Pre-existing Conditions

For a pre-existing condition to be covered under our policy it has to be stable for 90 days before the start of coverage. Our definition of stable is the following: 

Stable means any medical condition, whether or not the diagnosis has been determined, other than a minor ailment for which there has been:

1. no hospitalization; and 
2. no new diagnosis, treatment, or prescribed medication; and 
3. no alteration* in treatment or medication; and 
4. no new, more frequent, or more severe symptoms; and 
5. no new test results showing deterioration; and 
6. no referral to a specialist (made or recommended) and you are not awaiting surgery or the results of further investigations performed by any medical professional.   

* Alteration includes a new medication, stopped medication, increase or decrease in medication, but does NOT include changes between brand-name and generic versions of drugs with the same active ingredient and dosage, or routine adjustments of maintenance medications such as insulin, Coumadin, or Warfarin. 

Some examples are:

• If a student breaks their leg a month before coming to Canada and needs to continue treatment when they are here, this WOULD be considered an UNSTABLE pre-existing condition and not covered
• If a student has diabetes and it has been STABLE for 6 months before their coverage started and they had a flare-up while in Canada, this would be considered ELIGIBLE under the Explore Canada Plan