Application and Medical Questionnaire

  • Must be completed within 180 days of the effective date.
  • Single-Trip plans must be purchased for the entire duration of the trip that is out of Canada.
  • The Quick Trip plan is available to applicants 55 to 74 years of age travelling for 17 days or less.
  • BounceBack Benefit can only be purchased in conjunction with a Single-Trip plan (not applicable to Top-Ups).
If a paper-based application is being used, then the customer must sign the application and return it to us.

Eligibility and Rate Category

At the time of application, if the applicant is:

Under Age 55: Automatically qualifies for Rate Category A and does not need to complete the medical questions for eligibility or for rate category.

Age 55 to 74, travelling 17 days or less, and purchasing a Quick Trip or Quick Trip Canada Plan: Does not need to answer any medical questions and qualifies for Rate Category D.

Note: The Quick Trip and Quick Trip Canada Plans do not cover any pre-existing condition for which the applicant has taken, received or been prescribed medication or treatment in the three (3) months before the effective date; and/or
  • The applicant's heart condition if, in the three (3) months before the applicant's effective date the applicant has taken, received or been prescribed medication or treatment or the applicant has taken any form of nitroglycerine for the relief of angina pain; and/or
  • The applicant's lung condition if, in the three (3) months before the applicant's effective date the applicant has taken, received or been prescribed medication or treatment or the applicant require treatment with oxygen or Prednisone for the applicant's lung condition.
If the applicant does not care to purchase the Quick Trip or Quick Trip Canada Plan and is age 55 and over, the applicant must compete the Medical Questionnaire to determine the applicant's eligibility (Step 1) and rate category (Steps 2 and 3).

If not eligible to purchase this insurance
If the applicant is 55 or over and is not eligible to purchase this insurance, the applicant can apply for emergency medical coverage under Manulife’s Individual Medical Underwriting Plan, by calling 1-877-884-8283 or (519) 251-7417.
The applicant will need to be able to answer questions related to the applicant's health status and will need to know the applicant's travel dates in order to receive a quote. This quote will match the applicant's specific health needs and circumstances. When the applicant pays the quoted premium, the applicant's pre-existing conditions will be covered during the applicant's trip under the Individual Medical Underwriting Plan.

Instructions for Brokers and Clients (PDF)