Maximum Eligible Expense per Participant Reimburse
Extended Health Provision as indicated below
Drug Benefit 80% yes
Catastrophic drug coverage Eligible drug expenses in excess of $3,000 out-of-pocket drug expense incurred in a given calendar year 100% yes
smoking cessation aids $1,000 in a lifetime 80% yes
Erectile dysfunction drugs $500 every calendar year on a combined basis 80% yes
Vision Care Benefit 80% yes
eyeglasses/contact lenses (purchase and repairs) $275 every 2 calendar years commencing every odd year

no limit if required as a result of surgery or accident and purchased within 6 months of the event

eye examinations 1 examination every 2 calendar years commencing every odd year
Medical Practitioners Benefit 80% yes
Services of:  
physiotherapist up to $500 and over $1000 in a calendar year
psychologist $1,000 in a calendar year
Social worker (Isolated Posts only) $1,000 in a calendar year
massage therapist $300 in a calendar year
osteopath $300 in a calendar year
naturopath $300 in a calendar year
Podiatrist, or chiropodist $300 in a calendar year
chiropractor $500 in a calendar year
speech language pathologist $500 in a calendar year
electrologist (including treatment when performed by a physician) $20 per visit
nursing services $15,000 in a calendar year
Miscellaneous Expense Benefit 80% yes
orthopaedic shoes $150 in a calendar year
hearing aids (purchase/repairs) $1,000 less any eligible hearing aid expenses claimed during the previous 60 months

no limit if required as a result of surgery or accident and purchased within 6 months of the event

orthopaedic brassieres $200 in a calendar year
wigs $1000 during a 60 month period
insulin jet injector device $760 during a 36 month period
Durable Equipment
A. For Care  
Devices for physical movement
walker once in 60 months
lift/hoist once in a lifetime
wheelchair (purchase/repairs) once in 60 months, less any wheelchair expenses claimed for repairs during the previous 60 months. In case of dependant children, the 60-month maximum may not apply for medical necessity.
Devices for support and resting
hospital bed once in a lifetime
roho cushion once in 12 months
therapeutic mattress once in 60 months
Devices for monitoring
apnea monitor once in a lifetime
enuresis detector once in a lifetime
B. For Treatment
Devices for mechanical and therapeutic support
transcutaneous electric stimulator once in 120 months
traction kit once in a lifetime
infusion pump once in 60 months
extremity pump (lymphapress) once in a lifetime
Devices for aerotherapeutic support
CPAP's, BiPAP's, related dental appliances once in 60 months
compressor once in 60 months
maximist once in 60 months
Out-of-Province Benefit
Emergency Benefit While Travelling / Emergency Travel Assistance Services $500,000 per period of travel (not exceeding 40 consecutive days) 100% none
Referral Benefit $25,000 per illness or injury 80% yes
Hospital Provision
Level I $60 per day 100% none
Level II $140 per day 100% none
Level III $220 per day 100% none
Basic Health Care Provision 3x the amount otherwise payable under the current fee schedule of the Health Insurance Act 1972 of Ontario 100% none

1 The deductible is $60 per person, $100 per family. The deductible applies per calendar year to the combined eligible expenses under the Extended Health Provision.

Length of time a prescription is valid

services of a physiotherapist one year
services of a massage therapist one year
services of a speech language pathologist one year
services of a psychologist one year
Services of a social worker (isolated post) one year
services of a nurse one year, unless otherwise advised by the Administrator
services of an electrologist three years
orthotics three years
orthopaedic shoes one year

Note: Unless otherwise requested by the Administrator, all other prescriptions do not have a time limit.