Option 1

Out-of-Province (Country) Medical
EmergencyEmergency Travel Assistance (ETA)

100%

100%

$5,000,000

Unlimited

Option 2

Option 3

Option 4

• Other than airline, to and from the nearest hospital qualified to provide the necessary treatment.
• Emergency transportation within the insured's province of residence by airline to and from the nearest hospital, subject to a maximum benefit equal to the economy airfare for the insured, and, if medically required, a medical attendant who is neither a resident in your home nor a relative of your family.

• You must select one of the medical options you wish the first time you enroll in the plan. On subsequent re-enrollments you may only move one Option level per year up or down (i.e. if in Option 4 initially you can only move down to Option 3 and then Option 2 the next year before choosing Option 1).
• If you have coverage under your spouse's plan you can choose to waive the benefit.

• Charges for the purchase of hearing aids (excluding batteries). Covered expenses, per insured person, are limited to $500 for each consecutive 60 month period.

• In Canada - either semi-private or private coverage in a licensed Canadian hospital.
• Outside Canada - semi-private.

• While under the care of a physician or registered nurse provided the stay commences not less than fourteen days following a period of hospitalization and prescribed by a physician.
• Maximum of $75 per day, up to a maximum of 60 days.

• Purchase of orthopaedic shoes, orthotics and arch supports specially designed and molded, prescribed in writing by a Chiropodist or Podiatrist and are required to correct a diagnosed physical impairment.
• Limited to an overall maximum benefit of $500 per policy year.

• Duration of stay outside Canada - 180 days.
• Travel Assistance Services - provides on the spot help in case of emergency for covered employees and family members travelling outside province of residence. Full details can be downloaded.
• If on leave of absence, the maximum amount is $50,000 for a stay abroad that must not exceed 3 months; if not actively at work due to a lay-off, strike or lock-out for a period exceeding 3 months, the maximum amount as of the end of such period is $50,000.

• If referred by a physician for non-emergency treatment outside your province of residence, or for non-emergency treatment outside Canada, when treatment is unavailable in Canada and for which there is no medically sufficient alternate treatment available in Canada, the following are covered, in excess of any provincial government plan allowance, provided they are eligible for reimbursement in whole or in part by any provincial government plan.
• Semi-private accommodation in hospital (reasonable & customary charges).
• Services of a physician (reasonable & customary).
• Hospital services and supplies furnished during hospitalization, and for x-ray examinations and laboratory tests related to medical treatment rendered without hospitalization.
• Outside Canada referral expenses are subject to a maximum benefit of $100,000 per policy year.

• There is a $6 dispensing fee cap on drugs for all Options. Any amount charged over $6 will be the responsibility of the insured.
• Drugs or medicine (including preventive vaccines) required for therapy and which can only be obtained on the written prescription of a physician and dispensed by a pharmacist.
• No benefit will be payable for any single purchase of drugs which would not reasonably be used within 100 days from the date of purchase for maintenance drugs and 34 days from the date of purchase for other drugs.
• Fertility drugs are covered to a maximum of $1,000/year and $3,000/lifetime.
• Generic drug is a term for products that contain the same medicinal ingredient(s) as the original brand name drug.

• If recommended by a physician and only if medically necessary charges for services of a Registered Nurse, licensed practical nurse, Certified Nursing Assistant or member of Victorian Order of Nurses, while not confined to a hospital, provided such nurse is not a resident in your home or a relative of your family.
• Limited to an overall maximum benefit of $10,000 per policy year.

• Services, without written medical recommendation, of a Psychologist, Chiropractor*, Naturopath, Podiatrist/Chiropodist* and Speech Therapist to a maximum of $300 or $500 per policy year, per insured person.*Option 2 & 3 - Reimbursement begins once the provincial plan maximum has been reached.X-ray examinations made by a Chiropractor are limited to a maximum of four per policy year, at a maximum rate of $25.00 per examination.
• Services, with written medical recommendation, of an Osteopath, Physiotherapist and Masseur to a maximum of $300 or $500 per policy year, per insured person.
• Eligible expenses are limited to one professional visit per day for each type of specialist.

• Necessary dental treatment required as a result of an accidental injury to natural teeth provided by a dentist or specialist in accordance with the normal suggested fee for a general practitioner.
• The dental work must be completed within 12 months of the accident to be considered. All other dental expenses are excluded.

• Rental (or initial purchase at the option of Insurer) of a non-motorized wheelchair, crutches, manual hospital bed, respiratory equipment and any other durable medical equipment, excluding batteries and repairs, required on a temporary basis for therapeutic purposes (as approved by Insurer).

• Which are not covered by any provincial government plan, subject to a maximum benefit of $500 per policy year.

• Upon your death, eligible dependents' Medical insurance is extended, without premium payment, for twenty-four months from the date of death or to the date the policy or benefit terminates, whichever is earlier.

• Eligible expenses shall not include any of the following:
  

  -	charges which are considered an insured service of any provincial government plan,
  -	charges for general health examinations, and examinations required for use of third party,
  -	charges for a surgical procedure or treatment performed primarily for beautification, or charges for hospital confinement for such surgical procedure or treatment,
  -	charges for medical treatment or surgical procedure by a physician other than as provided under Out of Province and Country expenses,
  -	charges for transport or travel, other than as specifically provided under eligible expenses,
  -	charges not specified in the foregoing list of eligible medical expenses,
  -	charges for services or supplies which are furnished without the recommendation and approval of a physician acting within the scope of his license,
  -	charges which are not medically necessary to the care and treatment of any existing or suspected injury, disease or pregnancy,
  -	charges which are from an occupational injury or disease covered by any Workers' Compensation law or similar legislation,
  -	charges which would not normally have been incurred but for the presence of this insurance or for which you are not legally obligated to pay,
  -	charges which the Insurer is not permitted, by any law or regulation, to cover,
  -	charges for dental work where a third party is responsible for payment for such charges,
  -	charges for bodily injury resulting directly or indirectly from war or act of war (whether declared or undeclared), insurrection or riot, or hostilities of any kind,
  -	charges for services or supplies resulting from any intentionally self-inflicted wound,
  -	charges for drugs, sera, injectable drugs or supplies which are not approved by Health and Welfare - Canada or are experimental or limited in use whether or not so approved,
  -	charges for experimental medical procedures or treatment not approved by the Canadian Medical Association or the appropriate medical specialty society,
  -	charges made by a physician for travel, broken appointments, communication costs, filling in of forms, or physician's supplies,
  -	eye examinations

• Age 70 or earlier retirement.