What is 21st Century insurance?
Compare the Basic, Standard and Enhanced plans, including Manulife underwriting, emergency medical benefits, age eligibility, stable pre-existing conditions, the Enhanced medical declaration, waiting periods, monthly payments, claims and refunds.
Underwriter: The Manufacturers Life Insurance Company (Manulife)
Administrator or claims provider: Active Care Management (ACM) / Global Excel
Policy wording
Basic V11 and Standard/Enhanced V11, effective December 2025
Underwriter
Manulife
Monthly plan
Two monthly premiums plus CAD $50 policy fee at application; third premium at activation
Available plan options
Basic
Lower-cost emergency medical coverage for an eligible healthy traveller who does not need pre-existing-condition coverage.
- No pre-existing-condition coverage
- Prescription drugs up to CAD $500
- Extended healthcare up to CAD $5,000
- No emergency dental or AD&D
- Current Basic wording includes age-specific rules for age 86+
Standard
Comprehensive emergency medical and travel-support benefits without pre-existing-condition coverage.
- Available through age 85
- No medical declaration
- Prescription drugs up to CAD $1,500
- Accidental dental up to CAD $4,000
- Dental pain relief up to CAD $500
Enhanced
The Standard benefit package with potential coverage for eligible pre-existing conditions stable for 180 days.
- Available through age 85
- Medical declaration required at ages 60–85
- All declaration answers must be No
- Additional heart and lung restrictions
- Same listed benefits as Standard
Plan comparison
| 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 |
| Prescription drugs | Up to CAD $500 | Up to CAD $1,500 | Up to CAD $1,500 |
| Extended healthcare | Up to CAD $5,000 | Up to CAD $10,000 | Up to CAD $10,000 |
| Accidental dental | Not included | Up to CAD $4,000 | Up to CAD $4,000 |
| Dental pain relief | Not included | Up to CAD $500 | Up to CAD $500 |
| AD&D | Not included | Up to CAD $50,000 | Up to CAD $50,000 |
| 90-day reinstatement | Not included | Included, conditions apply | Included, conditions apply |
Benefit summary
| Benefit | Maximum or coverage | Important condition |
|---|---|---|
| Hospital and physician | Eligible emergency expenses up to the selected policy limit | Medical necessity and reasonable-and-customary limits apply |
| Diagnostic testing | Eligible laboratory and diagnostic services | Specified advanced tests require prior approval |
| Health-care practitioners | Up to CAD $1,000 combined per emergency | Written physician referral required |
| Ambulance and repatriation | Eligible ground or air transportation | Must be medically necessary and authorized |
| Extra Injury Coverage | Additional CAD $50,000 with an eligible CAD $100,000 Standard or Enhanced policy | Applies only to eligible injury expenses |
Who is eligible?
- Not travelling against physician advice
- No terminal illness with less than two years to live
- No listed recent pancreatic, lung, brain or liver cancer
- No metastatic-cancer history
- No organ or bone-marrow transplant, except corneal transplant
- No congestive heart failure
- No home oxygen during the last 12 months
- No kidney dialysis
- Not residing in a nursing home or long-term-care facility
Pre-existing conditions and medical history
- Basic and Standard exclude every pre-existing medical condition.
- Enhanced may cover an eligible pre-existing condition stable for 180 days immediately before the effective date.
- New symptoms, diagnosis, medication changes, treatment changes, hospitalization, referral or pending investigation can affect stability.
- Enhanced excludes a heart condition when nitroglycerine was required for angina during the preceding 180 days.
- Enhanced excludes a lung condition when prednisone was required for that lung condition during the same period.
Medical questionnaire and application guidance
Who completes the declaration?
Applicants age 60–85 who want the Enhanced plan must complete the medical declaration and answer No to all questions.
What does it ask?
The declaration addresses recent heart, lung and neurological changes, older heart procedures, internal bleeding, gastrointestinal hospitalization, cancer, prednisone, nitroglycerine, diabetes and heart medication.
What if an answer is Yes?
The applicant is not eligible for Enhanced; Basic or Standard may still be available if all general eligibility rules are met.
Waiting period and stability guidance
- Standard and Enhanced generally use a 72-hour sickness waiting period when purchased within 30 days after arrival.
- A seven-day sickness waiting period generally applies when purchased 31 days or more after arrival.
- Basic has additional age-specific waiting-period rules for applicants age 86 or older.
- A sickness manifesting during the waiting period remains excluded even when treatment occurs later.
Monthly-payment information
- Minimum 365-day coverage period and minimum CAD $100,000 policy limit.
- At application, two monthly premiums and a CAD $50 non-refundable policy fee are charged.
- The third monthly premium is payable when the policy is activated.
- There is no coverage before successful activation.
- Remaining premiums are collected according to the issued schedule.
Claims and emergency assistance
- Contact the Assistance Centre before treatment whenever medically possible.
- Report the claim within 30 days.
- Submit written proof and supporting documents within 90 days.
- Keep medical records, itemized bills, receipts and proof of travel.
Refunds and administration fees
- Unused premium is generally calculated on a prorated basis.
- A minimum premium of CAD $25 and a CAD $25 processing fee normally apply.
- Certain visa-related cancellations may be subject to a CAD $250 fee.
- The CAD $50 monthly policy fee is non-refundable.
- Claim-withdrawal handling fees may apply.
Important exclusions and limitations
- Pre-existing conditions not covered under the selected plan
- 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 intoxication-related losses
- Treatment after refusing recommended medical repatriation
Frequently asked questions
All answers remain openly displayed in the HTML for users, search engines, voice assistants and AI search systems.
What are the three plans?
Basic, Standard and Enhanced. Basic has reduced benefits, Standard has comprehensive benefits without pre-existing coverage, and Enhanced may cover eligible stable pre-existing conditions.
Who underwrites the coverage?
The Manufacturers Life Insurance Company, commonly known as Manulife.
What is the difference between Standard and Enhanced?
Their listed benefits are the same; the main difference is pre-existing-condition coverage and the Enhanced medical-declaration requirements.
Can it be paid monthly?
Yes, for qualifying applicants. Two monthly premiums and a CAD $50 policy fee are charged at application, and the third premium is due at activation.
Must the Assistance Centre be called?
Yes, whenever medically possible. Failure to call may result in 20% co-insurance.
Compare 21st Century before purchasing
Compare the plan, coverage amount, deductible, medical-history requirements, waiting periods, payment arrangement and premium.