Insurance Terms
In-Patient means a patient who occupies a Hospital bed for more than 24 hours for Medical Treatment and for which admission was Medically Necessary and recommended by a Physician.
Insured or Insured Person means a person for whom insurance is in force under this policy and who is on file/ declared with the Plan Administrator.
International Student means a non-Canadian student enrolled in and currently attending, or scheduled to attend, classes in an educational program at a Participating Educational Institution or Organization who has had to obtain a student visa and/or temporary visa status for the purpose of pursuing an education within Canada and is required to arrange insurance through the Participating Educational Institution or Organization.
Minor Ailment means any Sickness or Injury which does not require:
a. the use of medication for more than 15 days; or
b. more than one follow-up visit to a Physician, Hospitalization, or surgical intervention; or
c. referral to a specialist; and
d. which ends at least 30 consecutive days prior to the start date of coverage.
A Chronic Condition or any complication of a Chronic Condition is not considered a Minor Ailment.
Outpatient means a patient receives healthcare services and leaves the facility the same day.
Pre-existing condition is a health condition the student had prior to the date their health coverage began. For example, Pre-existing Conditions could include, but are not limited to, asthma, diabetes, cancer, or pregnancy.
Reasonable and Customary means the amount usually charged for treatment, services or supplies to provide an appropriate level of care given the severity of the Sickness or Injury being treated. The Reasonable and Customary amount is determined based on the geographical location where the treatment, services or supplies are provided.
Repatriation means the return of a student to their home country. For example, if student sustains an injury in a foreign country and needs to return to their home country for treatment, they would be repatriated. Additionally, in the unfortunate event that a student passes away while away from their home country, their remains can be repatriated home.
Stable means any medical condition, whether or not diagnosis has been determined, other than a Minor Ailment for which:
a. there has been no Hospitalization; and
b. there has been no new diagnosis, treatment or prescribed medication; and
c. there has been no alteration* in treatment or medication; and
d. there has been no new, more frequent or more severe symptoms; and
e. there has been no new test results showing deterioration; and
f. there has been no referral to a specialist (made or recommended); and
g. 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.