21st Century Visitors to Canada insurance: the three plans, and how to claim
Underwritten by Manulife. Basic, Standard or Enhanced, monthly payments for Super Visa, and what to do when your visitor needs a doctor.
21st Century sells Visitors to Canada and Super Visa insurance underwritten by The Manufacturers Life Insurance Company (Manulife). Assistance and claims are run by Active Care Management (ACM) / Global Excel. This page uses the Basic V11 and Standard/Enhanced V11 wordings, effective December 2025.
In short
21st Century has three plans. Basic is the low-cost option with $500 for drugs and no pre-existing cover. Standard adds full benefits to age 85 with no medical questions. Enhanced has the same benefits and can cover a pre-existing condition stable for 180 days, but from 60 to 85 every answer on its medical declaration must be "No". In an emergency, call the Assistance Centre first, report the claim within 30 days and send proof within 90 days.
Basic, Standard and Enhanced compared
The benefit limits that differ between the three plans. Every other benefit is the same on Standard and Enhanced.
| Feature | Basic | Standard | Enhanced |
|---|---|---|---|
| Pre-existing conditions | Not covered | Not covered | May be covered when stable for 180 days |
| Medical declaration | Not required | Not required | Required at ages 60–85 |
| Ages | Includes rules for 86+ | Through age 85 | Through age 85 |
| Prescription drugs | Up to $500 | Up to $1,500 | Up to $1,500 |
| Extended healthcare | Up to $5,000 | Up to $10,000 | Up to $10,000 |
| Accidental dental | Not included | Up to $4,000 | Up to $4,000 |
| Dental pain relief | Not included | Up to $500 | Up to $500 |
| AD&D | Not included | Up to $50,000 | Up to $50,000 |
| 90-day reinstatement | Not included | Included, conditions apply | Included, conditions apply |
Basic
For a healthy visitor who wants lower-cost emergency cover and doesn't need pre-existing conditions covered. Lower limits, no dental and no AD&D. The current wording has its own rules for applicants 86 and older.
Standard
Full emergency medical and travel-support benefits to age 85, with no medical declaration. Every pre-existing condition is excluded, so it suits visitors with no health history worth worrying about.
Enhanced
Standard's benefits plus possible cover for a pre-existing condition stable for the 180 days right before the effective date. A medical declaration is needed from 60 to 85, with extra heart and lung limits.
Which 21st Century plan can your visitor buy?
A quick check against the plan rules on this page. The insurer's application decides.
A planning aid only. The general eligibility rules below must also be met.
What the policy pays for
The main emergency benefits on Standard and Enhanced, and the condition attached to each.
| Benefit | Maximum or coverage | Condition |
|---|---|---|
| Hospital and physician | Eligible emergency expenses up to the policy limit you choose | Must be medically necessary; reasonable-and-customary limits apply |
| Diagnostic testing | Eligible lab and diagnostic services | Specified advanced tests need prior approval |
| Health-care practitioners | Up to $1,000 combined per emergency | Needs a written referral from a physician |
| Ambulance and repatriation | Eligible ground or air transport | Must be medically necessary and authorized |
| Extra Injury Coverage | An extra $50,000 on an eligible $100,000 Standard or Enhanced policy | Applies to eligible injury expenses only |
The Extra Injury Coverage is worth knowing for Super Visa families: on a $100,000 Standard or Enhanced policy, an accident can be covered to $150,000, while sickness stays at $100,000.
Who can buy 21st Century
Every plan has the same basic eligibility rules. Your visitor cannot be covered if any of these apply on the start date:
- Travelling against a physician's advice
- A terminal illness with less than two years to live
- Recent pancreatic, lung, brain or liver cancer of the kinds the policy lists, or any history of metastatic cancer
- An organ or bone-marrow transplant (a corneal transplant is fine)
- Congestive heart failure
- Home oxygen at any time in the last 12 months
- Kidney dialysis
- Living in a nursing home or long-term-care facility
How the 180-day rule works on Enhanced
Basic and Standard exclude every pre-existing condition. Enhanced may cover one that was stable for the 180 days immediately before the effective date. A new symptom, a new diagnosis, a change in medicine or treatment, a hospital stay, a referral or a test still pending can each break stability.
Two limits sit on top of that. A heart condition is excluded if nitroglycerine was needed for angina in those 180 days, and a lung condition is excluded if prednisone was needed for it in the same period.
The Enhanced declaration
- Who fills it in
- Applicants 60 to 85 who want Enhanced
- What passes
- Every answer must be "No"
- What it asks about
- Recent heart, lung and neurological changes, older heart procedures, internal bleeding, stomach or bowel hospital stays, cancer, prednisone, nitroglycerine, diabetes and heart medicine
- If any answer is "Yes"
- Enhanced is not available; Basic or Standard may be
Waiting periods if you buy after arrival
The waiting periods in the wording apply when you buy after your visitor has arrived. During them, sickness is not covered:
- Standard and Enhanced, bought within 30 days of arrival: 72 hours.
- Standard and Enhanced, bought 31 or more days after arrival: 7 days.
- Basic: extra age-based rules apply from age 86.
A sickness that shows up during the waiting period stays excluded, even if the treatment happens after the period ends. For example, suppose your mother arrives in May, you buy Standard 40 days later, and she starts coughing on day three of the policy. The 7-day wait applies, so the chest infection and anything that follows from it are not covered.
Monthly payments for Super Visa
21st Century lets qualifying Super Visa applicants pay by the month instead of all at once.
- The policy must run at least 365 days with at least $100,000 of coverage.
- At application you pay two monthly premiums plus a $50 non-refundable policy fee.
- The third premium is charged when the policy is activated.
- There is no coverage before activation succeeds.
- The rest is collected on the schedule in the issued payment agreement, which also sets the cancellation terms.
Other insurers handle monthly plans differently. See Super Visa monthly payment plans.
How to make a 21st Century claim
Save these numbers in your visitor's phone before they need them.
- Call before treatmentContact the Assistance Centre before going to a clinic or hospital whenever it is medically possible. If you don't, you may pay 20% of the eligible bills yourself.
- Report within 30 daysTell the claims team about the claim within 30 days of the emergency.
- Send proof within 90 daysSubmit the claim form, medical records, itemized bills, receipts and proof of travel dates within 90 days.
Keep original receipts and copies of everything you send. Step-by-step help for parents' claims is on the Super Visa claim process page.
Refunds and fees
- Unused premium is usually refunded pro rata.
- A $25 minimum premium and a $25 processing fee normally apply.
- Some visa-related cancellations may carry a $250 fee.
- The $50 monthly-plan policy fee is not refundable.
- Claim-withdrawal handling fees may apply.
For example, suppose your father goes home four months into a 12-month policy with no claim. You would usually get back the unused eight months, less the $25 processing fee. More on Super Visa insurance refunds.
What is not covered
- Pre-existing conditions not covered by the plan you chose
- Non-emergency, elective, cosmetic or experimental treatment
- Ongoing treatment after the emergency ends
- Specified pregnancy and childbirth expenses
- Professional or hazardous sports
- Illegal acts, substance abuse and losses linked to intoxication
- Treatment after refusing a recommended medical return home
This is not the full exclusion list. The application, confirmation and issued policy wording govern.
Questions about 21st Century visitors insurance
What are the three 21st Century visitor plans?
Basic, Standard and Enhanced: Basic has lower limits, Standard has full benefits without pre-existing cover, and Enhanced adds cover for conditions stable for 180 days.
Standard and Enhanced list the same benefits. The difference is the pre-existing cover and the medical declaration that comes with Enhanced.
Who underwrites 21st Century visitors insurance?
The Manufacturers Life Insurance Company (Manulife) underwrites it, and Active Care Management (ACM) / Global Excel handles assistance and claims.
Manulife also sells its own Visitors to Canada plans. See Manulife visitors insurance to compare.
What is the difference between Standard and Enhanced?
The benefits are the same; Enhanced can also cover a pre-existing condition that was stable for the 180 days before the start date.
From 60 to 85, Enhanced needs a medical declaration with every answer "No". Enhanced also excludes a heart condition if nitroglycerine was needed for angina in the 180 days before, and a lung condition if prednisone was needed for it.
What if my parent answers "Yes" to a question on the Enhanced declaration?
They can't buy Enhanced, but Basic or Standard may still be available if they meet the general eligibility rules.
Neither of those plans covers pre-existing conditions, so any claim linked to an existing condition would be refused. Ask Pankaj to compare plans from other insurers that accept the condition.
Is there a waiting period if we buy after arrival?
Yes. Standard and Enhanced have a 72-hour sickness waiting period if bought within 30 days of arrival, and 7 days if bought 31 or more days after arrival.
Basic has extra waiting-period rules for applicants 86 or older. A sickness that starts during the waiting period stays excluded even if treatment happens later.
Can I pay 21st Century monthly for a Super Visa?
Yes, for qualifying applicants: two monthly premiums plus a $50 non-refundable policy fee at application, and the third premium when the policy is activated.
The policy must be for at least 365 days with at least $100,000 of coverage. There is no coverage until activation succeeds. More on monthly Super Visa plans.
Do we have to call the Assistance Centre before treatment?
Yes, whenever medically possible; if you don't, you may have to pay 20% of the otherwise eligible expenses.
Canada and the US: 1-877-882-2957. From elsewhere, collect: +1-519-251-7856.
How long do we have to make a claim?
Report the claim within 30 days and send written proof with supporting documents within 90 days.
Claim status line: 1-855-297-4379. Keep medical records, itemized bills, receipts and proof of travel.
How do 21st Century refunds work?
Unused premium is usually refunded pro rata, less a $25 processing fee, with a $25 minimum premium kept.
Some visa-related cancellations carry a $250 fee, the $50 monthly-plan policy fee is never refunded, and claim-withdrawal handling fees may apply. See Super Visa insurance refunds.
Written by Pankaj Bhatia, CHS, PFA
Insure In Canada Inc. · Licensed in Ontario, Alberta, British Columbia, Manitoba, Saskatchewan, New Brunswick and Nova Scotia
Pankaj has 11 years of experience helping visitors, Super Visa families, workers, students and new immigrants compare emergency medical insurance. He goes through the Enhanced declaration with families before they apply.
Sources and related pages
- 21st Century Basic V11 and Standard/Enhanced V11 policy wordings, effective December 2025
- 21st Century Visitors to Canada policy (Standard/Enhanced)
- 21st Century Visitors to Canada policy (Basic)
- Manulife: Visitors to Canada insurance
- IRCC: Parent and Grandparent Super Visa
An independent summary, not the insurer's website. The application, confirmation and issued policy wording govern every claim.