Pre-existing medical conditions and visitors insurance: what "stable" means
A health history doesn't stop a visitor from getting covered. A recent change to that health history can.
Blood pressure pills, diabetes, a past heart problem: most parents visiting Canada have something. Here is how insurers decide whether that condition is covered, and how to answer the questions so a claim gets paid.
In short
A pre-existing condition is any health problem the visitor had before the policy started. It can be covered on plans that include pre-existing conditions if it has been stable for the plan's stability period, often 90 days under 60 and 180 days from 70. Stable means no medicine change, no new symptoms, no hospital visit and no tests waiting. Count from the last change to the policy start date, and answer the medical questions with the prescription list in hand.
What counts as "stable"
Insurers use nearly the same test. During the stability period before the policy starts, the condition must have had none of these:
Medicine change
A new prescription, a higher or lower dose, or stopping a medicine. Switching brand to generic at the same dose usually doesn't count.
New symptoms
New, more frequent or worse symptoms, even without a doctor's visit.
Hospital or ER
An admission, emergency visit or procedure for the condition.
Tests or referrals
A new diagnosis, a test showing it is worse, or a test, referral or surgery still waiting.
How long it has to be stable
Each insurer sets its own stability period, and it usually gets longer with age. For visitors and Super Visa plans, a common pattern is 90 days under 60, 90 to 120 days from 60 to 69 and 180 days from 70. Some plans ask for a full year at older ages; TuGo, for example, asks 365 days from age 86.
A few plans sell an option that covers a condition stable for only 7 days, at an extra cost, for younger visitors. Others don't cover pre-existing conditions at all, which makes them cheaper but useless for anyone with a health history.
The date that matters is the policy's start date. If the last change was 150 days ago and the plan needs 180, starting a month later can be the difference between cover and no cover.
Common conditions
- High blood pressure
- Covered when stable; dose changes restart the clock
- Diabetes
- Insulin and tablet changes count as changes
- Heart
- Some histories, like heart failure, rule people out on several plans
- Asthma, COPD
- Inhaler changes or new oxygen use count
- Thyroid, cholesterol
- Usually simple when the dose has been the same
Answering the medical questions
Many plans ask medical questions from age 60 or so, and some ask from 40. The answers decide whether the visitor can buy that plan and at what price. After a claim, the insurer reads the medical records and compares them with the answers.
Do these three things and most problems go away: get a printed prescription history from the pharmacy for the last 12 months, ask the doctor whether anything is pending, and fill in the questions together with the visitor rather than for them. If a question is unclear, ask before you answer it.
Questions people ask
What is a pre-existing medical condition?
Any illness, injury or symptom the visitor had before the policy started, whether or not it was diagnosed or treated.
Each policy defines it in its wording, often looking back a set period before the start date.
What does "stable" mean for travel insurance?
No new or changed medicine, no new or worse symptoms, no hospital visit and no tests or referrals waiting, for the plan's stability period.
The period is often 90 to 180 days, depending on the plan and the visitor's age.
Does switching to a generic medicine break stability?
Usually not, if the drug and dose stay the same. Most wordings say so directly.
A change in dose, or a different drug, does count.
Can an unstable condition be covered at all?
Rarely. A few plans sell an option for conditions stable for 7 days, for younger visitors, at extra cost.
Otherwise the visitor can still be covered for new, unrelated emergencies, and the condition can be covered once it meets the stability period.
What happens if we don't mention a condition?
The insurer can refuse any related claim, and sometimes cancel the policy.
Insurers check medical records after a claim, so a condition left out usually comes to light.
Does the Super Visa require pre-existing coverage?
No. IRCC requires at least $100,000 of emergency coverage for one year, not pre-existing cover.
But for a parent with any health history, a plan without it leaves the biggest risks uninsured.
Sources and related pages
General information, not legal or medical advice. Each policy's wording decides what is covered.