Clients
can then decide whether to receive treatment locally from their doctor or
specialist, in consultation
with the experts referred by Best Doctors, or travel to a medical facility
outside the country for treatment.
Patients
who decide to receive treatment within Canada receive a $25,000 CDN lump
sum benefit payment to spend in any way they choose, such as to help replace
lost income, in addition to ongoing, unlimited access to Best Doctors’
information services.
Patients
who choose treatment outside of Canada are covered for up to $1,000,000 CDN
in medical expenses, plus $10,000 CDN in travel expenses, along with continuing
access to Best Doctors.
The
unprecedented financial coverage of CriticalADVANTAGE empowers patients to
pursue the very best path to healing, regardless of where it may take them
on the globe. When combined with the vast knowledge resources of Best Doctors,
patients literally have the best chance in the world to regain their good
health.
How
long do my benefits last?
If your claim has been approved and you have chosen to receive treatment
outside of Canada, you have a 36- month period during which Transamerica
will cover treatment expenses up to the $1,000 , 000 benefit
amount. This 36-month period starts from the date the illness was first diagnosed,
and allows enough time to deal with virtually any treatable illness.
After
this period, the insured retains unlimited lifetime
access to Best Doctors’ knowledge and advice relating to the condition
that has been claimed, without
additional charge.
If
I choose the $25,000 lump sum, what happens to my coverage?
The lump sum cheque is payable only once — for the insured’s first
approved claim. The insured will
retain unlimited lifetime access to the information resources of Best Doctors
for the illness on which the
claim was approved.
Is
the $25,000 lump sum benefit taxable?
No, this benefit is not taxable according to current Canadian income tax
legislation.
Who
is Best Doctors?
Best Doctors is the world leader in connecting people with the best medical
care. Using its renowned
database of over 50,000 doctors recognized as the best by top specialists,
Best Doctors provides rapid access to the best medical knowledge, and peace
of mind to thousands of people around the world faced with a serious illness.
What
does Best Doctors provide?
The Best Doctors component of CriticalADVANTAGE includes three key bilingual
services:
InterConsultation™, or the medical second opinion, provides a
personalized report verifying the diagnosis
and recommending appropriate treatment options for the patient and their
treating physician to consider.
FindBestDoc™
is a highly personalized service that identifies medical physicians with
special expertise in qualifying covered illnesses. The recommended doctors
are selected from a comprehensive database of
the world’s leading 50,000 practitioners.
FindBestCare®
is a highly personalized service that identifies and arranges access to top
medical facilities when out-of-country treatment is pursued and includes
VIP Concierge Services to assist with medical appointments, travel and lodging
arrangements, preadmission arrangements, and coordination of your inquiries
by a Personal Care Manager.
What
types of illnesses are covered?
Because CriticalADVANTAGE is primarily focused on returning clients to good
health, the policy covers serious illnesses that are usually treatable, given
the right advice and medical care:
• Cancer
• Coronary artery by-pass surgery
• Aortic surgery
• Heart valve replacement
• Multiple sclerosis
• Kidney failure
• Major organ transplant
• Motor neuron disease (also known as ALS or Lou Gehrig’s)
• Parkinson's disease
• Benign Brain Tumor
For
degenerating diseases and conditions requiring chronic treatment, such as
Alzheimer’s disease and
stroke, traditional critical illness insurance may be a better choice, as
the lump sum benefit is typically used to make coping with the illness easier,
rather than trying to cure the condition.
How
do I apply?
Complete an application with your insurance advisor, who will submit the
application and your first payment to Transamerica. It is extremely important
that you answer all of the questions completely and truthfully. If you are
accepted, we will notify you of your coverage start date and you will receive
a CriticalADVANTAGE policy package within a few days of your acceptance.
The package contains your Best Doctors identification card and the Critical
Advantage policy.
Who
is eligible to apply?
Generally, CriticalADVANTAGE is available to anyone who lives in Canada.
Applicants must be at least 15 days of age and not older than 60 years of
age at issue.
Can
anyone qualify for coverage?
The CriticalADVANTAGE application is short and simple, with no medical examinations
required. Most
applicants without recent serious medical history will be eligible for coverage.
Applicants with pre-existing
conditions, or certain ongoing medical conditions or family history, may
not be eligible. If your application is not accepted, any premium collected
will be promptly returned to you with a letter stating that you did not qualify
for coverage.
Am
I covered for medical tests like an MRI or CT scan?
If the claim is approved and the insured elects to receive treatment outside
of Canada, any medical treatment recommended by Best Doctors and approved
by Transamerica is covered by CriticalADVANTAGE. Medical tests required to
diagnose your illness prior to the approval of your claim are not covered.
What
are the renewal terms?
CriticalADVANTAGE renews automatically every five years until age 65 for
adults and age 18 for children, as long as you continue to make premium payments
and unless you decide to cancel your policy with written notification. You
do not have to re-qualify or answer any medical questions on renewal.
Transamerica reserves the right to cancel coverage for a particular class
grouping of insureds, when the risk experienced becomes unacceptable. In
that situation, we would cancel the entire class grouping of policies and
not just one individual policy. If we cancel coverage, we will provide written
notification and 90 days’ notice from the next policy anniversary.
Will
the cost of coverage change?
In general, the cost of coverage will increase every five
years. Although we do our best to price coverage appropriately with the intention
of not adjusting the premiums in the future, we reserve the right to adjust
the cost of coverage at other times and in particular
situations. Any change in the cost of coverage will be the same for a particular
class grouping of Insureds— not just one individual policy. This will
only be done when costs for the class grouping do not reflect the risk experienced
and/or anticipated for that class grouping. Any change in rates will be made
on the policy anniversary with a minimum 90 days’ notice.
What
is a repatriation benefit?
In the unfortunate event that the insured dies while seeking approved treatment
outside of Canada,
Transamerica will reimburse up to $5,000 for expenses related to the return
of body to Canada. Best Doctors can provide a friend or family member with
the phone number of a repatriation service provider.
What
if I am diagnosed with another covered illness?
C r i t i c a lADVA NTAG E p r ovides benefits for the firs t occurrence
of one covered illness for a period of 36-months from diagnosis. For example,
if a client claims for cancer and is approved for coverage, benefits will
be payable to treat the cancer. If that client subsequently develops another
covered condition, such as
Parkinson’s disease, benefits will not be payable for the treatment
of the second illness — in this example, Parkinson’s disease.
Is
there a survival period?
Unlike critical illness policyowners who must survive at least 30 days following
the approval of the claim to receive benefits, CriticalADVANTAGE benefits
are payable immediately upon approval of the claim. This is extremely important
as prompt treatment can mean the difference between life and death when dealing
with certain conditions like advanced lung cancer, coronary artery bypass
surgery (CABS), aortic surgery, heart valve replacement, and others.
Start
here to obtain a CriticalADVANTAGE Quote.
