Common use of Covered Expenses Clause in Contracts

Covered Expenses. Covered Expenses included under the plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-occupational injuries, diseases or for pregnancy. HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES up to the difference between the hospital’s daily charge for xxxx and average semi-private accommodations. DRUGS AND MEDICINES obtainable only upon a physician’s prescription and dispensed through a registered pharmacist. PROFESSIONAL AMBULANCE SERVICE when used to transport the individual from the place where he is injured by an accident or stricken by a disease to the first hospital where treatment is given, or from a hospital to a convalescent hospital. No other expenses in connection with travel are included. OUT-PATIENT HOSPITAL SERVICES AND SUPPLIES in connection with:  use of examination or operating room,  drugs, dressings or casts  anaesthesia in connection with the performance of a surgical procedure but not charges made by a resident physician or intern of a hospital. REGISTERED GRADUATE NURSE (R.N.) other than a nurse who ordinarily resides in your home, or who is a member of your or your spouse’s family, provided such services have been ordered by a physician. CONVALESCENT HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES up to the difference between the hospital’s daily charge for xxxx and average semi- private accommodations for as many as 120 days during any one period of disability provided the individual is admitted to the convalescent hospital within 14 days following confinement in a hospital. All confinements in a convalescent hospital will be considered as one period of disability unless confinements are separated by at least 90 days. TREATMENT BY A PROVINCIALLY LICENSED OSTEOPATH, NATUROPATH, PODIATRIST OR CHRISTIAN SCIENCE PRACTITIONER up to $7.00 per treatment and up to $25 per disability for x-rays but not more than 30 visits in any calendar year for each type of practitioner. However, no benefit will be paid for any charges in excess of $7.00 per treatment and no benefit will be paid while the individual is entitled to similar benefits under any provincial health plan. TREATMENT BY A PROVINCIALLY LICENSED CHIROPRACTOR up to $15 per visit and up to $25 per disability for x-rays, subject to a maximum of $300 per calendar year. No benefits will be paid while the individual is entitled to similar benefits under any provincial health plan. PHYSIOTHERAPY by a person duly qualified and registered and legally engaged in the practice of physiotherapy, provided such services, by duration and type, have been prescribed by a physician.

Covered Expenses. Covered Expenses included under the plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-occupational injuries, diseases or for pregnancy. HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES up to the difference between the hospital’s daily charge for xxxx and average semi-private accommodations. DRUGS AND MEDICINES obtainable only upon a physician’s prescription and dispensed through a registered pharmacist. PROFESSIONAL AMBULANCE SERVICE when used to transport the individual from the place where he is injured by an accident or stricken by a disease to the first hospital where treatment is given, or from a hospital to a convalescent hospital. No other expenses in connection with travel are included. OUT-PATIENT HOSPITAL SERVICES AND SUPPLIES in connection with:  • use of examination or operating room,  • drugs, dressings or casts  • anaesthesia in connection with the performance of a surgical procedure but not charges made by a resident physician or intern of a hospital. REGISTERED GRADUATE NURSE (R.N.) other than a nurse who ordinarily resides in your home, or who is a member of your or your spouse’s family, provided such services have been ordered by a physician. CONVALESCENT HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES up to the difference between the hospital’s daily charge for xxxx and average semi- private accommodations for as many as 120 days during any one period of disability provided the individual is admitted to the convalescent hospital within 14 days following confinement in a hospital. All confinements in a convalescent hospital will be considered as one period of disability unless confinements are separated by at least 90 days. TREATMENT BY A PROVINCIALLY LICENSED OSTEOPATH, NATUROPATH, PODIATRIST OR CHRISTIAN SCIENCE PRACTITIONER up to $7.00 25.00 per treatment and up to $25 per disability for x-rays but not more than 30 visits and to a maximum of $300.00 in any calendar year for each type of practitioner. However, no benefit will be paid for any charges in excess of $7.00 25.00 per treatment and no benefit will be paid while the individual is entitled to similar benefits under any provincial health plan. TREATMENT BY A PROVINCIALLY LICENSED CHIROPRACTOR up to $15 25.00 per visit and up to $25 per disability for x-rays, subject to a maximum of $300 per calendar year. No benefits will be paid while the individual is entitled to similar benefits under any provincial health plan. PHYSIOTHERAPY by a person duly qualified and registered and legally engaged in the practice of physiotherapy, provided such services, by duration and type, have been prescribed by a physician.

Covered Expenses. Covered Expenses included under the plan Plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-occupational injuries, diseases or for pregnancy. HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES Class I Expenses Hospital Board and Room and Other Necessary Services and Supplies up to the difference between the hospital’s 's daily charge for xxxx and average semi-semi- private accommodations. DRUGS AND MEDICINES Vision Care expenses incurred by an employee and/or his covered dependents when recommended by a physician or optometrist as follows: Frames, lenses, and the fitting of prescription glasses, including contact lenses up to a total payment of $75.00 per family member, in any two consecutive calendar years. Class II Expenses Note: Any dollar limits referred to in the list of Class II Expenses are the charges recognized by the Plan and not the benefits payable since these charges are subject to the deductible as stated earlier. Drugs and Medicines obtainable only upon a physician’s 's prescription and dispensed through a registered pharmacist. PROFESSIONAL AMBULANCE SERVICE Professional Ambulance Service when used to transport the individual from the place where he is injured by an accident or stricken by a disease to the first hospital where treatment is given, or from a hospital to a convalescent hospital. No other expenses in connection with travel are included. OUTOut-PATIENT HOSPITAL SERVICES AND SUPPLIES Patient Hospital Services and Supplies in connection with:  - use of examination or operating room,  - drugs, dressings or casts  - anaesthesia in connection with the performance of a surgical procedure but not charges made by a resident physician or intern of a hospital. REGISTERED GRADUATE NURSE Registered Graduate Nurse (R.N.) other than a nurse who ordinarily resides in your home, or who is a member of your you or your spouse’s 's family, provided such services have been ordered by a physician. CONVALESCENT HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES Convalescent Hospital Board and Room and Other Necessary Services and Supplies up to the difference between the hospital’s 's daily charge for xxxx and average semi- semi-private accommodations for as many as 120 one hundred twenty (120) days during any one period of disability provided the individual is admitted to the convalescent hospital within 14 fourteen (14) days following confinement in a hospital. All confinements in a convalescent hospital will be considered as one period of disability unless confinements are separated by at least 90 ninety (90) days. TREATMENT BY A PROVINCIALLY LICENSED OSTEOPATHTreatment by a Provincially Licensed Osteopath, NATUROPATHNaturopath, PODIATRIST OR CHRISTIAN SCIENCE PRACTITIONER Podiatrist or Christian Science Practitioner up to $7.00 per treatment and up to $25 25.00 per disability for x-rays but not more than 30 visits in any calendar year for each type of practitioner. However, no benefit will be paid for any charges in excess of $7.00 per treatment and no benefit will be paid while the individual is entitled to similar benefits under any provincial Provincial health plan. TREATMENT BY A PROVINCIALLY LICENSED CHIROPRACTOR Treatment by a Provincially Licensed Chiropractor up to $15 15.00 per visit and up to $25 25.00 per disability for x-rays, subject to a maximum of $300 300.00 per calendar year. No benefits will be paid while the individual is entitled to similar benefits under any provincial Provincial health plan. PHYSIOTHERAPY Physiotherapy by a person duly qualified and registered and legally engaged in the practice of physiotherapy, provided such services, by duration and type, have been prescribed by a physician. Treatment by a Person Duly Qualified and Registered and Legally Engaged in the Practice of Psychology on the written recommendation of a physician up to $25.00 for the first visit and $10.00 for each additional visit, but not more than 30 visits in any calendar year. Treatment by a Person Duly Qualified and Registered and Legally Engaged in the Practice of Acupuncture for not more than $7.00 per visit, and not more than 30 visits per year. Treatments by a Masseur who is duly qualified and registered and legally engaged in the practice of massage provided such services, by duration and type, have been prescribed by a physician but not more than $7.00 per visit, and not more than 30 visits in any calendar year. Speech Therapy by a person duly qualified and registered and legally engaged in the practice of speech therapy provided such services, by duration and type, have been prescribed by a physician but not more than 30 visits in any calendar year. Psychoanalysis - Physician charges in connection with Psychoanalysis treatment are a covered expense where permitted by law. Out-of-Province Emergency Treatment as described in (1) and (2) below incurred in connection with emergency treatment while the individual is outside the province in which he normally resides or outside the country.

Covered Expenses. Covered Expenses included under the plan are the charges which you are required to pay for the following services and supplies received while you are insured, for the treatment of non-non- occupational injuries, diseases or for pregnancy. Class I Expenses VISION CARE expenses incurred by an employee and/or his covered dependents when recommended by a physician or optometrist as follows: Frames, lenses, and the fitting of prescription glasses, including contact lenses up to a total payment of per family member, in any two consecutive calendar year. Effective May the benefit will be increased to per family member in any two consecutive calendar years. HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES up to the difference between the hospital’s daily charge for xxxx and average semi-semi- private accommodations. Class II Expenses NOTE: Any dollar limits referred to in the list of Class II Expenses are the charges by the plan and not the benefits payable since these charges are subject to the Deductible as stated earlier. DRUGS AND MEDICINES obtainable only upon a physician’s prescription and dispensed through a registered pharmacist. PROFESSIONAL AMBULANCE SERVICE when used to transport the individual from the place where he is injured by an accident or stricken by a disease to the first hospital where treatment is given, or from a hospital to a convalescent hospital. No other expenses in connection with travel are included. OUT-PATIENT HOSPITAL SERVICES AND SUPPLIES in connection with:  with use of examination or operating room,  drugs, dressings or casts  anaesthesia in connection with the performance of a surgical procedure but not charges made by a resident physician or intern of a hospital. REGISTERED GRADUATE NURSE (R.N.) other than a nurse who ordinarily resides in your home, or who is a member of your or your spouse’s family, provided such services have been ordered by a physician. CONVALESCENT HOSPITAL BOARD AND ROOM AND OTHER NECESSARY SERVICES AND SUPPLIES up to the difference between the hospital’s daily charge for xxxx and average semi- semi-private accommodations for as many as 120 days during any one period of disability provided the individual is admitted to the convalescent hospital within 14 days following confinement in a hospital. All confinements in a convalescent hospital will be considered as one period of disability unless confinements are separated by at least 90 days. TREATMENT BY A PROVINCIALLY LICENSED OSTEOPATH, NATUROPATH, PODIATRIST OR CHRISTIAN SCIENCE PRACTITIONER up to $7.00 per treatment and up to $25 per disability for x-rays but not more than 30 visits in any calendar year for each type of practitioner. However, no benefit will be paid for any charges in excess of $7.00 per treatment and no benefit will be paid while the individual is entitled to similar benefits under any provincial health plan. TREATMENT BY A PROVINCIALLY LICENSED CHIROPRACTOR up to $15 per visit and up to $25 per disability for x-rays, subject to a maximum of $300 per calendar year. No benefits will be paid while the individual is entitled to similar benefits under any provincial health plan. PHYSIOTHERAPY by a person duly qualified and registered and legally engaged in the practice of physiotherapy, provided such services, by duration and type, have been prescribed by a physician.. TREATMENT BY A PERSON DULY QUALIFIED AND REGISTERED AND LEGALLY ENGAGED IN THE PRACTICE OF PSYCHOLOGY on the written recommendation of a physician up to for the first and for each additional visit but not more than visits in any calendar year. TREATMENT BY A PERSON DULY QUALIFIED AND REGISTERED AND LEGALLY ENGAGED IN THE PRACTICE OF ACUPUNCTURE For not more than per visit, and not more than visits per year. TREATMENTS BY A MASSEUR who is duly qualified and registered and legally engaged in the practice of massage provided such services, by duration and type, have been prescribed by a physician but not more than per visit, and not more than visits in any calendar year. SPEECH THERAPY by a person duly qualified and registered and legally engaged in the practice of speech therapy provided such services, by duration and type, have been prescribed by a physician but not more than visits in any calendar year. PSYCHOANALYSIS Physician charges in connection with psychoanalysis treatment are a covered expense where permitted by law. OUT-OF-PROVINCE EMERGENCY TREATMENT as described in and below incurred in connection with emergency treatment while the individual is outside the province in which he normally resides or outside the country. Charges by a general practitioner or specialist in excess of the amount allowed under the Provincial Hospital and Medical Plans in the individual’s normal province of residence, provided such charges are reasonable and customary in the area in which they were incurred. Up to per day for charges for hospital confinement in excess of the allowance for xxxx accommodation payable by the Provincial Hospital Plan in the individual’s normal province of residence. No charges will be considered unless all or part of the daily charge is payable under such Provincial Hospital Plan, nor for any type of accommodation for which the individual would not have been covered under this Plan had he been hospitalized in his normal province of residence. RENTAL OF IRON LUNG, WHEELCHAIR OR OTHER DURABLE MEDICAL OR SURGICAL EQUIPMENT. ARTIFICIAL LIMBS AND EYES, CRUTCHES, SPLINTS, CASTS, TRUSSES AND BRACES when prescribed or ordered by the attending physician. SHOES when prescribed by the attending physician, one pair per year subject to a maximum payment of EMERGENCY DENTAL WORK OR COSMETIC SURGERY performed by a physician or dentist for the prompt repair of natural teeth or other body tissue and required as a result of a non-occupational accident. ANAESTHESIA, OXYGEN, BLOOD AND BLOOD PRODUCTS. COLOSTOMY AND DIABETIC SUPPLIES. DIAGNOSTIC LABORATORY AND X-RAY EXPENSES. GENERAL DEFINITIONS Definitions Definitions relating to this Plan shall be those set out in Confederation Life Insurance Company Policy effective January