If you travel with a chronic health issue — high blood pressure, diabetes, heart disease, asthma — your travel insurance doesn't automatically cover every complication that might happen abroad. The key concept insurers use is "stability period": how long your condition must remain unchanged before your trip to be covered.
When a condition hasn't been stable for long enough, it's treated as unstable, and any emergency related to that condition can be excluded — even if you've bought emergency medical coverage. At Ehcover.ca, we spend a lot of time explaining this to travellers and international students, because misunderstanding stability is one of the most common reasons claims are denied.
What does "stable" actually mean?
Across Canadian travel insurers, the definition of "stable" is surprisingly similar. In general, a pre-existing condition is considered stable if, during the required stability period before departure:
- There are no new symptoms and existing symptoms don't become more frequent or severe.
- There is no new diagnosis and test results don't show the condition is getting worse.
- There is no new treatment and no change in treatment or medication — including dosage increases or decreases.
- There is no hospitalization, referral to a specialist, or pending tests/surgery related to that condition.
Many policies also treat you as unstable if you're waiting for test results, are on a surgery waiting list, or your doctor has ordered investigations that haven't yet been completed.
Everyday examples of unstable conditions
- Blood pressure medication change: Your doctor increases your blood-pressure pill dose 30 days before your trip. If your insurer requires 90 days of stability, your hypertension is now "unstable," and a stroke or heart attack abroad may be excluded.
- New insulin regimen for diabetes: You switch from pills to insulin six weeks before departure. Under many policies with 90–180-day stability windows, diabetes-related emergencies won't be covered.
- Recent COPD or heart failure hospitalization: A hospital stay for breathing issues or heart failure inside the stability period usually makes that condition unstable.
- Pending cardiac tests or surgery: If your doctor schedules an angiogram or heart surgery and you haven't done it yet, most insurers treat your heart disease as unstable until the investigation or procedure is completed.
How TuGo handles stability (and why we like them)
TuGo is one of the main partners we use at Ehcover.ca because their stability rules are transparent and, for many travellers, more forgiving than traditional 3–6 month windows. For TuGo's Traveller Emergency Medical Insurance (out-of-country trips), the stability period depends on your age and how long you're travelling:
- Age 0–59, trips ≤ 35 days: stable for at least 7 days before departure.
- Age 0–59, trips > 35 days: stable for at least 90 days.
- Age 60–74: stable for 180 days.
- Age 75+: stable for 365 days.
TuGo's Travel Within Canada emergency medical plan is even more flexible: it does not impose a stability requirement for pre-existing conditions, which is rare among major insurers.
TuGo's Unstable Pre-existing Medical Condition Coverage
What truly sets TuGo apart is its optional Unstable Pre-existing Medical Condition Coverage rider for certain snowbird-oriented plans. Most insurers simply exclude unstable conditions; TuGo offers a rider specifically designed to cover certain unstable conditions that would normally be excluded because of recent changes in treatment or tests.
Example: a 72-year-old snowbird's diabetes medication was changed 60 days before departure. Under TuGo's base rules, the diabetes is unstable (stability period 180 days), so diabetic complications abroad would be excluded. With the unstable-condition rider, that traveller may be able to obtain coverage for emergencies driven by diabetes itself, subject to the rider's underwriting and limits.
How other popular insurers define the stability period
Croix Bleue (Québec Blue Cross)
Croix Bleue treats a pre-existing condition as stable only if you haven't received new prescriptions or treatments, haven't changed dosages, and aren't waiting for treatment, surgery or test results. Standard Emergency Medical stability periods: 3 months (age 0–54) and 6 months (age 55+). For Trip Cancellation/Interruption, stability is required for 3 months before buying the insurance or the first trip payment, whichever is later.
Allianz Global Assistance (Canada)
Age-based windows with a very detailed stability definition: 90 days under age 65, 150 days for age 65+. Limited exceptions exist for routine insulin or warfarin adjustments and brand-to-generic medication changes.
Manulife Travel Insurance
Stability periods between 3 and 6 months before the effective date depending on rate category (A = 3 months; B and C = 6 months). Manulife also offers underwritten options such as TravelEase and the Individual Medical Underwriting Plan for travellers who want coverage with no stability requirement, subject to medical underwriting and a higher premium.
Desjardins Travel Insurance
Desjardins focuses on a "reference period" during which pre-existing conditions must remain stable. Notably, a "stable dosage" isn't required for travellers taking Coumadin or diabetes medication — a bit of extra flexibility for those specific cases. The exact reference period varies by product and age.
National Bank credit cards (World Elite, World, Platinum)
The free travel insurance included with National Bank credit cards applies a stability clause too: 3 months under age 55 and 6 months at age 55+. Credit-card coverage is not automatic peace of mind — your recent doctor visits and medication changes still matter.
Stability period comparison: TuGo vs major competitors
| Insurer / Product | Age group | Typical stability period | Notes |
|---|---|---|---|
| TuGo — Traveller Emergency Medical (out-of-country) | 0–59, trip ≤ 35 days | 7 days before departure | No deterioration, no new symptoms, no changes in treatment/medications, no pending tests/surgery. |
| 0–59, trip > 35 days | 90 days | Optional rider available for certain unstable conditions. | |
| 60–74 | 180 days | Medical questionnaire used to set premium, not just eligibility. | |
| 75+ | 365 days | Longest stability window; rider can be critical if health changed recently. | |
| TuGo — Travel Within Canada | All ages | No stability requirement | Unique advantage for domestic trips. |
| Croix Bleue Québec — Emergency Medical | 0–54 | 3 months | No new prescriptions, dosage changes, or pending treatment/surgery/tests. |
| 55+ | 6 months | Unstable conditions excluded from coverage. | |
| Allianz Global Assistance | Under 65 | 90 days | Very detailed stable definition; medical questionnaire required. |
| 65+ | 150 days | Longer window than many competitors. | |
| Manulife — Travelling Canadians | Rate Category A | 3 months | Stable = no new/worsening symptoms or treatment changes. |
| Rate Category B or C | 6 months | Underwritten plans can cover pre-existing conditions with no stability requirement. | |
| Desjardins Travel Insurance | Varies by product/age | Stability required during a "reference period" | Coumadin/diabetes meds don't need a stable dosage. |
| National Bank Mastercard travel insurance | Under 55 | 3 months prior to departure | No benefits for non-stable pre-existing conditions, other than minor ailments. |
| 55+ | 6 months prior to departure | Stability clause built into World Elite/World/Platinum coverage. |
What this means for Ehcover.ca clients in Québec
- Don't assume all insurers treat your condition the same way. Stability windows range from 7 days (TuGo, short trips under 60) to 365 days for older snowbirds — and credit-card insurance often uses 3–6 months.
- Small medical changes can have big insurance consequences. A dosage change, new test, or pending surgery inside the stability period can turn your condition "unstable" and void coverage for that issue.
- The right insurer is different for each profile. Younger travellers with mild conditions may benefit from TuGo's shorter windows; older travellers and snowbirds often need TuGo's unstable-condition rider or Manulife's underwritten plans.
If you're not sure whether your condition is considered stable, or if you've had recent changes in medications, tests or symptoms, reach out to us before you buy. We can review your medical history against different insurers' stability definitions, compare TuGo with Croix Bleue, Allianz, Manulife, Desjardins and National Bank credit-card coverage, and help you choose a plan — or optional rider — that protects you even if your health hasn't been perfectly stable in the last few months.
That way, when you board your next flight from Montréal, you'll know exactly which conditions are covered, which are excluded, and why — and you won't be discovering the meaning of "unstable" for the first time in an emergency room abroad.