This is only a summary of your plan benefits. It does not describe all the details, such as applicable maximums and exclusions. Certain limitations and conditions apply.

Health benefits
Ambulance	• 100%
Drugs	• 100% of eligible expenses for drugs requiring a prescription after you pay the first $7.50 per eligible drug appearing on your prescription
Hospital	• 100% of the difference between ward and semiprivate room
Medical services/ equipment	• 100%
Paramedical services	• Effective June 1, 2009, a combined maximum of $1,500 per calendar year
Vision care	For expenses incurred on or after July 1, 2006: • 100% of the cost of one eye exam, including eye refractions, every 24 consecutive months (every 12 consecutive months for persons under 18) • 100% of the cost of a macular degeneration test • 100% of the cost of eyeglasses and contact lenses, up to $160 every 24 consecutive months (every 12 consecutive months for persons under 18)     For expenses incurred before July 1, 2006: • 100% of the cost of eye exams, eyeglasses and contact lenses, up to $160 for expenses incurred on or after December 1, 2005, or $100 for expenses incurred previously, every 24 consecutive months (every 12 consecutive months for persons under 18)

Additional benefits may be payable in the event of accidental injury. Also, certain health care expenses are not covered.

Dental benefits
Basic services	• 80%
Major services	• 50% (max. $1,000 per person per calendar year)
Orthodontic services	• 50% for you and your dependents (lifetime max. $3,000 per person)—coverage applies only to expenses incurred on or after July 1, 2006

Examples of eligible expenses Basic services Major services   Orthodontic services • Routine check-ups • Fillings • Teeth polishing/cleaning • Root canal therapy • Dentures • Crowns • Bridges • Inlays/onlays   • Appliances • Adjustments • Surgical exposure of teeth • X-rays

Certain conditions and limitations apply. Also, certain dental expenses are not covered.

Disability benefits
Benefit equal to 70% of your monthly earnings, indexed annually, to a maximum of $6,000 per month. Long-term disability benefits may be reduced or not payable in certain cases.

Travel benefits

Coverage of up to $1 million per emergency above what your provincial plan pays.

Examples of eligible expenses and services Reimbursement at 100% Reimbursement at the same level as in Canada • Hospitalization • Physician services • Referrals • Return home airfare • Return of vehicle • Living expenses for travelling companion • Arrangements for direct payment for physicians’ services, hospitalization, and other insured services • Prescription drugs • Wheelchairs • Crutches • Other eligible expenses under the plan’s health coverage

Certain travel expenses are not covered.