Visitors to Canada Medical Insurance
&
Returning Canadians from Ray Battiston
21st. Century Travel
Insurance Ltd, underwritten by Manulife
Financial

The 21st. Century, Manulife policy is one of
our best Visitor to Canada Medical Insurance Plans. It can be
purchased prior to arrival for immediate coverage on
arrival, with no age limit. It can also be
purchased after arrival, subject to a waiting period as
described below. Unlike most visitors plans, it can
cover stable pre-existing conditions right up to age 85,
as defined in the policy. Applicants age 70 -85
will have to answer "no" to four short questions on the Medical
Declaration in order to qualify for Stable Chronic Condition
coverage. Younger visitors will have to have stable medical
conditions (details in policy wording).
Yes, there is a difference in coverage
with Visitors Insurance plans. Always ask your Broker if
Pre-existing medical conditions can be covered! This plan DOES
cover stable chronic conditions as outlined in the policy
wording. (up to age 69, optionally age 70-85)
Manulife Insurance "brands"
different programs. This particular program is another
Manulife variation sold by over 700 Agents and Brokers,
including our office. The premium rate charged by all 700
plus Brokers through this program are exactly the same.
We are proud to be one of the oldest and largest producing Brokers contracted with 21st Century Travel Insurance
Ltd.
You can purchase Manulife Insurance Visitors to
Canada Medical Insurance from us via E mail, scanned e mail,
fax or phone, or can download
the following policy and rate information to study before you
buy! We do recommend you speak with one of our
Brokers prior to purcahse. You should get a response either the
same day, or next day at the latest. Coverage is bound as soon
as I confirm this to you. The original policy, receipt and ID
card is always mailed out via Canada
Post.
Medical
Declaration -required for age 70-85 applying for
Table 2 pre-existing conditions
FULL
POLICY WORDING FOR NEW POLICIES Effective june 15 2009 - yOU
CAN PRINT OUT THIS WORDING TO REVIEW POLICY TERMS, CONDITIONS,
EXCLUSIONS, AND COVERAGE.
New: SIDE TRIPS WORLD WIDE FOR
VISITORS TO cANADA. rEAD THE
CONDITIONS
Visitors Claims Form: Claim
Form
Maximum Coverage Period
Coverage is available under a policy for 365 days in total
for ages up to 85. For those age 86 and older, coverage can be
purchased to insure up to the first 180 days following
the date of a arrival in Canada from your country of
origin.
Maximum limit now available is
$150,000 per person to age 80, $100,000 81 and over.
Additional $50,000 of coverage is
available for Accident claims when the $100,000 option is
chosen.
$10,000. Accidental Death & Dismemberment
is automatically included for ALL applicants.
All Applicants us Table 1 unless Age 70-85
and applying for "stable chronic condition" Option.
| 21ST CENTURY TRAVEL INSURANCE LIMITED RATE PER
DAY/PERSON- MINIMUM POLICY OR EXTENSION PREMIUM IS
$25.00 PER POLICY (Family rate=double highest
single) |
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Rates with Regular Deductible of $50 ($500 age 86+) |
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Table 1 |
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Is SCC Option Included? |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
No |
No |
No |
No |
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Up to 25 years |
26 to 34 years |
35 to 39 years |
40 to 54 years |
55 to 59 years |
60 to 64 years |
65 to 69 years |
70 to 74 years |
75 to 79 years |
80 to 85 years |
86 and older |
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$10,000 |
$1.55 |
$1.65 |
$1.75 |
$1.85 |
$1.96 |
$2.88 |
$3.09 |
$3.76 |
$4.33 |
$4.69 |
$9.01 |
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$15,000
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$1.91 |
$1.96 |
$2.06 |
$2.37 |
$2.52 |
$3.30 |
$3.86 |
$4.74 |
$5.36 |
$6.08 |
$11.59 |
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$25,000
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$2.01 |
$2.16 |
$2.32 |
$2.68 |
$2.88 |
$3.86 |
$4.38 |
$5.46 |
$5.87 |
$6.75 |
$13.65 |
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$50,000
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$2.32 |
$2.47 |
$2.58 |
$3.04 |
$3.24 |
$4.53 |
$5.15 |
$6.49 |
$7.36 |
$8.55 |
n/a |
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$100,000
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$3.04 |
$3.35 |
$3.55 |
$4.53 |
$4.69 |
$5.61 |
$6.95 |
$8.14 |
$9.58 |
$10.82 |
n/a |
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$150,000
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$3.32 |
$3.77 |
$4.18 |
$5.48 |
$6.12 |
$8.62 |
$11.48 |
N/A |
N/A |
N/A |
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Table 2 |
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Is SCC Option Included? |
Yes |
Yes |
Yes |
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70-74 years |
75 to 79 years |
80 to 85 years |
86 and older |
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$10,000 |
$4.53 |
$5.41 |
$7.21 |
n/a |
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$15,000
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$5.82 |
$6.70 |
$9.06 |
n/a |
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$25,000
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$6.28 |
$7.62 |
$10.56 |
n/a |
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$50,000
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$7.47 |
$9.58 |
$12.41 |
n/a |
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$100,000 |
$9.37 |
$11.59 |
$15.71 |
n/a |
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Deductible Options up to age 85 |
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Rates with $0 Deductible |
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Apply 5% surcharge |
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Rates with $250 Deductible |
Apply 10% discount |
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There is a standard $50.00 deductible
on ages to 85. On ages 86 and above there is a $500.
deductible. For ages to 85 wishing a $0. deductible add
5% to the premium and advise us 0 is required.
An option $250 deductible results in a
10% premium discount.
What is the Stable Chronic Condition
Option?
When this option is automatically
included to age 69 in Table 1 or purchased for the extra
premium in Table 2, the Pre-Existing condition exclusion will
not apply to Insured Services incurred after any applicable
Waiting Period to respond to a Stable Chronic Condition (as
defined in the policy)
Note that, even with this option included,
conditions that do not fit the definition of Stable Chronic
Condition are still subject to the regular exclusion
(reproduced below).
Pre-existing Condition
Exclusion:
“ We” will not
reimburse “you” for “insured services” or pay an Accidental
Death and Dismemberment claim arising from:
1. any sickness, disease or “injury” which had
manifested itself in the 180-day period immediately preceding
the “effective date” of this policy. Unexpected “emergency”
sickness, disease or “injury” shall be considered to have
manifested itself when:
a) medical care, advice, investigation or
treatment has been received; or b) drugs or medicines have been
taken or prescribed to treat the sickness, disease or “injury”;
or c) “you” have experienced symptoms which would cause a
reasonably prudent person to seek diagnosis, care or treatment.
Important Note: A “stable chronic condition” is
covered (Exclusion # 1 a) to c) will not apply) in the following
circumstances:
i) to a condition that was diagnosed or treated
more than 180 days prior to the “effective date” and which did
not require any treatment during this 180 day period; or ii) to
“insured services” incurred after any applicable “waiting
period” to respond to a “stable chronic condition”, if “you” are
under 70 years of “age” on the policy “effective date”; or iii)
to “insured services” incurred after any applicable “waiting
period” to respond to a “stable chronic condition”, if “you” are
70 to 85 years of “age”, completed the Medical Declaration and
paid the required premium to purchase the “stable chronic
condition” option. Note that the “stable chronic condition”
option is not available to applicants who are “age” 86 or over
on the “effective date” of coverage. Under Exclusion #1, each
time “you” purchase another policy from “us” because “you” are
staying in Canada longer, each new policy will have a new
“effective date” and “you” will not be covered under the new
policy for any sickness, disease or “injury” which had
manifested itself in the 180-day period immediately preceding
that new “effective date”.
Manulife
VISITORS INSURANCE POLICY HIGHLIGHTS* New plan June 15 2009
APPLICATION:
VISITORS TO CANADA HEALTH INSURANCE
(if e mailing
application, copy and paste into your e mail, or scan
application and e mail in, faxes also accepted) Eligibility
and Premium rates:
“ You” are not
eligible for coverage under this policy if: • a “physician” has
advised “you” not to travel; • “you” have been diagnosed with a
terminal illness with less than two (2) years to live; • “you”
have a kidney condition requiring dialysis; and/or • “you” have
used home oxygen during the 12 months prior to the date of
application. Provided “you” are under “age” 70, the “stable
chronic condition” option in Exclusion #1 relating to “stable
chronic conditions” automatically applies to “you”. No Medical
Declaration is required.
If “you” are “age” 70 to 85, a Medical
Declaration must be completed to determine if “you” are eligible
for the “stable chronic condition” option. Eligibility for this
option will be determined by answers provided in the completed
Medical Declaration. If eligible and purchasing this option,
“you” must pay the premium set out in Table 2 of the premium
rate card. If “you” waive this option, no Medical Declaration is
required and “you” pay the premium set out in Table 1 of the
premium rate card.
Insured
(family name)
(first
name)
(date of
birth)
1)_____________________________________________________________________________
2)_____________________________________________________________________________
3)_____________________________________________________________________________
Country
of Origin:__________________________ Name of
Sponsor____________________
check only one: ( ) New
Immigrant ( ) Returning Canadian(s) ( )
Visitor ( )Work/student ( )
Other_____________
Check only one: ( ) Prior 21st
Century Travel Insurance Policy #__________( )
None
Do I need to complete the Medical
Declaration?
Under age 70- Rate Table 1, Medical
Declaration not required
Age 86 and over: Rate Table 1, Stable
Chronic Condition Option not available but must complete
Medical Declaration
Age 70- 85: Rate Table 1 for new
conditions, choose Rate Table 2 to cover pre-existing
conditions, and requires "no" answers to Medical
declaration
( ) I would like to apply for Table 2
stable chronic conditions
( ) I do not wish to apply for Table 2
stable chronic conditions, age 70- 85
() $0. Deductible Option requested
to age 85. Add 5% to premium.
() $250 Deductible Option, delete 10% to
age 85.
Medical
Declaration -to be used for ages 70-85, must be downloaded, signed and faxed
to Ray Battiston . Applicants age 70-85 answering "yes"
are not eligible for Table 2 stable chronic condition
coverage. Please contact Ray Battiston for further review. Age
86 plus must complete this Declaration.
For Visitors who are already in
Canada and have other coverage during the first part of their
trip- they can apply under the Special
Eligibility Questionnaire to apply to waive the waiting
period. Please allow at least five business days for this
approval. Proof of other coverage will be
required
Address in Canada
___________________________________________________________
Home
Address
_____________________________________________________________
Phone
Number
Residence____________________________________Business______________Fax________________
E
Mail__________________________________Web
page__________________________
Arrival Date in
Canada________________________________
Effective
Date___________ Expiry Date ________________Number of
days_____________
COVERAGE
________________________________________________________________________________
PLAN
Limit _____# OF PERSONS_____ RATE/PERSON__ NO. of DAYS____
PREMIUM____ Family rate is twice the older adult premium
rate and list all Applicants on the App. A "Family" is
defined as three or more of Parent(s), or legal guardian(s)
and their unmarried children under Age 21 who are visiting
Canada with them and dependent on them for their sole means of
financial support.
Premiums paid determines coverage
purchased. Minimum premium of $25.00. Age means
the age on the effective date of the
policy. ________________________________________________________________________________
$10,000._________________
X_____________X___________
=$___________________
$15,000.__________________x______________x____________=$__________________
.
$25,000.__________________x______________x____________=$__________________
$50,000___________________x_____________x____________=$__________________
$100,000.__________________x_____________x____________=$__________________
$150,000,
_________________x______________x____________=$_________________
This certificate is an extension of Certificate
#________________________________ Total coverage must not
exceed 365
days.
__________________________________________________________________________________ DATE
OF APPLICATION DAY MONTH YEAR TIME OF
ISSUE
____________AM/PM
__________________________________________________________________________________ SIGNATURE
OF APPLICANT OR
SPONSOR
X________________________________________________
PREMIUM
PAYABLE TO RAY BATTISTON INSURANCE OR BY VISA OR Master
Card
(CIRCLE CHOICE) CARD
#________________________________ EXPIRY
DATE_________
SIGNATURE OF CARDHOLDER
X___________________________
NAME of cardholder__________________
CREDIT CARD
PAYMENT PLEASE FAX TOLL FREE IN NORTH AMERICA TO RAY BATTISTON
1-888-751-5124 or 705
752-5198
x_____________________________________________ Medical
Declaration This app can be used for applying for
chronic conditions coverage ages 71-85. The new Medical Declaration is not
yet available. However, the questions do not change
other than the addition of the word “congestion” before “heart
failure” in Question 1. We will now ask about
“congestive heart failure”, which is a much more specific
medical problem. Also, it will now be used for Stable
Chronic Condition coverage up to age 85 and ANY
coverage age 86 and over.
For age 86 plus, if there are
any "yes" answers on the Medical Declaration, no coverage of
any kind is available form 21st Century.
For visitors who have been in Canada
over 30 days, or have let their Manulife policy lapse longer
than 3 days there will be an additional waiting period
on sickness as outlined in the policy wording.
EXTENSION REQUESTS SHOULD
BE MADE PRIOR TO EXPIRY FOR CONTINUED INSURANCE.
EXTENSION PREMIUMS ARE NOT GUARANTEED.
MINIMUM POLICY OR EXTENSION PREMIUM IS $25.00
PER POLICY (Family rate-double highest
single)
Full Policy Wording on policies purchased on
or after
June
15 2009
Visitors to Canada Medical
declaration-for chronic care application age 70-85, and all
ages 86 and over for table 1 rates (new conditions only) Visitors
Medical Declaration, 70-85
Visitors Claims Form: Claim
Form
Cancellation requests:
CANCELLATION REQUESTS ARE CONSIDERED PROVIDED NO
CLAIM HAS TAKEN PLACE AND THERE IS MORE THAN $25.00 IN
PREMIUMS PAID IN ADVANCE. 21ST cENTURY REQUIRES PROOF OF
DEPARTURE, OR PROOF OF cANADIAN GOVERNMENT INSURANCE WITH A
LETTER STATING CANCELLATION DATE REQUEST AND CLAIM WILL NOT BE
FILED. tHIS SIGNED LETTER AND PROOF CAN BE FAXED OR
SCANNED AND E MAILED TO US. 21ST. CENTURY CHARGES A $25.00
CANCELLATION PENALTY FOR EARLY POLICY
CANCELLATIONS. ______________________________________________________________________________________ Disclaimer: This is a brief description
only. Refer to actual policy wording for full details. Policy
is not in force until counter signed and issued by Ray
Battiston, Insurance
Broker
Phone toll free in
North America 1-800-526-7420. EMAIL:mailto:raybattiston@on.aibn.com
Insurance
Plans sold: "Per Trip" and multi trip Out of Canada Medical
Insurance, Visitors Medical Insurance Plans, Air Flight
Accident, 24 Hour Accidental Death & Dismemberment,
Baggage, Trip Cancellation and Interruption, Expatriate
Medical, Rental Vehicle Damage, Group, Dental, Extended
Health.
Contact me today for personal
service on your Travel Medical, Visitors and Expatriates
Insurance requirements
Ray Battiston, BA, CAIB, CIP Insurance Broker 151 Osprey
Cres, Callander, Ontario P0H 1H0 Canada 1-800-526-7420 Toll Free North
America Business: 1
-705-752-1723 FAX
1-705-752-5198 raybattiston@on.aibn.com
Business Hours: 9 am: 5 PM Mon-Friday
EST. Closed holidays. We cannot promise, but we may be able to return
calls on holidays and weekends if we are
available. |