Health & dental insurance with guaranteed acceptance

A pre-existing condition is any injury, sickness, or condition that exists before the date an insurance policy takes effect.

Examples of pre-existing conditions include:

• Asthma
• Diabetes
• Anxiety
• Depression
• High blood pressure
• High cholesterol
• And more

"Guaranteed acceptance" refers to guaranteed-issue insurance policies, where your acceptance is assured at the time of application, even if you have a pre-existing condition. This type of insurance simplifies the application process, as you are not required to answer medical questions or undergo medical tests when applying.

To quickly and easily find out if your condition is covered by one of our plans, we recommend speaking with a Licensed Insurance Advisor.

Please call us at 1-877-268-3763 for personalized assistance.

Our health and dental plans that offer guaranteed acceptance, including the Flexcare^® ComboPlus™ Starter Plan, Guaranteed Issue Enhanced Plan, and all four FollowMe™ plans for people whose group benefits are ending, cover eligible pre-existing conditions and eligible current medications. Our other health and dental plans only cover new medications. Refer to your policy for more details.

We currently process 90% of complete and accurate claims forms within 2 business days, meaning we determine if they are approved or denied. The remaining 10% are generally processed by the third business day. When your claim is approved, you will generally receive payment on the following business day. When information is missing, we may have to return the claim form to you. This delays processing and payment.

Every province and territory has a different health insurance plan –  check your health ministry's website for details – but most may not cover:

• Prescription drugs
• Dental checkups and treatment
• Vision care
• Semi-private or private hospital rooms
• Registered specialists and therapists such as Acupuncturists, Chiropodists, Chiropractors, Naturopaths, Osteopaths, Physiotherapists, Podiatrists, Psychologists/Psychotherapists, Registered Massage Therapists, Speech Pathologists/Therapists
• Health-related products such as orthotics, hearing aids, prosthetics and medical equipment
• Health-related services such as ambulance, homecare and nursing, medical coordination and second medical opinions
• Emergency medical care for travellers

First, check to see if your provider has already submitted your claim. Often, you don't have to submit a claim because many hospitals, pharmacies and dentists can submit your claim directly to us. There's no online form or paperwork for you, and you only pay the amount your plan doesn't cover.

If your provider hasn't already submitted your claim, you can submit your claim online or on paper by mail.

Submit your claim online:

• Within 12 months of the date you were charged
• After you've paid more than any deductible in your plan
• Specify the currency if your claim is for services outside Canada
• Hold onto original receipts and applicable supporting documentation for 12 months

Submit your claim on paper by mail:

• Within 12 months of the date you were charged
• After you've paid more than any deductible in your plan
• Specify the currency if your claim is for services outside Canada
• Include original receipts and applicable supporting documentation
• Make sure you've signed your claim form
• Extended health claim form – for all covered expenses except dental expenses
• Dental benefit claim form – must be completed by your dentist or dental specialist