You are not covered for pre-existing health conditions during the first two years of coverage. However, pre-existing health conditions are covered conditions after you have been continuously insured in the plan for 2 years.
You are not covered for any chronic medical conditions. Examples of some chronic medical conditions include: Diabetes, Multiplesclerosis, and HIV/AIDS.
You are not covered for any specialist consultations during your first 90 days of Healthsure™. Coverage for specialist consultations begins 90 days after the effective date of your coverage.
You are not covered for back, knee or hip surgical procedures during the first 2 years of coverage under your Healthsure™ plan. Coverage for bakc, knee or hip surgical procedures begins 2 years after the effective date of your coverage.
Although the Healthsure™ plan does provide for approved travel expenses for surgical procedures (up to $500 each for transportation for you and an approved companion, plus up to $150 a day to a total of $1,500 for your companion's accomodation and meal expenses), you are not covered for any travel costs relating to any diagnostic testing or specialist consultations.
If your doctor were to chare you to provide a letter or other documentation regarding your referral for a diagnostic test, sppecialist consulation, or surgical procedure to be provided under the Healthsure™ plan, such a charge would not be covered under Healthsure™.
It is important for you to review the 'Definitions' (page 10) and 'Policy Limitations and General Exclusions' (pages 15 and 16) sections of the Healthsure™ policy prior to enrolling so that you know and understand what is not covered under the plan. Click here to view a sample policy.
Under the Healthsure™ policy (see page 16 of the 'Sample Policy' on our website here) 'Pre-existing Condition' means:
a) A condition for which an insured person is given medical care, treatment, services, medication, diagnosis, diagnostic test or consultation prior to the insured person's effective date of coverage or prior to the effective date of any benefits that is added to existing coverage; or
b) A condition which produced symptoms prior to the insured person's effective date of coverage or prior to the effective date of any benefit that is added to existing coverage. These symptoms must be distinct and significant enough to establish onset or manifestation by one of the following tests:
i) The symptoms would allow one learned in medicine to make a diagnosis of the disorder;
ii) The symptoms would cause an ordinarily prudent person to seek medical diagnosis or treatment.
This includes, but is not limited to any condition for which the insured person is already on a surgical/procedural waiting list in Canada.
As "[any] symptoms [that] would cause an ordinarily prudent person to seek medical diagnosis or treatment" are not covered, it is quite possible that this condition is not covered - these would be determined on a case-by-case basis.