791
1,081
1,538
2,249
3,164
67-75
404
646
725
899
1,235
1,691
2,505
3,598
76-82
454
702
785
995
1,375
1,971
2,750
3,974
83-90
519
728
835
1,105
1,499
2,186
3,074
4,400
91-96
548
779
910
1,199
1,645
2,385
3,319
4,754
97-105
641
868
1,007
1,371
1,825
2,567
3,667
5,420
106-112
675
955
1,100
1,510
1,999
2,808
3,937
5,863
113-120
709
1,042
1,168
1,611
2,162
3,011
4,234
6,305
121-126
756
1,119
1,275
1,755
2,340
3,206
4,586
6,596
127-135
809
1,171
1,415
1,888
2,543
3,429
4,975
7,191
136-142
884
1,244
1,527
1,990
2,672
3,625
5,390
7,668
143-150
926
1,289
1,617
2,135
2,945
3,835
5,734
8,424
151-156
963
1,355
1,715
2,252
3,181
4,076
6,176
8,941
157-165
1,027
1,477
1,898
2,369
3,500
4,353
6,747
9,647
166-175
1,105
1,604
2,081
2,516
3,633
4,626
7,261
10,278
176-183
1,157
1,719
2,212
2,713
3,823
4,978
7,605
10,643
184-190
1,235
1,906
2,435
2,986
4,262
5,474
8,292
11,388
191-200
1,436
2,144
2,663
3,245
4,918
6,103
9,267
12,228
201-212
1,678
2,381
3,151
3,820
5,699
6,953
10,648
12,666
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
152 $
66 to 70
71 to 75
76 to 79
1-888-MEDIPAC (1-888-633-4722)
185 $
227 $
311 $
473 $
80 to 85
86 PLUS
1,008
TRIP
OVER 41
30 $
63 $
83 $
116 $
139 $
231 $
347 $
486
DAYS $
$
131 $
61 to 65
664 $
25
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
265 $
373 $
399 $
489 $
593 $
890 $ 1,372 $ 2,035
51-60
278
406
439
568
739
1,093
1,586
2,302
61-66
332
491
505
636
871
1,217
1,788
2,656
67-75
353
565
575
725
996
1,355
1,979
3,021
76-82
397
607
625
801
1,125
1,544
2,186
3,352
83-90
449
645
688
890
1,220
1,720
2,444
3,694
91-96
480
682
744
973
1,333
1,868
2,645
4,001
97-105
555
758
835
1,106
1,490
2,028
2,913
4,546
106-112
591
835
899
1,213
1,635
2,199
3,131
4,924
113-120
625
911
968
1,299
1,744
2,343
3,365
5,297
121-126
660
995
1,058
1,385
1,845
2,506
3,650
5,547
127-135
706
1,035
1,146
1,499
1,999
2,672
3,954
6,021
136-142
769
1,088
1,232
1,605
2,154
2,879
4,279
6,437
143-150
810
1,121
1,312
1,735
2,373
3,006
4,533
7,071
151-156
849
1,185
1,377
1,816
2,566
3,202
4,906
7,506
157-165
897
1,299
1,532
1,907
2,783
3,412
5,304
8,099
166-175
966
1,403
1,677
2,021
2,929
3,638
5,773
8,629
176-183
1,012
1,516
1,819
2,183
3,099
3,907
6,046
8,902
184-190
1,080
1,665
1,992
2,409
3,435
4,289
6,590
9,398
191-200
1,245
1,870
2,261
2,642
3,963
4,780
7,364
10,727
201-212
1,466
2,082
2,582
3,080
4,592
5,376
8,460
11,618
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
26
117 $
66 to 70
71 to 75
76 to 79
150 $
184 $
253 $
376 $
80 to 85
86 PLUS
796
TRIP
OVER 41
23 $
50 $
63 $
91 $
113 $
167 $
254 $
370
DAYS $
$
102 $
61 to 65
523 $
www.medipac.com
TRIP
LENGTH
AGE BANDS
Up to 55
56 to 60
61 to 65
66 to 70
71 to 75
76 to 79
80 to 85
86 PLUS
41-50 $
239 $
325 $
345 $
449 $
535 $
818 $ 1,239 $ 1,768
51-60
251
366
399
513
699
987
1,435
2,025
61-66
293
425
444
571
799
1,099
1,615
2,330
67-75
320
499
515
659
899
1,197
1,799
2,656
76-82
358
535
558
723
999
1,355
1,974
2,949
83-90
409
575
599
794
1,113
1,515
2,207
3,250
91-96
445
615
663
879
1,199
1,687
2,397
3,494
97-105
489
679
758
995
1,330
1,815
2,631
3,926
106-112
534
746
825
1,099
1,478
1,987
2,827
4,314
113-120
560
821
878
1,173
1,574
2,121
3,040
4,658
121-126
584
892
955
1,242
1,655
2,273
3,285
4,879
127-135
639
926
1,026
1,345
1,799
2,428
3,572
5,245
136-142
698
983
1,112
1,449
1,946
2,601
3,858
5,662
143-150
733
1,018
1,185
1,555
2,137
2,713
4,114
6,220
151-156
760
1,071
1,248
1,639
2,316
2,875
4,418
6,550
157-165
812
1,155
1,381
1,723
2,499
3,080
4,845
7,113
166-175
872
1,263
1,514
1,833
2,640
3,285
5,212
7,579
176-183
913
1,370
1,641
1,975
2,784
3,512
5,459
7,859
184-190
975
1,507
1,799
2,176
3,103
3,874
5,951
8,271
191-200
1,136
1,693
2,042
2,385
3,581
4,317
6,619
9,208
201-212
1,325
1,880
2,331
2,781
4,149
4,916
7,641
10,224
23 DAY
ADD-ON
ANNUAL ADD-ON RATES
Up to 55
56 to 60
101 $
66 to 70
71 to 75
76 to 79
1-888-MEDIPAC (1-888-633-4722)
127 $
157 $
215 $
318 $
80 to 85
86 PLUS
649
TRIP
OVER 41
17 $
37 $
51 $
65 $
79 $
116 $
185 $
278
DAYS $
$
89 $
61 to 65
439 $
27
Policy Text
Medipac
®
2016-2017 Travel Emergency
Medical Insurance Policy
Please read the policy carefully.
Certain conditions and limitations apply.
The following 11 pages contain
the actual policy text.
Underwritten by
Old Republic Insurance Company of Canada
28
www.medipac.com
Policy Text
Please read this policy carefully for an understanding If, during the Single Trip Plan, You return to Your province
of the coverage provided. This policy is underwritten or territory of residence for any other reason and resume
by Old Republic Insurance Company of Canada or in travel, this insurance does not provide benefits for any
Quebec, Reliable Life Insurance Company, which have Medical Emergency concerning, relating to, caused by or
appointed Medipac International Inc. (Medipac) to perform arising from any medical or physical condition for which
certain administrative services, including enrolment and You received Medical Attention while in Your province or
customer service, and Medipac Assistance International territory of residence. The number of days You return to
Inc. (Medipac Assist) to perform all assistance and Your province or territory of residence cannot be refunded.
claims services. The Company will pay benefits specified If You have purchased the Annual Add-on to the Single
subject to the exclusions, limitations, definitions and other Trip Plan, then for every other trip:
provisions of this policy. For an understanding of the
exclusions, please refer to "WHAT IS NOT COVERED" 1. Outside Canada, Your insurance coverage begins
at 12:01 a.m. on each day You leave Canada during
and "GENERAL LIMITATIONS". The section titled "THE
the 365-day period following Your Effective Date of
DEFINITIONS" provides an explanation of the words and
Insurance.
Your coverage ends on the earlier of: (a)
phrases shown in italics.
12:01 a.m. 23 days after the date You leave Canada;
This coverage is available to Canadian residents only
(b) the date You return to Canada; or (c) 365 days after
and must be purchased prior to the Date of Departure
Your Effective Date of Insurance.
and from within Canada. You must be covered under
the Government Health Insurance Plan of the Canadian 2. W ithin Canada, Your insurance coverage begins
at 12:01 a.m. on each day You leave Your Canadian
province or territory in which You reside. Family coverage
province or territory of principal residence. Your
is available to You (if under age 56), Your Spouse and Your
coverage
ends on the earlier of: (a) 12:01 a.m. 90 days
Children who are travelling together with You. A Spouse
after
the
date You leave Your Canadian province or
over age 55 is not covered by a family policy.
territory of principal residence; (b) the date You return to
This policy covers Reasonable and Customary Charges
Your Canadian province or territory of principal residence;
incurred by You outside Your province or territory of principal
or (c) 365 days after Your Effective Date of Insurance.
residence; that result from a Medical Emergency occurring
The
period of coverage is subject to the automatic
during the period of coverage (as explained below); and that
extension
provision explained in "WHAT HAPPENS TO
You incur for Medically Necessary Medical Treatment.
MY INSURANCE COVERAGE IF I AM HOSPITALIZED AND
This policy contains a provision removing or CANNOT RETURN ON MY SCHEDULED RETURN DATE?"
restricting the right of the insured to designate
persons to whom or for whose benefit insurance The insurance coverage must be purchased for the entire
duration of Your Trip, unless otherwise expressly stated in
money is to be payable.
this policy.
This insurance policy is in force only if Medipac has
received Your completed application and premium; and a If You have purchased the 23-Day Annual Add-on to the
Single Trip Plan, You can extend any single 23-day Trip
policy has been issued.
during Your policy's 365-day period. When extending Your
PERIOD OF COVERAGE
Annual Add-on, the same coverage type and deductible
For the Single Trip Plan, Your insurance begins at 12:01 option MUST apply. Your Annual Add-on cannot be used in
a.m. on Your Effective Date of Insurance as set out in Your combination with Your Single Trip Plan.
Application for insurance and cannot begin earlier unless
You notify Medipac in advance. Your insurance ends on
the earlier of: (a) 11:59 p.m. on the scheduled return date
set out in Your Application for insurance; (b) the date You
return to Canada for any medical reason. Once treatment
ends You may apply to Medipac Assist to have Your policy
reinstated. To be valid, a policy endorsement is required.
WHAT SHOULD I DO IN A MEDICAL EMERGENCY?
You MUST notify Medipac Assist PRIOR to seeking Medical
Treatment.
1-800-813-9374 (U.S. and Canada)
416-441-6337 (collect or direct from all other locations).
Failure to call will result in reimbursement of only 75% of all
eligible Covered Expenses to a maximum of $25,000 USD
Policy Page 1
1-888-MEDIPAC (1-888-633-4722)
29
Policy Text
If You are not able to call because You are medically
incapacitated, You or someone on Your behalf MUST contact
Medipac Assist as soon as reasonably possible. Do not
assume that someone has called Medipac Assist on Your
behalf; it remains Your responsibility to ensure that Medipac
Assist has been contacted.
"Company" means Old Republic Insurance Company of
Canada or in Quebec, Reliable Life Insurance Company.
"Covered Expense" means Reasonable and Customary
Charges in excess of the Government Health Insurance
Plan of the Canadian province or territory in which You
reside or any private or provincial or territorial Auto
All medical procedures and/or tests (including MRI, MRCP, Insurance Plan for supplies, treatment or services listed in
CAT Scan, CT Angiogram, Nuclear Stress Test, Angiogram or The Benefits section subject to policy limitations.
Cardiac Catheterization or ANY surgery) MUST be authorized "Deductible Amount" means the amount of Covered
by Medipac Assist in advance. Reimbursement is subject to Expenses that You will be responsible for paying. Covered
the terms and conditions of this policy.
Expenses are first paid by Your Government Health
Whenever possible, Medipac Assist will:
Insurance Plan; then Your Deductible Amount applies
• verify Your insurance coverage;
before any remaining Covered Expenses are paid under
• direct You or transfer You to one of our network of this policy. The Deductible Amount, if any, applicable to
Hospitals, Physicians or other medical providers near this policy is shown in U.S. dollars on the Policy Validation
You and help to manage Your emergency medical Label affixed to this policy and applies to each Trip.
claim;
"Effective Date of Insurance" means for the Single Trip
• provide multilingual interpreters to communicate Plan, the later of 1) the Date of Departure shown on Your
with Physicians and Hospitals in foreign countries;
application for insurance or 2) the date You leave Your
• contact Your family and Physician;
province or territory of residence. If purchasing the Single
• p ay Covered Expenses directly to Hospitals, Trip Plan to top up another medical travel insurance policy,
Physicians and other medical providers on Your it means the Effective Date of Insurance indicated on Your
behalf;
application for insurance. If purchasing the Annual Add-on,
• monitor Your medical condition;
it means the date You choose Your insurance coverage to
• arrange for return transportation to a Hospital in take effect as indicated on Your application for insurance.
Canada, if necessary.
"Hospital" means an institution which is licensed as a
A Medical Treatment plan will be developed to provide Hospital and which:
Medically Necessary Medical Treatment in a managed care
(a) is primarily engaged in providing medical, diagnostic
setting.
and surgical services for the care and treatment of sick
You MUST provide authorization for the release of medical
or injured persons on an in-patient basis; and
records and information from Your attending Physician(s)
(including any test results, hospital and pharmaceutical (b) provides medical care under the supervision of a staff
of Physicians, with 24-hour-a-day care by registered
records). No benefits will be payable under this policy
nurses; and
without the required information.
(c) is not otherwise licensed as a home for the aged, a rest
THE DEFINITIONS
home, health spa, nursing home, convalescent hospital,
hospice, palliative care facility, a place for the care and
The following words have specific meanings:
treatment of drug addicts or alcoholics, custodial or
"Children" means unmarried dependent sons or
educational facility, or any rehabilitation facility.
daughters under the age of 19 and born at least 3 months
prior to Your Effective Date of Insurance or Your Trip Start
Date.
"Hospitalized" and "Hospitalization" means
confinement in a Hospital as defined above.
Policy Page 2
30
www.medipac.com
Policy Text
"Injury" means any accidental bodily harm that occurs
and results in Covered Expenses while this policy is in
force. Such Injury must be caused solely by external,
violent and accidental means, and independent of
Sickness and of any other cause.
(f) the most appropriate supply or level of service which
can be provided on a cost-effective basis (including,
but not limited to, in-patient vs. outpatient care, electric
vs. manual wheelchair, surgical vs. medical or other
types of care).
"Insured" means a person who is named on the
application for insurance and in whose name the required
premium has been paid.
The fact that the Insured’s attending Physician prescribes
the services or supplies does not automatically mean
such services or supplies are Medically Necessary and
covered by this policy.
"Medical Attention": see Policy Page 6 for details.
"Medical Emergency" means a Sickness or Injury which:
(a) results in symptoms which occur suddenly and
unexpectedly; and
(b) requires immediate Physician’s care to prevent death
or serious impairment of Your health and/or to relieve
acute pain and suffering; and
(c) occurs outside Your Canadian province or territory of
principal residence.
"Physician" means a medical practitioner (other than
the Insured, a Spouse or relative) who was at the time of
treatment currently licensed to prescribe and administer
Medical Treatment within the scope of a medical doctor's
licence, or a surgeon who performs surgery within
the scope of a surgeon's licence and whose legal and
professional standing within their jurisdiction is equivalent
to a doctor of medicine (M.D.) duly licensed to practise in
any province or territory of Canada.
"Medical Treatment" means any reasonable medical, "Pre-Existing Condition": see Policy Page 5 for details.
therapeutic or diagnostic measure, service or supply "Reasonable and Customary Charges" means charges
that is Medically Necessary and that is prescribed by a which are usually made for care, services or supplies of
Physician in any form, including prescribed medication, the level usually furnished for cases of the nature and
reasonable investigative testing, Hospitalization, surgery severity of the case being treated, provided they are in
or other prescribed or recommended treatment directly accordance with representative fees and prices in the
referable to the condition, symptom or problem. Medical area.
Treatment does not include either: (a) the use of prescribed “Routine Check-up” means any medical examination
drugs or medication for a controlled condition, symptom which is performed for the purpose of general health
or problem when the dosage, drug or medication remains monitoring, which may include routine medical tests
unchanged; or (b) a check-up where the Physician and which is unrelated to any specific symptom, illness,
observes no change in a previously noted condition, condition or disease.
symptom or problem.
"Sickness" means an illness or disease which results in
"Medically Necessary" in relation to any service, a Covered Expense while this coverage is in force. The
supply or other matter means one which is ordered by a Sickness must be serious enough for a reasonable person
Physician and one which the Company determines is:
to seek personal Medical Treatment from a Physician.
(a) provided for the diagnosis or direct treatment of an "Spouse" means a person with whom the Insured is
Injury or Sickness;
cohabiting and who either:
(b) appropriate and consistent with the symptoms and
findings or diagnosis and treatment of the Insured’s
Injury or Sickness;
(c) not experimental or investigative;
(d) provided in accordance with generally accepted
medical practice;
(e) not possible to delay until You return to Canada; and
(a) is legally married to the Insured; or
(b) has lived with the Insured, in a conjugal relationship,
for a period of twelve (12) consecutive months
immediately prior to the commencement of insurance
coverage under this policy and who has been publicly
represented as the Insured’s Spouse in the community
in which they reside.
Policy Page 3
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Policy Text
"Stable and Controlled": see Policy Page 6 for details.
"Trip" means the defined period of travel between the
time You leave home and the date You are scheduled to
return home.
"Trip Start Date" means the Date of Departure each time
You leave Your province or territory of principal residence
during the period of coverage if You have purchased the
Annual Add-on.
"You" and "Your" mean the same as Insured defined
above.
THE BENEFITS
The following are Covered Expenses provided they are
incurred by an Insured as a result of a Medical Emergency.
1. Hospital/Medical/Ambulance Expenses:
(a) H ospital room and board, up to the semi-private
charge, services, supplies, intensive care unit and
coronary care unit expenses;
(b) Physician's charges for medical and surgical care;
(c) X-rays and other diagnostic tests when prescribed by
the attending Physician and approved in advance by
Medipac Assist;
(d) The cost of local licensed ambulance service to the
nearest medical facility able to provide appropriate
care;
(e) Drugs and medication which by law require a written
prescription and are dispensed by a pharmacist up to a
maximum limit of a 30-day supply;
(f) The cost or rental of casts, splints, trusses, braces,
crutches, rental of a wheelchair or other medical
appliances when prescribed by a Physician and
approved in advance by Medipac Assist.
2. Private Duty Nursing Expenses: covers the cost
of the professional services of a registered private
duty nurse for out-of-Hospital nursing care only if
recommended as Medically Necessary by the attending
Physician. Charges for the services of a registered private
duty nurse who is a Spouse or is related to You are not
covered. The maximum benefit amount is $7,500. This
benefit must be approved in advance by Medipac Assist.
3. Chiropractic Services: covers the cost of the
professional services of a licensed chiropractor for a
Medical Emergency. Charges for the services of a licensed
chiropractor who is a Spouse or is related to You are not
covered. The benefit amount is a maximum of $500.
4. Other Professional Services: covers the cost of the
professional services of a licensed chiropodist, osteopath,
podiatrist or physiotherapist only if recommended as
Medically Necessary by the attending Physician. Charges
for the services of a licensed practitioner who is a Spouse
or is related to You are not covered. The benefit amount is
a maximum of $500.
5. Emergency Dental Expenses: If You suffered an
Injury to Your teeth as a result of an external accidental
blow to the mouth or face (chewing accidents are not
covered), You will be reimbursed up to $5,000 per
Insured person for dental treatment to repair or replace
natural teeth or permanently attached artificial teeth.
Dental treatment must take place within 90 days of
the accidental blow to the mouth or face. If You need
treatment for relief of dental pain, a maximum of $500
will be allowed for such treatment. Dental treatment must
take place before You return to Your Canadian province or
territory of principal residence.
6. Return of Vehicle: If neither You nor anyone travelling
with You is able to operate Your owned or rented vehicle
due to Sickness, Injury or death while travelling outside
Your province or territory of residence, this plan will
reimburse a maximum of $5,000 for the return of the
vehicle.
Eligible for reimbursement is the lesser of the cost of
the return performed by a professional agency or the
following necessary and reasonable expenses incurred
by an individual returning the vehicle on Your behalf: fuel,
meals, overnight accommodation and one-way economy
airfare. To receive reimbursement, original receipts
must be submitted. Any other expenses are not covered.
Benefits will only be payable when pre-approved and/or
arranged by Medipac Assist and the vehicle is returned to
Your normal place of residence or the nearest appropriate
rental agency within 30 days of Your return to Canada.
Car rental costs while awaiting the return of Your vehicle
are not eligible expenses. A copy of vehicle ownership is
required.
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Policy Text
7. Bringing a Relative to Your Bedside: covers the cost
of a round-trip economy class airfare, accommodations
and out-of-pocket expenses to have one family member or
a close friend visit You in Hospital. The benefit amount is
up to $350 per day to a maximum of $2,000. This benefit
is payable in the event You are in Hospital for at least three
(3) consecutive nights due to a Medical Emergency. The
Company requires original receipts for the incurred costs.
This benefit must be approved in advance by Medipac
Assist.
8. Out-of-Pocket Expenses for Accompanying Family
Member: covers the cost of Reasonable and Customary
Charges for commercial accommodation, meals, essential
telephone calls and taxi expenses incurred by an
accompanying family member in the event that You are
Hospitalized on the scheduled return date to Canada, as
indicated on the Application. The benefit amount is up to
$350 per day to a maximum of $2,000. The Company
requires all original receipts for the expenses incurred.
9. Return of Spouse and Children: covers the cost of an
economy class airfare to the departure point for the return
of Your Spouse and Children, if the Company requires that
You return to Canada for immediate Medical Treatment or
in the event of Your death. This benefit is payable up to
a maximum of $2,500. This benefit must be approved in
advance by Medipac Assist.
10. Emergency Air Transportation: covers, as a result
of a Sickness or Injury: (a) the cost of a one-way, economy
class airfare to Your departure point in Canada; or (b) the
cost of additional airline seats to accommodate a stretcher
when recommended by the attending Physician. Any air
transportation must be arranged and approved in advance
by Medipac Assist.
11. Qualified Medical Attendant: covers the
Reasonable and Customary Charges for the services
of a medical attendant. These services must be on the
recommendation of a Physician and must be approved in
advance by Medipac Assist. Charges for the services of a
medical attendant who is a Spouse or is related to You are
not covered.
12. Air Ambulance: covers the cost of air ambulance
transportation, when medically required, between
Hospitals. This benefit must be arranged and approved in
advance by Medipac Assist.
13. Return of Deceased: covers the cost of preparation
and transportation of a deceased Insured to the original
departure point in Canada. This benefit includes the cost
of a standard transportation container (excludes cost of
a casket). The maximum benefit amount is $10,000. For
cremation or burial of the deceased Insured at the place
of death, the maximum benefit amount is $5,000. If it is
necessary to identify the deceased Insured before release
of the body, the benefit also covers the cost of a roundtrip, economy class airfare for one family member or close
friend and their out-of-pocket expenses up to $350 per
day to a maximum of $2,000. The Company requires
original receipts for the incurred costs. This benefit must
be approved in advance by Medipac Assist.
14. Return to Destination: covers the cost of an
economy class airfare to return You and/or Your Insured
Spouse back to Your original Trip destination so You
can continue Your Trip after Your medically approved
emergency evacuation back to Canada. This benefit is
available only if no further treatment is required and
Medipac Assist has approved Your return under Your
existing policy. To be valid, a policy endorsement is
required.
NOTE: NOTWITHSTANDING THE OTHER PROVISIONS OF
THIS POLICY, ANY MEDICAL TREATMENT, SERVICE OR
SUPPLY THAT IS NOT SPECIFICALLY LISTED IN THE
SECTION "THE BENEFITS" IS NOT COVERED BY THIS
POLICY.
WHAT IS NOT COVERED
PRE-EXISTING CONDITIONS
This insurance does not provide benefits for any Medical
Emergency concerning, relating to, caused by or arising
from any of the following:
1.Any Pre-Existing Condition that has not been Stable
and Controlled in the 90 days immediately prior to
the Effective Date of Insurance or Your Trip Start Date.
This includes any reaction that results from a change
in medication prescribed for such a condition.
“Pre-Existing Condition” means any medical or
physical condition, symptom, illness or disease for
which Medical Attention was received or for which an
ordinarily prudent person would have sought Medical
Attention prior to the Effective Date of Insurance or
Your Trip Start Date.
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Policy Text
“Stable and Controlled” means, during the 90 days
immediately prior to the Effective Date of Insurance or
Your Trip Start Date:
(a) the medical or physical condition, symptom,
illness or disease did not first manifest itself;
and/or
(b) the medical or physical condition, symptom,
illness or disease was not first investigated; and/or
(c) the medical or physical condition, symptom,
illness or disease has not worsened; and/or
(d) no change in any medication or its usage or
dosage occurred, was prescribed and/or
recommended by a Physician; and/or
(e) no Medical Attention was received, prescribed or
recommended by a Physician.
“Medical Attention” means any medical,
therapeutic or diagnostic procedure, service
or supply that is prescribed, performed or
recommended by a Physician, including but not
limited to prescribed medication, investigative testing
and surgery. Medical Attention does not include either
the unchanged use of prescribed medication for a
medical condition, symptom or problem which is
Stable and Controlled; or a Routine Check-up.
A change in medication does not apply to cholesterol
lowering medication or to a change in any other
medication from a brand name medication to a
generic brand medication (insofar as the dosage is
not modified). If You are taking Coumadin (warfarin)
or insulin and are required to have Your blood levels
tested on a regular basis and You are required to
adjust the dosage of Your medication only to ensure
correct blood levels are maintained, such a change
is not considered to be a change in medication,
provided Your medical condition remains unchanged.
2.Any medical or physical condition, symptom, illness
or disease that, in the 12 months prior to Your
Effective Date of Insurance or Your Trip Start Date,
required: a) a total of three (3) or more Emergency
Room visits, Hospitalizations, Day Surgeries or
any combination of all three; and/or b) a single
Hospitalization for more than 48 consecutive hours.
or disease for which treatment and/or investigation(s)
was recommended but not received prior to Your
Effective Date of Insurance or Your Trip Start Date.
GENERAL EXCLUSIONS
This insurance does not cover, provide services or pay
claims resulting directly or indirectly from:
4.War, whether declared or not, any act of civil war,
rebellion, insurrection or terrorism, participation in a
riot, civil commotion or demonstration or service in
the armed forces of any country.
5.Suicide, attempted suicide or self-inflicted Injury
(whether You are sane or insane).
6.(a) Normal pregnancy; (b) normal childbirth; or (c) any
complication, condition or symptom of pregnancy
occurring within the last 18 weeks before the
expected delivery date.
7.Any child born during a Trip.
8.A Trip that is undertaken to secure treatment, general
health examinations or check-ups, or surgery as a
purpose of the Trip.
9.Emotional, psychological or mental disease, disorder,
condition or symptom.
10.Expenses for medical or surgical care which is
primarily cosmetic, or for any treatment which is
experimental.
11.Any expenses incurred due to any medical or physical
symptom, illness or disease for which, prior to Your
Trip Start Date, Medical Attention or a change in
medication has been recommended or scheduled for
a date after Your Trip begins.
12.Expenses for which no charge would normally be
made in the absence of insurance.
13.
E xpenses for rehabilitation, the continued
treatment, or complication of the medical condition
which caused the Medical Emergency, once You
are discharged from Hospital or once a Medical
Emergency ends, as determined by the Company.
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Policy Text
14.Any expenses incurred after the date on which the
Insured has declined an offer of repatriation and/or
medical evacuation.
25.Any expenses incurred during a Trip under the Annual
Add-on for which proof of departure has not been
provided.
15.The commission or attempted commission of any
criminal act by You.
26.Any expenses which result directly or indirectly from
scuba diving, mountaineering, rock or precipice
climbing, hang gliding, paragliding, sport parachuting,
skydiving or bungee jumping.
16.Any treatment, services or supplies not Medically
Necessary (as defined), or any medical procedures
and/or tests (including MRI, MRCP, CAT Scan, CT
Angiogram, Nuclear Stress Test, Angiogram or
Cardiac Catheterization) not authorized by Medipac
Assist in advance. All surgery must be authorized by
Medipac Assist prior to being performed except in
extreme circumstances where surgery is performed
on an emergency basis immediately upon admission
to a Hospital.
17.Emergency medical relocation unless arranged and
approved in advance by Medipac Assist.
18.Any treatment, services or supplies provided by a
home for the aged, a rest home, health spa, nursing
home, convalescent hospital, hospice, palliative care
facility, a place for the care and treatment of drug
addicts or alcoholics, custodial or educational facility,
or any rehabilitation facility.
19.Any Hospital/medical benefits if You are not covered
under the Government Health Insurance Plan of Your
Canadian province or territory of principal residence.
20.Any damage to or loss of: hearing aids, eyeglasses,
sunglasses, contact lenses, artificial teeth or artificial
limbs and resulting prescription thereof.
21.Any expenses that result from abuse of medication,
including refusal to take prescribed medication,
the abuse of drugs or alcohol, or refusal to accept
recommended medical treatment.
22.Any expenses for regular treatment or regular care of
a condition that existed prior to the Effective Date of
Insurance or any expense in connection with general
health examinations or regular check-ups.
23.Any expenses directly or indirectly incurred due to HIV,
AIDS or AIDS-related complex.
24.A Heart, Lung, Liver, Kidney, Pancreatic or Bone
Marrow Transplant.
27.A ny expenses which result directly or indirectly
from participation in speed or endurance contests
and/or participation in athletic or sport activities for
remuneration or prize money.
or disease for which the results of any test(s) and/
or investigation(s) were not available prior to the
Effective Date of Insurance or Your Trip Start Date.
29.Travel in a country or specific area for which, prior to
Your Effective Date of Insurance or Your Trip Start Date,
Foreign Affairs, Trade and Development Canada has
issued a travel warning advising Canadian residents
not to travel to that country or specific area.
GENERAL LIMITATIONS
If Your health changes at any time between Your Date
of Application and Your Effective Date of Insurance, You
must contact Medipac at 1-888-633-4722 right away. A
reassessment for Your eligibility and rate qualification
is required. Failure to contact Medipac may result in
claim denial, or payment of only a portion of the Covered
Expenses.
Individuals Excluded from Coverage
You cannot be covered by this policy, and all insurance
coverage is null and void, and the liability of the Company
will be limited to return of premium if:
1.Coverage is not purchased for the entire duration of
Your Trip (unless otherwise expressly stated in this
policy).
2.Coverage is applied for while outside Canada (with
the exception of post-departure applications for
extension of coverage).
3.A ny material misrepresentation is made on the
application or in connection with any claim for
benefits under this policy.
Policy Page 7
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Policy Text
and/or if between Your Date of Application and Your
Effective Date of Insurance:
4.You had been diagnosed as having a terminal illness,
been advised by a Physician not to travel or had HIV,
AIDS or AIDS-related complex.
5.You had been diagnosed with Pulmonary Fibrosis.
6.You had stem cell treatment or an organ or bone
marrow transplant (excluding cornea or skin graft).
7.
You had been treated for, taken or been prescribed
medication for, or been diagnosed with Lung Cancer,
Metastatic Cancer or two or more types of cancer
(excluding Basal Cell and Squamous Cell Skin
Cancer).
8.You had a Cardiac condition with an ejection fraction
of less than 40% or a ventricular function grade of 3
or 4.
9.You had Moderately Severe or Severe Cardiac Valve
Stenosis.
10.
You had an Aneurysm greater than 4.5 cm in
size (diameter or width) which remains surgically
untreated.
11.
You underwent Chemotherapy for Cancer or
Malignant Tumour(s).
12.
You had Cardiac Pacemaker Implant surgery,
Coronary Bypass surgery or surgery on any artery.
17.
You had taken or been prescribed Insulin or two (2)
or more medications for Diabetes and medication for
a Heart Condition. The term “medication” includes
Nitroglycerin in any form.
If You are under the age of 56 and travelling for less
than 41 days, items 4. to 17. above do not apply.
Misstatement
If You misstate Your response to any question in section A
of the application, then this policy is null and void and Your
premium will be refunded.
If You misstate Your response in any other section of
the application and, as a result, paid a lower premium
than required, this policy will cover only the proportion
of Covered Expenses that the premium paid bears to
the required premium. You will be responsible for the
remaining portion of Covered Expenses.
CHANGE IN DEPARTURE DATE
For the Single Trip Plan, if there is a change in Your Date
of Departure, notice MUST be provided to Medipac from
within Canada prior to the Date of Departure shown in
Your application. If You have purchased the Annual Addon, You are not required to provide advance notice of Your
Trip Start Date for every other Trip. However, evidence of
these dates will be required at the time of claim.
IS THERE ANYTHING ELSE I NEED TO KNOW?
13.
You had any other Heart surgery (including Ablation,
Cardiac Defibrillator Implant, Angioplasty and/
or Stent), had a Heart Attack or an episode of
Congestive Heart Failure.
Yes, the following are the general conditions that apply to
Your insurance under this policy:
14.
You had a Stroke, a Transient Ischemic Attack (TIA), a
Ministroke or Amaurosis Fugax.
B.The Company and its agents are not responsible for the
availability, quality or results of any Medical Treatment
or transportation, or the failure of the Insured to obtain
Medical Treatment or proper Hospitalization.
15.
You had any Chronic Lung Disease (including
Emphysema, Chronic Obstructive Pulmonary Disease
[COPD], Chronic Bronchitis, Reactive Airway Disease
or Asthma) which caused You to be Hospitalized for
more than 24 consecutive hours, or for which You
had taken or been prescribed Prednisone or SoluMedrol.
16.
You had taken or been prescribed Home Oxygen for
any reason.
A.This policy will reimburse You for Covered Expenses up
to a maximum of $2,000,000 USD per Insured.
C.The Company reserves the right to return You to
Canada or to transfer You to one of our preferred health
care providers. Refusal to comply with the transfer
or the return to Canada renders this policy void;
i.e., Your insurance coverage under this policy ends.
The Company has the right and You shall afford the
Company the opportunity to have You medically
examined by an independent medical professional.
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Policy Text
D.There is no insurance coverage if the premium is not
received by Medipac due to an N.S.F. cheque or invalid
credit card charge.
J.All benefit amounts under this policy are in United
States currency unless stated otherwise. If You have
paid a Covered Expense in a currency other than that
of
United States or Canada, any reimbursements made
E.Every action or proceeding against an insurer for
will be in Canadian currency at the prevailing rate of
the recovery of insurance money payable under the
exchange on the date the service was provided. No
contract is absolutely barred unless commenced
sum payable under this policy shall bear interest.
within the time set out in the Insurance Act, or other
applicable legislation.
K.T his insurance is supplementary health coverage;
i.e., this policy covers expenses in excess of those
F.In no event will a claim be accepted after one year from
covered under Your Government Health Insurance Plan,
the date of occurrence.
any Private or Provincial or Territorial Auto Insurance
G.Any fraud, attempted fraud, misrepresentation or nonPlan or any other insurance. If You are retired and
disclosure of any material fact relating to this insurance
You have similar out-of-country/province extended
or to a claim under this policy renders this policy null
health benefits with a lifetime maximum coverage
and void. If You have misstated Your age, and such
of: (a) $100,000 CAD or less, the Company will not
misstatement results in Your paying premium which
co-ordinate payment with such coverage; or (b) over
is less than the required premium, this policy will
$100,000 CAD, the Company will co-ordinate payment
cover only the proportion of Covered Expenses that the
with such coverage in excess of $100,000 CAD.
premium paid bears to the required premium.
H.If You incur Covered Expenses under this insurance L.For purposes of determining eligibility under the
section “Individuals Excluded From Coverage” in the
due to the fault of a third party, the Company has a
General Limitations of this policy or for determining the
legal claim against such “at fault” third party for all
validity of a claim, hospital records, pharmaceutical
benefits that the Company pays to You or for You
records and the medical records of Your attending
under this policy. You must take all reasonable steps
Physician(s)
(including Your regular Canadian
to protect and to advance the Company's claim
Physician(s)), will be obtained and reviewed by
against such party at fault. This includes keeping the
the Company. Your claim cannot be processed and no
Company informed about all legal proceedings against,
benefits
will be payable under this policy without the
and settlement negotiations with, such party at fault,
required information.
making a claim on behalf of the Company in any such
legal proceedings and negotiations, and not settling T he Company has the right, and You shall afford
Your claim without first allowing the Company to start or
the Company the opportunity, to have You medically
continue a lawsuit in Your name against such party at
examined, when and as often as may reasonably be
fault for benefits that the Company has paid or will pay.
required while benefits are being claimed or paid under
Any settlement must first be applied to any expenses
this policy. In the event of death, the Company has the
that the Company has paid on Your behalf.
right to request an autopsy if not prohibited by law.
I.When the Company has made Hospital or other M.Despite any other provision contained in the contract,
medical payments on Your behalf, You must sign an
the contract is subject to the applicable statutory
Authorization Form included with this policy which
conditions in the Insurance Act, as applicable in Your
authorizes and allows the Company to recover such
province or territory of residence, respecting contracts
payments from Your other insurers and other health
of accident and sickness insurance.
plans (including Your Government Health Insurance
Plan). You must assist the Company in obtaining such N.The right of any person to designate persons to whom
or for whose benefit insurance money is payable is
reimbursement. If an advance has been made for any
restricted.
expense that is not covered by this insurance policy,
You will be required to reimburse the Company.
Policy Page 9
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Policy Text
WHAT HAPPENS TO MY INSURANCE COVERAGE IF
I AM HOSPITALIZED AND CANNOT RETURN ON MY
SCHEDULED RETURN DATE?
This policy provides automatic extension of coverage at no
additional cost to You in each of the following situations:
1.If You are in Hospital due to Injury or Sickness on
Your scheduled return date, insurance coverage will
remain in force for the period of time You remain in
Hospital, plus a further period of 72 hours following
Your discharge from Hospital.
2.If Your return is delayed beyond Your scheduled
return date due to the delay of a common carrier in
which You are scheduled to travel; or, while travelling
by automobile, You are involved in an accident or a
mechanical breakdown, insurance coverage will be
extended until You return to Your point of departure
or for 72 hours after the date when the insurance
coverage would otherwise have terminated, whichever
occurs first.
However, in any event, insurance coverage will not be
extended more than twelve (12) consecutive months
immediately after the date of Your Medical Emergency
which was the cause of Your delay beyond Your scheduled
return date.
HOW DO I PRESENT MY CLAIM?
When You contact Medipac Assist at the time of Your
Medical Emergency, we will send You a Claim Kit within
10 days, containing everything necessary to submit Your
claim, including instructions and forms. These forms
must be returned to our office within 30 days of
the date of Your claim. Failure to provide the required
documents in a timely manner will reduce any amount
payable under this policy.
To adjudicate Your claim, the Company will require:
• a completed Claim and Authorization and Release
Form
• o riginal invoices and/or receipts
• p ayment of Your Deductible Amount, if any
• p ayment of outstanding premium, if any
• complete Medical Records including final diagnosis
by the attending Physician
• Historical Medical Records
• a ny other relevant documentation
• if claiming under the Annual Add-on, proof of
Your departure date.
For payment, please submit ONLY original itemized bills,
the HCFA-Form 1500, UB-04 (with itemized statement)
OR an original itemized doctor’s bill with:
• formal letterhead with full name and address
• tax I.D.
• procedure and diagnostic codes with dollar amounts
• original doctor’s signature (stamped photocopied
signatures are not acceptable)
Original bills must be provided for any eligible out-of-pocket
expenses. Cash register receipts are not considered original
bills.
For Claim inquiries please phone the Medipac Assist Claims
Department:
Toll-free from the U.S.A. and Canada: 1-888-311-4761
or from other locations: (416) 441-7073
POLICY EXTENSIONS
Extension of Coverage must be applied for and approved
by Medipac at least 3 days prior to Your scheduled return
date. In order to apply for an Extension of Coverage, You
must be in good health and cannot have any medical
condition for which surgery or Hospitalization is anticipated.
No extensions are available if a claim has been
incurred. To apply for an extension of coverage, call
Medipac at 1-888-633-4722 toll-free from the U.S.
or Canada or at (416) 441-7070 from other locations.
A declaration of good health must be made before an extension
can be issued. Extensions are available in trip length units as
published. An Administration Fee per person, per extension,
applies.
Exclusion:
This Policy Extension does not cover, provide services
or pay claims for expenses resulting directly or indirectly
from any Sickness or Injury that was first manifest, first
diagnosed, or first treated after the Effective Date of
Insurance or Trip Start Date and prior to the date when
Your application to extend Your period of coverage under
this insurance was approved.
Policy Page 10
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Policy Text
REFUND POLICY
Signed for the Company by:
1. No refunds are available if a claim has been incurred.
2. The premium for the Annual Add-on cannot be
refunded once coverage begins.
3. All refund requests must be made in writing from
within Canada.
A refund will be provided to an Insured in the
following situations:
FULL REFUND only if, prior to the Effective Date of Insurance:
• the Insured or his/her Spouse is unable to travel due to
Sickness or Injury (a Physician’s statement is required); or
Paul M. Field, CPA, CA
President and Chief Executive Officer
Underwritten by
Old Republic Insurance Company of Canada.
In Quebec underwritten by Reliable Life Insurance Company.
Box 557, 100 King Street West, Hamilton, Ontario L8N 3K9
• the Insured is unable to travel due to a death in the immediate
family.
FULL REFUND less a $50 Administration Fee per person if
prior to the Effective Date of Insurance:
IMPORTANT NOTICE – PLEASE READ CAREFULLY
• the policy is cancelled for any other reason.
• Cancellation of the Single Trip Plan will also terminate
the Annual Add-on.
PARTIAL REFUND less a $20 Administration fee per person if:
• the Insured returns to Canada at least 10 days prior to the
scheduled return date.
• Travel insurance is designed to cover losses arising
from sudden and unforeseeable circumstances. It is
important that you read and understand your policy
before you travel, as your coverage may be subject to
certain limitations or exclusions.
• A pro-rata refund will be calculated using the later of the
postmarked date of the written request and the requested
termination date.
• A pre-existing exclusion may apply to medical conditions
and/or symptoms that existed prior to your trip. Check to
see how this applies in your policy and how it relates to
your departure date, date of purchase or effective date.
• If You have purchased the Annual Add-on, only the premium
in excess of a minimum 22-24 day Single Trip Plan will be
eligible for a refund.
• In the event of an accident, injury or sickness, your
prior medical history may be reviewed when a claim is
reported.
• Your request MUST include a statement that no claims
have been incurred.
• If your policy provides travel assistance, you may be
required to notify the designated assistance company
prior to treatment. Your policy may limit benefits should
you not contact the assistance company within a
specified time period.
All requests for refunds can be mailed to:
Medipac Travel Insurance
180 Lesmill Road,
Toronto ON M3B 2T5
Please read your policy carefully before you travel.
Policy Page 11
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39
MedipacPLUS Endorsement (If purchased)
If purchased, this Endorsement forms part of Your policy and is subject to ALL of the terms and conditions,
including definitions, of Your Medipac Travel Emergency Medical Insurance Policy. MedipacPLUS is only in
effect during the Medipac period of coverage.
CLAIM FORGIVENESS
If You are entitled to a Medipac Claim Free Discount for Your next policy purchase, and You add this
Endorsement, the claim that causes You to exceed Your deductible is forgiven and not considered a claim for
the purpose of calculating Your Medipac Claim Free Discount; any subsequent claims will not be forgiven for
this purpose. Your current discount will carry forward for your next year's purchase.
POLICY MAXIMUM
Policy Page 8 under “IS THERE ANYTHING ELSE I NEED TO KNOW?” Point A. has been modified as follows:
A. T his policy will reimburse You for Covered Expenses up to a maximum of $5,000,000 USD per Insured.
MEDICAL EVACUATION BENEFIT
The Medical Evacuation Benefit pays You $100 CAD per day to a maximum of 10 days if Medipac
Assist returns You to Canada for medical reasons and You are Hospitalized within 3 days of Your return.
Hospitalization must be for consecutive days and You must provide medical records of Your Canadian
Hospital stay when making a claim under this benefit.
RETURN TO CANADA BENEFIT
The Return to Canada Benefit covers the cost of a return economy class airfare to a maximum of $2,000 to
fly You from Your vacation destination to Canada and back to Your vacation destination. Any flight outside
Your Period of Coverage is not eligible for reimbursement. In addition, this benefit covers out-of-pocket expenses including ground transportation and accommodations to a maximum of $350. This benefit is payable
in the event a member of Your Immediate Family, who is not travelling with You, dies after You leave Home; or
a natural disaster causes Your Principal Residence to become uninhabitable after You leave Home (provided
Your home insurance policy pays for the damage in part or in full). The Company requires all original receipts
for the expenses incurred. This benefit must be approved in advance by Medipac Assist.
Additional Definitions under MedipacPLUS
“Company”, under MedipacPLUS, refers to Old Republic Insurance Company of Canada or Reliable Life
Insurance Company.
“Home” means Your Canadian province or territory of residence.
“Immediate Family” means Spouse, Mother, Father, Mother-in-law, Father-in-law, Son, Daughter, Son-in-law,
Daughter-in-law, Grandson or Granddaughter. Brothers and Sisters are not included.
“Principal Residence” means the dwelling located at the Canadian address indicated in Your application for
the Medipac Travel Emergency Medical Insurance Policy under which this Endorsement was purchased.
EXCLUSION FOR RETURN TO CANADA BENEFIT
No benefits are payable if:
1. The deceased Immediate Family member was Hospitalized within 30 days prior to the Effective Date of
Insurance or Your Trip Start Date; OR
2. A t the time You applied for coverage, a reasonable person would have expected that an event payable
under the Return To Canada benefit would occur prior to Your scheduled return date.
40
www.medipac.com
MedipacPLUS Endorsement (If purchased)
EXCESS LUGGAGE BENEFIT
NEW
The Excess Luggage Benefit reimburses up to $500 in shipment expenses to return Your Excess Luggage to
Canada if Medipac Assist returns You to Canada for Medical Treatment during Your Period of Coverage if You
are unable to return Your Excess Luggage by any other means. The Company requires all original receipts for
the expenses incurred. This benefit must be approved in advance by Medipac Assist.
PET BENEFIT
The Pet Benefit reimburses up to $750 in transportation expenses to return Your pet(s) to Canada if Medipac
Assist returns You to Canada for Medical Treatment during Your Period of Coverage; or ifYou have an eligible
claim under the Return to Canada benefit, the Company will reimburse You for boarding costs for Your pet(s)
for 1 week up to a maximum of $500 while You are in Canada. The Company requires all original receipts for
the expenses incurred. This benefit must be approved in advance by Medipac Assist.
ACCIDENTAL DEATH BENEFIT
Insured Risk
You are covered for $5,000 CAD if You die as a result of an accident which occurred while You are outside
Your province or territory of residence and while Your Medipac Travel Emergency Medical Insurance policy is
in force.
This benefit is payable to Your estate for the loss of Your life resulting within 12 months from the date of the
accident described as an insured risk.
This benefit will begin on Your Effective Date of insurance and will remain in effect during the Period of
Coverage as defined on page 1 of Your Medipac Travel Emergency Medical Insurance policy.
EXCLUSION FOR ACCIDENTAL DEATH BENEFIT
The Company will not pay any claim under the Accidental Death Benefit resulting directly or indirectly from:
1. Training, serving or taking part in any capacity in armed forces (land, sea or air) or their operations in any
country or international authority.
2. W
hile serving as a pilot or crew member of any aircraft or while as a passenger in an aircraft which is
being used for a purpose other than transportation.
3. While making a parachute jump for any purposes other than to save Your life.
Claims Procedures
To make a claim under this benefit, written notice of the accident must be given to the Company within
30 days of the date of the accident and written proof must be submitted within 90 days of the date of
the accident. The Company provides the necessary claim forms as well as instructions covering other
requirements that may aid in a prompt handling of the claim.
If the Company does not receive the required notice and proof of loss, the claim may not be considered after
the 90 day period has expired, unless there is a good reason for the delay. In no event is a claim considered
after one year from the date of the accident if the Company was not notified and the necessary forms not
completed and submitted to the Company.
1-888-MEDIPAC (1-888-633-4722)
41
Notice on Privacy
Privacy
Collecting personal information about You is essential to our ability to offer You high
quality insurance products and service. The information provided by You will be used
only for determining Your eligibility for coverage under the Policy, assessing insurance
risks, managing and adjudicating claims and negotiating or settling payments to third
parties. This information may also be shared with third parties, such as other insurance
companies, health organizations and government health insurance plans to adjudicate
and process any claim. In the event that we must share Your information with a
third party who conducts business outside of Canada, there is a possibility that this
information could be obtained by the government of the country in which the third party
conducts business. We take great care to keep Your personal information accurate,
confidential and secure.
Our privacy policy sets high standards for collecting, using, disclosing and storing
personal information. If You have any questions about our privacy policy, please contact
our privacy officer at 905-523-5587; by writing to : Privacy Officer, Old Republic
Insurance Company of Canada/Reliable Life Insurance Company, P.O. Box 557,
Hamilton, Ontario, L8N 3K9; or by email to [email protected]
Administration Fees
1. Change (first change at no charge)....................................... $20.00
2. NSF cheque......................................................................... $25.00
3. Rush Service (overnight courier)........................................... $25.00
Two-day courier................................................................... $15.00
4. Extension............................................................................. $10.00
5. Top-up.................................................................................... FREE
6. Cancellation for medical reasons............................................ FREE
7. Non-medical cancellation.................................................... $50.00
8. Partial refund....................................................................... $20.00
42
www.medipac.com
Short Term Rates
Short-Term Travel Medical Insurance
Medipac offers coverage for short-term travel at affordable rates, perfect for friends or family
who visit you at your winter destination.
You can also turn your short-trip plan into year-round protection with our 23-day Annual Add-on.
If you are over age 55, complete the application to determine your rate category and find your
rate on pages 44 to 46.
If you are age 55 and under, there are no medical questions. Simply call Medipac to purchase or
apply online at www.medipac.com.
Family plans are available, provided that both you and your spouse are under the age of 56, all
of your children are at least 3 months old and under the age of 19 and all family members are
travelling together on the same trip (for the definition of children see policy page 2).
INDIVIDUAL RATES FOR APPLICANTS AGE 55 AND UNDER
$99 USD DEDUCTIBLE
TRIP LENGTH
AGE
1-3
TO 55
55
4-6
61
7-9
Zero Deductible add 10%
to $99 Deductible Rates
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
66
71
73
79
85
92
97
106
110
119
128
Annual
23 Day
Add-on
65
You must buy a minimum 22-24 day trip to purchase the Annual Add-on.
FAMILY RATES FOR APPLICANTS AGE 55 AND UNDER
$99 USD DEDUCTIBLE
1-3
TO 55
TRIP LENGTH
AGE
110
4-6
122
7-9
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
132
142
146
158
170
184
194
Annual
23 Day
Add-on
212 220 238 256 130
Note: If you or your spouse is over the age of 55 or if any child is over the age of 18, you must
purchase a separate policy for that person and a family policy for everyone else.
Family plans cannot be extended beyond 40 days.
Call 1-888-633-4722 for more information or assistance
1-888-MEDIPAC (1-888-633-4722)
43
Short Term Rates
SHORT TERM RATES FOR INDIVIDUALS OVER AGE 55
PREFERRED PLUS - $99 USD DEDUCTIBLE
AGE
1-3
4-6
7-9
TRIP LENGTH
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
69
75
81
85
98
110
125
137
148
159
169
61-65
74
79
88
95
105
121
133
151
163
175
191 205 225 105
66-70
78
83
92
99
110
127
145
163
179
191
210 226 244 127
71-75
83
89
98
110
124
146
170
191
210 230 259 287
319 149
76-79
89
107
151
175
198 234 269 305
341 380 408 439
475 212
80-85
119
351 404 455
613 681 754
86+
151 225 296
156 246 343 425
AGE
1-3
4-6
525
185
197
80
816 905 327
513 601 681 779 888 999 1,145 1,305 1,456 408
PREFERRED PLUS - $1,000 USD DEDUCTIBLE
TRIP LENGTH
7-9 10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
64
69
76
79
91
105
119
131
143
155
164
179
189
77
61-65
68
75
81
86
99
114
129
140
155
165
182
195
211
92
66-70
72
79
87
95
105
120
135
150
168
185
198
210 230 108
71-75
76
85
92
106
119
141
166
187 205 221 244 270 299 125
76-79
81
99
138
167
189
215 248 277
80-85
106
136 200
261
313 359 404 486 545 590 669 727 808 285
86+
134
213 291 368 437
AGE
1-3
4-6
316 353
378 404 440 187
519 589 673 777 864 952 1,124 1,253 355
PREFERRED PLUS - $5,000 USD DEDUCTIBLE
TRIP LENGTH
7-9 10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
58
62
66
70
79
88
97
107
116
125
131
139
149
66
61-65
61
65
69
76
85
97
106
115
125
136
147
160
177
76
66-70
65
69
73
80
89
103
115
127
138
148
163
176
195
88
71-75
69
76
85
95
105
119
131
145
158
173
194
215 239 103
76-79
72
86
119
141
162
183 205 228 256 286 306 330 356 149
80-85
89
106
86+
109
176 207 246 284
319 364 423 469
167 230 288 349 408 462
528 634 722
516 564 626 219
813
911 1,017 287
44
www.medipac.com
Short Term Rates
PREFERRED - $99 USD DEDUCTIBLE
AGE
1-3
4-6
7-9
TRIP LENGTH
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
56-60
79
89
109
135
155
173
61-65
89
110
129
148
169
188 209 229
66-70
101
129
160
185
214 245
71-75
113
149
185
214
247 279 322 352 392
76-79
135
173 239 298 354 394 469
80-85
189 245
86+
AGE
4-6
199
274 299
217 234
249
271 299 106
249 267 278 295 325 143
331 352
375 406 435 198
424 455 490 565 231
516 582 636 659
746 855 331
341 439 538 599 699 809 906 986 1,082 1,197 1,355 463
250 344 501 632 779
1-3
189
Annual
23 Day
Add-on
7-9
916 1,068 1,200 1,348 1,472 1,604 1,741 1,899 571
PREFERRED - $1,000 USD DEDUCTIBLE
TRIP LENGTH
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
73
85
99
115
131
156
61-65
81
96
119
141
159
178 202
66-70
95
110
149
174
197
218 256 283
71-75
105
126
168
199 233 257 305 330 368 392 425 460 490 186
76-79
127
160
224
275 328 365 434
80-85
145
215 322 406 495 555 655 738 829 905 1,002 1,107 1,190 377
86+
225
319 463 584
AGE
1-3
4-6
7-9
179
189 205 222 234 255
278
85
219 239 253 269 284 299 125
312 330 344 382 409 161
476 538 588
610 691
744 261
721 835 989 1,092 1,248 1,362 1,474 1,610 1,751 497
PREFERRED - $5,000 USD DEDUCTIBLE
TRIP LENGTH
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
69
77
88
99
115
129
138
149
161
169
179
61-65
75
85
99
114
125
139
149
159
169
181
192 206 239 103
66-70
87
105
122
143
164
179
197
215 229 239
252 280 326 131
71-75
99
121
138
164
191
211 230
76-79
121
155
185 228 270 304 335 356 402 428 456
80-85
132
188
270 338
86+
207
275 384 494 609 699 758 832 935 1,017 1,115 1,225 1,333 399
410 456
199 222
83
249 269 287 302 338 406 151
517 592 216
525 568 630 683 750 829 892 308
1-888-MEDIPAC (1-888-633-4722)
45
Short Term Rates
AGE
1-3
4-6
STANDARD - $99 USD DEDUCTIBLE
TRIP LENGTH
7-9 10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
56-60
89
100
116
142
61-65
100
116
142
183 209
66-70
109
133
190 226 271 299 358 392 440
71-75
119
151 221 270 325 356
76-79
136
185
80-85
185
281 425 555 665
86+
276 353
183 209
416
231
231 271
414
479 555
259
281
Annual
23 Day
Add-on
319
352
376
281 330 352
376
416 452 208
478
416 171
524 548 588 263
478 540 587 653
710
752 360
641 727 808 898 999 1,099 546
755 899 1,042 1,182 1,315 1,482 1,641 1,786 768
278 420 690 877 1,101 1,243 1,471 1,724 1,942 2,074 2,217 2,378 2,587 1,152
AGE
1-3
4-6
7-9
STANDARD - $1,000 USD DEDUCTIBLE
TRIP LENGTH
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
85
95
110
135
161
61-65
95
110
135
161
189 204 225 248 284
66-70
101
125
168
199 238 265
71-75
109
141
196 239 299 325 368 425
76-79
125
175 244
80-85
166 225
375
86+
246 372
610 783 973 1,101 1,246 1,471 1,680 1,873 1,999 2,111 2,255 1,008
AGE
1-3
4-6
7-9
312
179 204 225
316
248 284
313 333 369 152
313 333 369 401 185
347 390 427 464 484 509 227
478
520 577 629 699 311
370 435 499 557 643
715 794 892 977 473
475 544 654
757 890 1,035 1,164 1,311 1,452 1,580 664
STANDARD - $5,000 USD DEDUCTIBLE
TRIP LENGTH
10-12 13-15 16-18 19-21 22-24 25-27 28-30 31-33 34-36 37-40
Annual
23 Day
Add-on
56-60
78
89
103
119
140
159
174
186
61-65
82
103
125
140
161
174
186
199 222 243 262 286 329 150
66-70
95
115
139
172 208 228 259 269 304
71-75
101
129
169 206 248
76-79
115
165
210 269
80-85
155
215 300
86+
276
316 334
199 222
262 286 117
331 358 377 425 184
371 404 448 487 535 253
318 367 409 439 493 553
381 449 508 599 705
243
616 692 768 376
811 903 1,017 1,126 1,227 523
219 293 485 623 776 903 1,044 1,187 1,330 1,454 1,563 1,681 1,825 796
46
www.medipac.com
Trip Days – Quick Calculator
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JUL
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TRIP DURATION CALCULATOR
Select the Red numbers beside your departure and return dates. Insert them
into the formula and complete the calculation. Statutory holidays shown in green.
EXAMPLE: (If you are leaving
CALCULATE YOUR
October 15 and returning March 25)
TRIP LENGTH:
Return Date #
237
minus Effective Date #
-76
subtotal
161
Add 1
+
Equals Trip Duration (days)
1
+
1
162
Select the 165-day package to
cover your entire trip.
1-888-MEDIPAC (1-888-633-4722)
47
Strength In Partnership
Quality
Value
Reliability
Financial Strength
… A Tradition of Excellence
Need Help? Just Call
1-888-MEDIPAC
1-888-633-4722
You can apply online at www.medipac.com
Rates subject to change

Medipac Travel Insurance Guide

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