先懂词,再看保障
把保单里的词说清楚
🎧 听这一页:直付、自付额、等待期:读懂报价页上的旅行医疗险术语(约 11 分钟)
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同一个词在不同产品里可能有不同定义。先用白话理解,再展开下面的产品原文。
稳定
Stable / Stability period
一段回看期内,病情与治疗符合保单的稳定定义。没有住院不代表已经稳定;症状、药量和待做检查也可能影响判断。
稳定=医生判定未恶化+无新的或更频繁更重的症状+无治疗或用药改变+无新治疗被开具或建议;另有「生效前已安排或建议但未出结果的检查/手术/转诊」除外
原文与来源
There has been no change in treatment by a physician or other registered medical practitioner or any alteration in any medication related to the medical condition, and d There has been no new treatment received, prescribed or recommended查看官方文件 ↗核对:2026-10-02安联访客险(普通 Visitors to Canada 计划) · 对应条款格 →
59 岁以下 90 天;60–89 岁 180 天
原文与来源
b) If you are 60 to 89 years of age on the effective date: … not stable at any time during the 180 days immediately before the effective date.查看官方文件 ↗核对:2026-10-02既往症
Pre-existing medical condition
保障生效前已经存在的病情,具体可包括曾有症状、接受治疗或被建议检查的情况。不是只有已确诊、长期吃药才算。是否保,要同时看计划与稳定条款。
安联访客险(普通 Visitors to Canada 计划) · 对应条款格 →
稳定的既往症保:按年龄看生效日前稳定期
原文与来源
Benefits are not payable for costs incurred due to or resulting from your medical condition or related condition that was not stable at any time during the 90 days immediately before the effective date.查看官方文件 ↗核对:2026-10-02不稳定既往症加保
Unstable pre-existing condition optional coverage
付额外保费,把原本因未满足稳定期而被排除的部分病情纳入。仍有限定年龄、近期病情排除和赔付上限,不能理解成所有旧病都保。
79 岁及以下可加买「不稳定既往症」附加险:生效前 7 天内仍不稳定的病不保,赔付不超过所选保额
原文与来源
To be eligible to purchase this Optional Coverage, you must be 79 years and under … Exclusion Any pre-existing medical condition that is not stable on or within the 7 days before the effective date of this Policy.查看官方文件 ↗核对:2026-10-02等待期
Waiting period
买下保单后,某类保障还未开始承担风险的时间段。疾病与意外可以不同;等待期间起病的后续费用也可能不赔。它与生效前回看的稳定期不同。
抵加前买无等待期;抵加 60 天内买,疾病等待 48 小时;第 61 天及以后买,疾病等待 7 天;等待期内起病的相关费用之后也不赔
原文与来源
a For Insurance purchased within 60 days after arrival in Canada: There is no coverage for any disease or illness arising in … the first 48 hours … b For Insurance purchased 61 days or more after arrival in Canada: … the first 7 days查看官方文件 ↗核对:2026-10-02自付额
Deductible — per claim / per incident / per policy
发生受保费用后,由自己承担的约定金额。每次理赔、每次事故和每张保单是不同口径,还要看是否按每位被保险人计算。遇到同一份文件口径冲突,先取得书面确认。
自付额按每位被保险人、每次事故计;24 小时意外附加给付不扣自付额
原文与来源
We will pay eligible expenses for losses incurred in excess of the amount of the deductible as shown on the Policy declaration, per insured per incident claimed.查看官方文件 ↗核对:2026-10-02保单定义同一段里前句写「每次理赔每人」、后句又写「每张保单每人」,自相矛盾;按前句理解是每次理赔扣一次,需向宏利确认。
原文与来源
the amount of eligible expenses that you are responsible for paying per claim per insured before our obligation to reimburse any eligible expenses begins. ... The deductible amount is shown on your policy confirmation and applies per policy per insured.查看官方文件 ↗核对:2026-10-02直付
Direct billing
保险公司或援助机构安排向医疗方结算,减少你先垫款的需要。它不是保证每家医院都接受,也不等于保险公司已经认可这次理赔;就医前后的联系、授权要求仍要遵守。
保单未用「直付」字样,但写明若先自付会按「本应直接付给医疗方」的合理费用报销,意味着先打援助中心可由公司直接付给医院;能否直付以援助中心安排为准。
原文与来源
we reimburse you according to reasonable and customary charges that we would have paid directly to the provider.查看官方文件 ↗核对:2026-10-02AD&D
Accidental Death and Dismemberment
因受保意外导致身故或指定伤残时,按条款给付的利益。它和急诊、住院的医疗费用报销不同,可能已含在主险,也可能需要另买。
基本计划已含「24-Hour Accident」意外身故/残疾给付 25,000 元(不扣自付额);另可加买 AD&D:公共交通/航班意外 10 万+全天候意外再 2.5 万。「24-Hour」指全天候任何情形,不是「24 小时内」
原文与来源
24-Hour Accident Insurance: Maximum limit — $25,000 … 24-hour Accident Death or dismemberment as a result of an accident sustained during the period of coverage in any other situation not specifically mentioned under Air Flight/Common or Chartered Carrier查看官方文件 ↗核对:2026-10-0224-Hour Accident
24-Hour Accident Insurance
全天候意外保障的名称。在这里的 TuGo 条款中,它是意外身故或伤残给付,不是要求一天之内申请,也不是意外医疗费用只能赔一天。
基本计划已含「24-Hour Accident」意外身故/残疾给付 25,000 元(不扣自付额);另可加买 AD&D:公共交通/航班意外 10 万+全天候意外再 2.5 万。「24-Hour」指全天候任何情形,不是「24 小时内」
原文与来源
24-Hour Accident Insurance: Maximum limit — $25,000 … 24-hour Accident Death or dismemberment as a result of an accident sustained during the period of coverage in any other situation not specifically mentioned under Air Flight/Common or Chartered Carrier查看官方文件 ↗核对:2026-10-02超级签证合规
Super visa health insurance requirements
看实际签发的保险是否符合 IRCC 对保额、保期、保障范围、付款及承保人的要求。产品名或保险公司的「适用」声明,只能作为核对起点。
IRCC 官方要求
每位申请人至少 10 万加元;自入境日起至少一年,每次入境有效;涵盖医疗、住院及遗返;付清或付订金后分期,报价单不算保险证明;承保人须是加拿大保险公司或经 OSFI 授权的境外保险公司。
原文与来源
provide a minimum of $100,000 emergency coverage per applicant; be valid for a minimum of 1 year from the date of entry; cover the applicant(s) for health care, hospitalization and repatriation; be paid in full or in installments with a deposit (quotes are not accepted)查看官方文件 ↗核对:2026-10-26安联访客险(普通 Visitors to Canada 计划) · 对应条款格 →
官网称满足父母祖父母超级签证的健康险要求(须选 10 万以上、保期一年)
原文与来源
Meets the health insurance requirements for the Super Visa for parents and grandparents.查看官方文件 ↗核对:2026-10-02OSFI 认可
Authorized by the Office of the Superintendent of Financial Institutions
在超签语境中,指境外保险公司须满足 OSFI 授权及名单等条件。不是经纪网站获得一个标志就算合规,也不代表监管机构保证每宗理赔都会赔付。
IRCC 官方要求
境外保险公司须获 OSFI 授权经营意外与疾病保险、列在公开名单中,并在加拿大经营保险业务时签发保单。核对实际承保人,不能只查经纪或理赔管理方的品牌。
原文与来源
Insurance brokers and insurance claims administrators are not insurance companies and will not appear on the OSFI list.查看官方文件 ↗核对:2026-10-02