GMS 公司成立于1949年,总部设在加拿大Saskatatchewan省,2003年GMS把业务扩展到Saskatatchewan省外的其他省份。
GMS是一家为个人提供访加旅游医疗保险和加拿大居民出境旅游的专业保险公司,同时还提供团体医疗保险和个人牙科医疗保险。
其旅游保险的特点是,申请要求相对严格,但理赔迅速。
GMS外出旅游保险保障范围
紧急医疗服务,最高赔偿5百万
保障范围:
住院费用
医生费用
救护车
x光等诊断费用
处方药费用(最多30天)
必须的医疗用具(如轮椅等)
私人护理(必须是医生要求的)
其它辅助专科医师:手足科医师,脊椎治疗师,物理治疗师和足科医师等,每个专科医师费用高达$300;
牙医服务:牙医,X光诊断,处方药最多$2000;牙痛最多$250;
(复诊:必须是在第一次治疗的14天以内)
紧急空中交通(必须要得到保险公司的批准和安排):最多$20,000;
医务人员(必须要得到保险公司的批准和安排,还有不能是家庭成员或旅游同伴):
陪同医务人员的,最直接的航线往返机票的费用(必须要医生证明;)
额外费用:如果在您回程时,您需要住院,保险公司将会赔偿给你的旅游同同伴$150/天的住宿费用,最多$1,000;
如果您是由紧急空中交通返回居住省份,或遗体运返,保险公司会支付:
单程的机票给18岁以下的儿女或孙子女回到出发地;
如果有需要时,合资格的看护人员的费用;
遗体运返:如果在受保期间旅游,发生死亡,保险公司会赔偿:
遗体准备和运送回居住省份,包括基本的遗体运送容器(不包括棺材),最多$7,000;
如果是在当地埋葬/火化,最多赔偿$3,000(不包括丧礼,棺材或骨灰盒);
如果需要家庭成员前往事发地点确认您的身份,成员的交通费用,最多$2,000; 膳食/住宿费用,最多$300; 和在确认您的身份期间,家庭成员都会得到一份“紧急医疗保险” (有相关条件限制);
家庭成员返加:在您需要返加治疗或死亡时,保险公司将会支付一张单程机票给您的同行家庭成员返加,最多$1,000;
家庭成员到床边(必须要得到保险公司的批准和安排):
在您住院期间,如果医生认为有需要,保险公司会赔偿您一个家庭成员/朋友的来回机票或地上交通的费用,最多$3,000;和$150/天,最多$750的膳食/住宿等费用 ;
儿童运返(必须要得到保险公司的批准和安排);
托儿费用:和您一起旅游18岁以下的儿童,最多$500/天,
宠物运返:如果您是由紧急空中交通返回所居住省份,或遗体运返,和您一起旅游的宠物将会运返,最高赔偿$300;
运返汽车:如果医生认为您和您的旅游同伴不能够再使用汽车继续您的行程,保险公司会赔偿:
最高$2,000,处理/运送您自己的车或租车;
单程的机票给您的家庭成员或朋友去汽车所在地,和膳食/住宿,汽油的费用将您自己/租用的汽车开回居住省份 ;
保险继续:在保险有效期,如果您返回所居住的省份的期间,保险不会生效,和期间的保费将不会得到退还,不过在您再次离开加拿大,继续行程时,保险继续有效。
GMS稳定旧病
(中文内容仅供参考,一切以英文Policy为准)
1. 如果旧病在出发之前180天不是稳定的,GMS将不会提供任何的赔偿,包括:
GMS does not cover any expenses resulting from medical condition(s) which have not been stable for one hundred eighty (180) days immediately prior to your departure date, including:
a. 疾病您已经接受治疗或治疗咨询,和/或
Medical condition(s) for which you received medical treatment or medical consultation, and/or;
b. 尚未确诊的疾病,源于您已经接受治疗或医疗咨询的疾病;
Undiagnosed medical condition(s) related to symptoms for which you received medical treatment or medical consultation;
稳定旧病的含义是根据本保单的说明,任何医生或其它医疗服务提供者的意见都无效。
You must be stable based on the definition of stable in this policy, regardless of the opinion of your physician or any other person who may provide an opinion on your medical condition(s).
GMS外出旅游保险购买资格
所有的申请人都必须符合条件才能购买。如果您是60岁以上,当申请时,您必须要完成‘购买资格’和‘健康问卷’才能购买。
All applicants are subject to this Eligibility section. If you are sixty 60 years old or older, you must complete both Eligibility and Medical Questionnaire portions of the application when you apply.
1. 您不符合购买资格,如果:
You are Not Eligible if you:
a. 您有植入转复除颤器;
Have an Implantable Cardioverter Defibrillator;
b. 曾经患有充血性心力衰竭;
Have or been diagnosed with Congestive Heart Failure(CHF);
c. 正在等候心脏疾病进一步的查验或治疗,包括心绞痛,心率不整,心脏病,局部缺血性心脏病,心脏瓣膜病和心肌病等;
Are awaiting further tests or treatment for heart disease which includes but is not limited to angina, irregular heartbeat, heart attack, ischemic heart disease, valvular heart disease and myocardiopathy;
d. 需要胰岛素治疗糖尿病同时还有需要处方药治疗c所形容的心脏病;
Require insulin to treat diabetes and also take prescription drugs for heart disease(see (c) above for heart disease description);
e. 被诊断患有转移性的癌症;
Have been diagnosed with metastatic cancer;
f. 患有癌症(除了乳癌或前列腺癌,,只需要接受荷尔蒙疗法或基底细胞癌)需要接受化疗,电疗或其它除了复诊以外的疗法;
Have cancer (except breast cancer or prostate cancer treated exclusively with hormonal therapy or basal cell carcinoma) which requires chemotherapy, radiotherapy or other medical treatment other than routine follow-up;
g. 有任何的血管动脉瘤还没有通过外科手术治疗;
Have any vascular aneurysm that surgically untreated;
h. 有未确诊的晕厥,跌倒(晕倒)的经历;
Have undiagnosed episodes of fainting or falling (syncope);
i. 因为肺部而服用口服激素;
Take oral steroids for a lung condition;
j. 您是70岁或以上,需要别人帮助完成日常的起居生活,如:个人的卫生整理,穿衣和脱衣,自己进食,正常移动(如上下床,上下轮椅,马桶,等),正常大小2便,正常吃药等;
Are seventy (70) years of age or older require assistance from another person(s) with activities of daily living (ADL) which include, but not limited to, personal hygiene and grooming, dressing and undressing, self-feeding, functional transfer(getting into and out of bed or wheelchair, getting onto or off the toilet, etc), bowel and bladder management, and/or medication management, or
k. 因为任何的病症而需要使用家居氧气。
Have any medical condition necessitating the use home oxygen.
2. 如果在您申请之前12个月,您被确诊患有,或以下的疾病在过去12个月不稳定,您将不符合购买保险的资格:
You are not eligible if, within the twelve (12) months prior to applying, you have been diagnosed with any of the following conditions or you have any of the following conditions which have not been stable for twelve (12) months prior to applying:
a. 艾滋病
Acquired Immune Deficiency Syndrome(AIDS);
b. 绝症;
A terminal illness (an advanced stage of a progressive disease with an unfavorable prognosis and no known cure);
c. 心房扑动;
atrial flutter;
d. 心房/心室纤维性颤动;
Atrial/ventricular fibrillation;
e. 周围性血管疾病
Peripheral vascular disease;
f. 中风/迷你中风;
Stroke/transient ischemic attack(TIA);
g. 血栓
Blood clot(s);
h. 肠胃出血;
Gastrointestinal bleeding; and/or
i. 肾/肝衰竭。
Kidney/liver failure.
3. 如果在过去12个月,您参加接受过以下的手术,您将不符合购买资格,包括:
You are not eligible if, within twelve (12) months of applying, you have undergone any of the following procedures:
a. 肾透析
Kidney dialysis;
b. 瓣膜置换术
Valve surgery or replacement; and/or
c. 器官,干细胞或/和骨髓移植。
Organ, stem cell and/or bone marrow transplant.
4. 您在整个旅行的行程,必须是加拿大公民或永久居民,并享有有效的省医疗保障。
You are not Eligible if you are not a Canadian resident with valid provincial health coverage for the entire duration of your trip.
5. 如果出发之后,或离开居住的省份是不符合购买条件的,除非您已经购买了本公司的旅游保险,而这是补充(Top-up)。
You are not Eligible to purchase after your departure date or if you are outside of your province of residence, unless purchased as a top-up to an existing GMS policy.
6. 如果您的行程是超过政府医疗计划所允许的天数,是不符合购买资格的。
You are not Eligible if your total trip length exceed total number of days allowable under your government health plan.
如果在申请之后,出发之前,您的健康情况有任何的改变,您必须要通知GMS和更新您的申请表。您健康情况的变化可能会:
Should any changes to your health occur after the application date and prior to the effective date, GMS must be notified and your application updated. A change in your health may:
1. 影响到您的购买资格
Affect your eligibility for coverage;
2. 增加您的保费
Increase your required premium.
健康情况的变化不会影响到您的购买资格,不过可能会影响到您的‘稳定旧病’的保障。Changes to your health that do not effect eligibility will still constitute a change in stability and may limit your available coverage.
家庭保障 FAMILY COVERAGE
未成年家庭成员16岁以下,如果是跟付费的申请人一起旅游是免费的。不过您必须将一起旅游的未成年家庭成员填写在申请表上。Coverage for dependents under sixteen (16) of age travelling with paying adults is provided at no cost. Coverage will only be provided for dependents under sixteen (16) if they are listed on your application.