Bringing parents or grandparents to Canada under the Super Visa and Visitor visa can be a wonderful way to spend time with family and loved ones. However, one critical requirement established by the Government of Canada is ensuring they have adequate medical insurance, especially if they have pre-existing conditions. In this blog, we are going to specifically shed some light on a very specific case of people having pre-existing conditions like diabetes and heart issues together. Understanding how these conditions impact insurance coverage is essential. So, let’s delve into it further.
The quick answer is: it depends on the policy and the stability of the conditions. Most insurers in Canada offer multiple plans, broadly two kinds; one that covers pre-existing conditions and one that does not. Having said that, insurers do not automatically cover pre-existing conditions under the under the no-preexisting conditions plans. They will give you a questionnaire and when you (and you must) disclose all the pre-existing conditions, along with their last stability, medications being taken etc., to your insurance advisor. Stability is the key factor that insurance providers look for. Generally, a condition is considered stable if there have been no significant changes in treatment, medication, or symptoms for a specific period, typically between 90 and 180 days, before the policy starts. Some may even have requirement for 365 days and they may offer some implicit price break if the stability period is more.
Defining what counts as a “stable” condition can vary by insurance provider, but generally, it includes the following criteria:
Now, let’s say for instance, imagine your parent or grandparent has diabetes that has been well-controlled for the past six months, maintaining consistent blood sugar levels and not requiring any emergency care or hospitalizations. In this case, they may be considered stable and might qualify for coverage related to their diabetes. However, if they also experienced a recent heart attack or underwent a procedure for heart issues (along with their diabetes condition) during that same period, it could complicate matters significantly. The insurance provider may classify the heart condition as unstable, which could lead to exclusions for any related medical expenses in Canada. And based on our research, typically cases like these are excluded under “eligibility criteria” not fulfilled by most insurers in Canada.
If your loved one’s diabetes or heart condition is deemed “unstable,” they may still be able to get insurance, but most likely it won’t cover these specific conditions. For instance, if an individual has a history of fluctuating blood sugar levels and recent hospital visits related to diabetes and/or heart condition, any resulting medical costs in Canada would likely be out of pocket.
Example: Consider a situation where a visitor with diabetes has to go to the hospital for a routine check-up but has experienced symptoms of heart or vice-versa in the weeks leading up to the trip. If their condition is deemed unstable, the insurance may cover other unrelated health issues but exclude any treatments related to their diabetes and heart.
For individuals with significant pre-existing conditions, there are specialized high-risk travel insurance policies. These plans often come with higher premiums but can offer comprehensive coverage, including pre-existing conditions, depending on the assessment of stability. For your satisfaction and peace of mind, please check with your insurance advisor to explore this option for you.
While applying for such a policy, insurers may request detailed medical histories and potentially require a medical examination. This step can provide peace of mind that should any medical emergencies arise related to those conditions, the coverage will kick in.
While it’s reassuring to hear that some insurance advisors or insurers might verbally confirm that diabetes and heart conditions can be covered together, it's crucial to approach such assurances with caution. Always remember to get everything in writing. Verbal agreements can be misleading or misinterpreted, especially when it comes to complex insurance terms. Ultimately, if you didn’t had anything in writing explicitly, you will have to bear the burden of the associated costs, if any emergencies do happen.
Insurance policies often have fine print that outlines specific exclusions and conditions that might not be discussed in casual conversations. Even for exclusions, many policies might have vague statements. For instance, just because a representative states that your loved one's diabetes will be covered doesn't guarantee that any complications arising from heart conditions will also be included. If your loved one experiences a health issue related to their heart while the policy excludes it, the costs could be substantial.
Additionally, be aware of edge cases. Some insurers might have specific criteria regarding the stability of pre-existing conditions that they don’t disclose upfront. For example, if an individual has a recent history of hospitalization for heart issues but has stable diabetes, the insurer may consider that history a risk factor that affects overall coverage eligibility.
Finally, always read the policy documents carefully before signing anything. If there’s something that feels ambiguous or unclear, don’t hesitate to ask questions until you fully understand what’s covered. Insurance is designed to provide peace of mind, so ensuring you have clear and accurate information is key to avoiding unexpected surprises down the road.
When shopping for Super Visa and Visitor insurance, be sure the policy meets the $100,000 minimum coverage requirement mandated by the Canadian government. Here are additional considerations specifically for those with diabetes and heart conditions:
In a discussion thread on CanadaVisa, one user shared their experience of trying to purchase coverage for a relative with both diabetes and heart conditions. They shared their experience as (in their own words) “I don't think there are any insurance companies out there that offer health insurance to patients who have both diabetes and heart issues.”
Another case on Tripadvisor highlighted a traveler who faced difficulty in finding affordable insurance because of pre-existing conditions and their experience was (in their own words) “I didn't qualify for the insurance available through the travel agent because of diabetes and heart issues.”. This emphasizes the importance of seeking personalized quotes that take health history into account.
Insurance companies often assess risk based on a person’s health profile, and having both diabetes and heart conditions (specifically even if one is unstable) raises several medical concerns that impact coverage decisions. Here’s why insurers may be cautious:
Compounded Health Risks: Both diabetes and heart disease can lead to serious health complications. Diabetes increases the risk of cardiovascular issues, while heart conditions can exacerbate diabetes management. This interconnectedness means that individuals with both conditions may face higher medical risks, prompting insurers to limit or exclude coverage to mitigate potential costs.
Complexity of Treatment: Managing diabetes and heart conditions often involves complex treatment regimens, including medications and lifestyle changes. If either condition fluctuates or worsens, it can complicate treatment for the other. Insurers recognize that these complexities can lead to increased healthcare needs, making them more hesitant to provide comprehensive coverage.
Stability Concerns: Insurers typically require that pre-existing conditions be stable for a certain period before they can offer coverage. If a person has experienced changes in their diabetes control or has had recent heart issues, the insurer may view both conditions as unstable. Stability is crucial for insurers to assess risk accurately and provide coverage.
Increased Healthcare Utilization: Individuals with both diabetes and heart conditions are likely to require more frequent medical visits, tests, and potentially hospitalizations. This higher utilization of healthcare services presents a financial risk to insurers, leading them to impose exclusions or restrictions on coverage for these conditions.
Potential for Complications: The presence of both conditions significantly raises the likelihood of complications, such as heart attacks, strokes, or diabetic emergencies. Insurers are aware that these complications can result in high costs, prompting them to limit coverage to protect their financial interests.
If your loved one has diabetes or a heart condition and experiences a medical emergency, the outcome hinges on whether the policy covers those pre-existing conditions. If covered, insurance should pay for necessary treatments, hospitalizations, or doctor visits. However, if those conditions aren’t covered due to exclusions or instability, they will likely be responsible for the costs themselves, which can be substantial in Canada.
Navigating Super Visa and Visitor insurance can feel stressful, especially with the added complexity of pre-existing conditions like diabetes and heart disease. We believe, that finding the right advisor is more important than finding the right policy. If you found the right advisor, he will take all this burden from you and do research and find the right product on your behalf. Also, remember, it’s crucial to disclose all relevant health information and understand the policy details thoroughly.
For the best outcome, consult with insurance providers or brokers who specialize in Super Visa and Visitor policies. They can help clarify the nuances, ensuring that your family enjoys their time in Canada without worrying about unexpected health-related expenses. After all, the goal is to make lasting memories together, not to stress about potential medical issues.
The above article is for informational purposes only and should not be considered as professional advice. Always consult with a licensed insurance broker or financial advisor before making any decisions regarding insurance coverage.