Manulife Super Visa
Insurance — Get a Quote

Please fill in the details below so I can prepare your personalized quote quickly. All information is kept strictly confidential.

📋 What is Super Visa Insurance? The Canadian Super Visa requires parents and grandparents visiting from abroad to have at least $100,000 CAD in emergency medical coverage for a minimum of 1 year. Please complete this form accurately so I can find you the best available rate.

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Your Full Name

Phone Number

Email Address

Date Completed

Visitor & Policy Details

Country Where Visitor Currently Lives

Province of Residence in Canada Province where they will be staying in Canada

Covered by a Canadian Government Health Insurance Plan?

Yes No

e.g. OHIP, MSP, AHCIP

Is This for a Super Visa Application?

Yes No

Topping Up an Existing Annual Insurance Plan?

Yes No

Topping Up a Travel80 Term Travel Insurance Plan?

Yes No

Travelling to Study?

Yes No

Travel & Coverage Dates

Arrival Date in Canada

Coverage Start Date Usually same as or just before arrival date

Coverage End Date Super Visa requires minimum 1 year of coverage

Will the Visitor Leave and Return to Canada During This Period?

Yes No, staying for the full period

Traveller Information

👤 Traveller 1

First Name

Last Name

Date of Birth

Age Auto-calculated when date of birth is entered

Relationship to You

Parent Grandparent Other

Pre-existing Medical Conditions?

Yes No Not sure

Coverage Preferences

Preferred Coverage Amount

$100,000 $150,000 $200,000 Not sure

Minimum $100,000 required for Super Visa

Deductible Preference

$0 (no deductible) $500 $1,000 Not sure

A higher deductible lowers your premium

Would You Like Coverage for Pre-existing Conditions?

Yes No Not sure — please advise me

Additional Notes

Anything else I should know? (health history, special circumstances, questions)

Milbonita Financial Guide · linktr.ee/MilbonitaFinancialGuide · Your information is kept strictly confidential

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Your information has been received. Milbonita will review your details and be in touch shortly with your Super Visa insurance quote.

Questions? Visit linktr.ee/MilbonitaFinancialGuide

Manulife Super VisaInsurance — Get a Quote

👤 Traveller 1

Thank You!

Manulife Super Visa
Insurance — Get a Quote