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- Non-residents in Canada should have visitor insurance to avoid high out-of-pocket medical expenses, as they are not covered under Canada's public healthcare system
- Visitor insurance policies typically exclude pre-existing conditions, non-emergency procedures, mental health care, high-risk activities, and more
- Policies often have coverage limits, waiting periods, and restrictions on certain ailments or treatments
- To find the best insurance, assess personal needs, consider the length of stay, and consult with insurance brokers to secure comprehensive and appropriate coverage
- What does visitor insurance cover in Canada?
- Why is visitor to Canada insurance important for non-residents?
- What are the typical exclusions in a visitor insurance policy?
- Other common exclusions for visitors to Canada health insurance
- What are the limitations of visitors’ insurance policies?
- What medical conditions should be mentioned when getting visitor health insurance for parents in Canada?
- Can you be refused visitor to Canada insurance?
- Tips for choosing the right insurance policy in Canada
- Frequently asked questions
Visitors to Canada face high emergency medical treatment costs as Canada’s provincial healthcare system does not cover them. Visitor health insurance protects travellers by covering emergency medical expenses during their stay. However, insurers include visitor emergency insurance exclusions and limitations to these plans that travellers must understand before arriving in Canada.
Statistics Canada reports that overseas residents took 1.2 million trips to Canada in the last quarter of 2024, reflecting the country’s growing appeal to international visitors. In this blog, we explain the most common visitor insurance exclusions in Canada to help you choose the right plan for your trip.
What does visitor insurance cover in Canada?
Visitor insurance in Canada offers emergency medical protection for non-residents during their trip. Typically, this insurance provides coverage for some crucial healthcare requirements, such as:
- Hospital stays
- Emergency doctor visit
- Ambulance services
- Prescription medications
- Evacuation and repatriation
- Paramedical services
- Other emergency treatments like dental or AD&D
The breadth of coverage ensures that visitors can enjoy their time in Canada with peace of mind, knowing they are safeguarded against the high healthcare costs in the event of unforeseen medical emergencies.
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Why is visitor to Canada insurance important for non-residents?
Visitors to Canada insurance is essential for non-residents because Canada’s public healthcare system does not cover non-residents, international students, or temporary workers.
Without this insurance, a simple doctor’s visit or a walk-in clinic could be anywhere from $100 to $600, while an emergency room or hospitalization could be as high as $6,000 per day!
Having a comprehensive visitor insurance policy in Canada ensures that non-residents have access to quality care without the fear of exorbitant bills.
What are the typical visitor insurance exclusions in Canada?
While visitor insurance provides essential coverage, pre-existing health conditions, non-emergency procedures, pregnancy-related routine treatment, and injuries due to participating in high-risk activities are not included. Understanding these exclusions can help avoid surprises and ensure adequate preparation for any medical situation.
1. Pre-existing conditions in visitor medical insurance policy
Various insurers provide the option to choose between two types of plans – one that covers stable pre-existing health conditions and another that doesn’t. Visitor medical insurance plans that do not include pre-existing condition coverage exclude those health conditions and do not cover them under the policy.
A pre-existing condition is any medical condition for which the visitor has received treatment or medication during a specific period before the policy’s effective date, such as chronic illnesses, heart disease, or diabetes.
Plans that cover pre-existing conditions have higher premiums and have certain requirements like age and stability period of the condition.
2. Non-emergency procedures and visitor medical insurance
Since health insurance for tourists is for emergency medical only, it does not cover non-emergency procedures. Visitor health insurance excludes coverage for planned surgeries, routine check-ups, preventive care, elective surgeries (such as liposuction or cosmetic procedures), holistic treatments, or any care that insurers do not consider medically necessary.
3. Anything outside the “Usual, Customary, and Reasonable”
Visitor insurance policies often deny coverage for expenses that they do not consider “usual, customary, and reasonable.”
What is meant by “Usual, Customary, and Reasonable”?
“Usual, Customary, and Reasonable” also known as UC&R refers to the standard amount that hospitals commonly charge for a particular service within a specific geographic area.
Insurance companies maintain a database of UC&R for various provinces and review the claims based on it. If the claim is excessively higher than the standard cost of the treatment, they will not provide coverage for it.
For instance, if the cost of a kidney stone surgery is around $1,000 in Ontario as per the UC&R rate and your hospital charges $2,000 for the same procedure, you’ll not receive coverage for the treatment.
4. Diagnostic tests covered in health insurance for visitors
Many visitor insurance policies limit or exclude coverage for diagnostic tests unless they are directly related to a covered emergency. It means that the insurer may deny coverage for tests used to routinely monitor a condition or for any tests they deem unnecessary.
Some routine diagnostic tests that are generally not covered by visitor insurance policies include magnetic resonance imaging (MRI), computerized axial tomography (CAT) scans, ultrasounds, biopsies, etc.
Insurers may cover these tests only in extreme scenarios. For instance, if doctors perform these tests immediately after an emergency hospitalization, you may get coverage.
5. Pregnancy and maternity care under visitors to Canada insurance
Except for emergencies, pregnancy, and maternity care are typically excluded from visitor insurance policies unless explicitly stated otherwise.
Even in cases where you may receive some coverage, it is usually limited to emergency situations related to pregnancy and does not cover regular prenatal or postnatal care.
6. Mental health care and visitors’ health insurance
Insurers typically exclude mental health services, including counseling, therapy, and psychiatric care, from visitor medical insurance policies. Even if you do receive coverage, it is usually limited to emergency psychiatric care.
7. Drugs and alcohol-related conditions in visitors’ health insurance
Incidents or illnesses resulting from chronic usage of drugs, alcohol, or other narcotics are generally excluded from visitor insurance coverage.
Insurers include any injuries sustained while the traveller is under the influence, as well as severe medical conditions linked to drug or alcohol abuse that began even before the coverage period started, under the visitor health insurance.
8. Self-inflicted injuries as a part of medical insurance for visitors
Self-inflicted injuries, including those resulting from attempted suicide or any form of self-harm, are typically excluded from visitor insurance policies. These exclusions also extend to injuries sustained from reckless behavior or intentional harm.
Some insurance companies may provide partial coverage if there is medical evidence that the injury was a result of a mental health illness.
9. High-risk activities and health insurance for visitors
Insurers exclude high-risk activities such as extreme sports (skydiving, scuba diving, bungee jumping), motor racing, and mountaineering from visitor health insurance coverage.
However, Tugo offers a Sports and Activities Coverage add-on that can provide substantial coverage if you participate in some high-risk activities. The company is willing to cover reasonable and customary expenses if an acute medical emergency arises while participating in activities listed within its benefits section.
These include high-risk adventures like mountaineering, paragliding, scuba diving, white water sports, boxing, snowboarding, downhill mountain biking, and more.
Other common exclusions for visitors to Canada health insurance
Apart from these common travel medical insurance exclusions, there are a few other limitations that you may find in your policy, such as:
- War and terrorism: Injuries or illnesses resulting from acts of war or terrorism are typically not covered
- Ignoring medical advice: Any emergency that occurs or recurs after medical advisors recommend that the foreigner return home following emergency treatment, and the visitor chooses not to, is excluded
- Non-compliance with prescribed treatment: Not following recommended or prescribed therapy or treatment can void coverage
- Aviation-related activities: Any death or injury sustained while piloting an aircraft, learning to pilot an aircraft, or acting as a member of an aircraft crew is excluded
What are the limitations of visitors’ insurance policies?
In addition to exclusions, visitor insurance policies also come with certain limitations such as coverage limits, waiting periods, restrictions on specific health conditions, or limitations when it comes to partner hospitals that restrict the scope of coverage.
- Coverage limits: There are often maximum amounts the insurance will pay for a covered medical service. Coverage limits can range from $150,000 in the case of Manulife to $500,000 in the case of Allianz or Tugo. Some of the best visitor insurance companies in Canada, like RIMI-Secure Travel and MSH, offer coverage as high as $1,000,000. Once this limit is reached, the visitor must cover any additional costs
- Waiting periods: Most insurance companies have a waiting period on their visitor health insurance policy that generally varies from 48 hours to 8 days. However, the waiting period does not apply to claims related to accident/injury – clients are covered for accidents/injuries from the moment of purchase, except for Travelance, which imposes a 24-hour waiting period for accident/injury as well.
- Restrictions on specific ailments: Policies may limit coverage for certain conditions or treatments, particularly if they are deemed high-risk or require specialized care
- Limited network hospitals: Some insurance plans only cover treatment at specific hospitals or clinics within a designated network. Seeking care outside this network may result in reduced coverage or a complete denial of claims
What medical conditions should be mentioned when getting visitor health insurance for parents in Canada?
When you’re getting medical insurance for parents in Canada, it’s essential to mention any chronic illnesses, past surgeries or hospitalizations, and even mental health conditions to ensure proper coverage. Key conditions that you must disclose include:
- Chronic conditions: Conditions like diabetes, hypertension, asthma, or heart disease, which require ongoing treatment or medication
- Recent surgeries or hospitalizations: Any surgeries, hospital stays, or significant medical procedures in the past year
- Respiratory issues: Conditions like chronic obstructive pulmonary disease (COPD), bronchitis, or other breathing-related illnesses
- Cardiac conditions: Heart conditions, including heart attacks, arrhythmias, or strokes
- Kidney or liver diseases: Chronic kidney disease, liver conditions, or any issues requiring regular treatment
- Mental health conditions: Depression, anxiety, or any psychological treatments that are ongoing
- Cancer: Any history of metastatic cancer, including remission status
- Bone or joint issues: Conditions like arthritis or recent bone fractures
Can you be refused visitor to Canada insurance?
Yes, you can be refused access to avail the visitor to Canada insurance based on various factors, such as any undisclosed pre-existing medical conditions, high-risk health profiles, or advanced age.
Insurers may also deny tourist medical protection coverage if applicants have a history of severe illnesses or require ongoing treatment that poses a significant risk. Additionally, people who live in rehabilitation centers, or old age homes or require assistance with conducting day-to-day activities may also be denied coverage.
Can you go to a hospital in another province in Canada?
Yes, you can go to a hospital in another province in Canada. However, if you are a resident of a different province, you may need to pay for services upfront, as public health insurance typically only covers services within your home province.
To minimize costs, it’s advisable to carry your health card and check if your insurance covers out-of-province care. Visitors should ensure they have medical health insurance to cover potential medical expenses.
Is visitor insurance coverage denied if the traveller fails to disclose a medical condition?
Yes, insurance companies deny visitor emergency insurance coverage if travellers fail to disclose medical conditions when applying for visitor insurance in Canada. Insurers require accurate and complete information about all pre-existing or current medical conditions to evaluate risk and decide coverage terms.
If travelers omit or misrepresent their medical history, insurers treat this as misrepresentation or nondisclosure. When insurers discover this during a claim review, they can:
- Cancel the insurance policy without a refund
- Deny claims related to the undisclosed medical condition
- Refuse all claims under the policy, leaving the traveller responsible for all medical expenses
Most visitor insurance policies include a pre-existing condition clause that clearly states which medical conditions travellers must disclose. Failing to provide this information can cause serious consequences, including future difficulty obtaining insurance.
Being truthful during the application protects travellers from denied claims and unexpected medical bills during their stay in Canada.
Can exclusions be waived or covered with an add-on rider in visitor health insurance?
Yes, some exclusions in visitor health insurance can be waived or partially covered through add-on riders or supplemental plans. Insurance providers often offer optional riders that allow travellers to extend coverage beyond the standard policy limits or excluded conditions. For example:
- Pre-existing condition riders may provide limited coverage for certain stable medical conditions
- Adventure sports riders can cover injuries from high-risk activities like skiing or scuba diving
- Maternity or pregnancy riders may offer some coverage for pregnancy-related emergencies, although these are rare and limited
- Dental or prescription drug riders can add coverage for treatments usually excluded from basic plans
However, insurance companies cannot waive off all exclusions, and add-ons usually come with higher premiums and specific terms and conditions. Always disclose your medical history and travel plans accurately to get the right add-ons tailored to your needs.
Tips for choosing the best visitor insurance policy in Canada
Choosing the best visitor insurance policy in Canada is all about tailoring the coverage to fit your unique needs and circumstances. Start by assessing your personal health and any pre-existing conditions, as well as the activities you plan to enjoy during your stay.
Also, consider the length of your visit—whether it’s a short trip or an extended stay, having the right level of coverage can protect you from unexpected medical costs, giving you the freedom to explore Canada without financial worry.
To get a customized plan with the lowest prices, connect with an insurance expert at PolicyAdvisor. We’ll help you find a one-stop solution for all your visitors’ insurance needs!
Frequently Asked Questions
What should visitors do if their insurance policy has a significant exclusion?
If a policy has a significant exclusion, visitors should consider purchasing supplemental coverage or a different policy that provides the needed protection. It is also advisable to review exclusions thoroughly before purchasing a plan.
Are there any policies that cover all types of medical care without exclusions?
No policy covers all types of medical care without exclusions. All insurance plans come with specific exclusions, but some may offer more comprehensive coverage than others. It is essential to compare policies and choose one that provides the best balance of coverage and cost.
How can visitors get coverage for high-risk activities?
Visitors participating in high-risk activities should look for specialized insurance plans that offer coverage for such activities. Some insurers such as Tugo provide optional add-ons to cover extreme sports or other high-risk activities.
What steps should be taken in case of a medical emergency if the insurance policy has limitations?
In case of a medical emergency, visitors should immediately contact their insurance provider to understand the coverage and limitations. They should also follow the prescribed steps in their policy for emergency situations to ensure maximum coverage and avoid claim denials.
Are injuries from adventure sports like skiing or skydiving excluded from visitor insurance in Canada?
Most visitor insurance providers in Canada exclude injuries from adventure sports such as skiing or skydiving. Companies like TuGo offer coverage for injuries arising from high-risk activities but the premium costs may be significantly higher.
Are cosmetic surgeries or elective procedures covered under visitor insurance policies in Canada?
No, visitor insurance in Canada does not cover elective procedures and cosmetic surgeries. It is primarily designed to protect visitors in Canada from medical emergencies.
Is COVID-19 treatment covered by visitor insurance in Canada?
Many visitor insurance policies in Canada cover COVID-19 treatment, but coverage depends on the insurer and the policy’s specific terms. Insurers typically provide coverage only if the traveller develops symptoms after purchasing the policy and while staying in Canada.
They exclude treatment for infections contracted before the policy begins and generally do not cover routine COVID-19 testing for travel. If travellers ignore official advisories, such as a Level 4 “Avoid All Travel” warning, insurers may deny coverage. Always review the policy carefully.
Visitors to Canada should consider purchasing insurance to cover medical expenses, which can be a substantial financial burden for non-residents. However, visitor insurance policies often have exclusions and limitations, such as pre-existing conditions, non-emergency procedures, mental health care, high-risk activities, and more. Understanding these common exclusions and limitations in a visitor insurance policy is crucial for making informed decisions.
Statistics Canada. “Travel between Canada and Other Countries, March 2025.” The Daily, May 30, 2025.
