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The overall maximum for all levels of extended health is $7,500 (excludes Accidental Death and Dismemberment and travel)
| Level A | Level B | Level C | |
| Preferred hospital accommodations (semi-private or private rooms) | |||
| Preferred hospital accommodations (semi-private or private rooms) | $1,000 | $2,000 | $3,000 |
| Hospital cash | |||
| Hospital cash | - | $400 | $600 |
| Hospital beds (lifetime maximum) | |||
| Hospital beds (lifetime maximum) | - | $1,000 | $1,500 |
| Home nursing | |||
| Home nursing | - | $2,500 | $2,500 |
| Auxiliary care | |||
| Auxiliary care | - | - | $1,000 |
| Level A | Level B | Level C | |
| Individual Assistance Program (IAP) | |||
| Individual Assistance Program | 12 sessions | 12 sessions | 12 sessions |
| Psychologist per visit | |||
| Psychologist per visit | $75 | $75 | $75 |
| Psychologist maximum | |||
| Psychologist maximum | $450 | $600 | $750 |
| Chiropractor per visit | |||
| Chiropractor per visit | - | $35 | $35 |
| Phsyiotherapist per visit | |||
| Phsyiotherapist per visit | - | $50 | $50 |
| Massage therapist per visit | |||
| Massage therapist per visit | - | $50 | $50 |
| Combined maximum (chiropractor, physiotherapist and massage therapist) | |||
| Combined maximum (chiropractor, physiotherapist and massage therapist) | - | $500 | $750 |
| Podiatrist and chiropodist per visit | |||
| Podiatrist and chiropodist per visit | - | $25 | $25 |
| Combined maximum (podiatrist and chiropodist) | |||
| Combined maximum (podiatrist and chiropodist) | - | $300 | $300 |
| Acupuncturist, homeopath, osteopath and naturopath per visit | |||
| Acupuncturist, homeopath, osteopath and naturopath per visit | - | - | $50 |
| Combined maximum (acupuncturist, homeopath, osteopath and naturopath) | |||
| Combined maximum (acupuncturist, homeopath, osteopath and naturopath) | - | - | 650 |
| Speech language Pathologist per visit | |||
| Speech language Pathologist per visit | - | - | $80 |
| Combined Speech language Pathologist maximum | |||
| Speech language Pathologist maximum | - | - | $500 |
| Level A | Level B | Level C | |
| Ambulance services (ground and air) | |||
| Ambulance services (ground and air) | 100% | 100% | 100% |
| Accidental dental care (per incident) | |||
| Accidental dental care (per incident) | $2,000 | $2,500 | $3,000 |
| Custom braces (every two years) visit | |||
| Custom braces (every two years) | - | 70%; $750 | 70%; $750 |
| Foot orthotics | |||
| Foot orthotics | - | $300 | $300 |
| Wheelchair (every three years) | |||
| Wheelchair (every three years) | - | $1,500 | $1,500 |
| Medical aids (crutches, canes, casts, cervical collars, walkers, splints, trusses and traction kits) | |||
| Medical aids (crutches, canes, casts, cervical collars, walkers, splints, trusses and traction kits) | - | $250 | $250 |
| CPAP (sleep apnea appliance) (every five years) | |||
| CPAP (sleep apnea appliance) (every five years) | - | $500 | $750 |
| Hearing aids (every four years) | |||
| Hearing aids (every four years) | - | $500 | $1,000 |
| Ileostomy/colostomy, urinary catheters and supplies | |||
| Ileostomy/colostomy, urinary catheters and supplies | - | $1,200 | $1,200 |
| Surgical stockings | |||
| Surgical stockings | - | $200 | $200 |
| Mastectomy prosthesis (every two years) | |||
| Mastectomy prosthesis (every two years) | - | $200 (single) | $200 (single) |
| - | $400 (double) | $400 (double) | |
| Prosthetics | |||
| Prosthetics | - | $300 | $300 |
| Oxygen and equipment | |||
| Oxygen and equipment | - | - | $1,000 |
| Wigs and hairpieces (every five years) | |||
| Wigs and hairpieces (every five years) | - | $250 | $250 |
| Balance online wellness program | |||
| Balance online wellness program | Included | Included | Included |
| Level A | Level B | Level C | |
| Vision care including eye exams (every two years) | |||
| Vision care including eye exams (every two years) | $150 | $300 | $500 |
| Level A | Level B | Level C | |
| Travel per trip maximum, terminates at age 85* | |||
| Travel per trip maximum, terminates at age 85* | $5 million | $5 million | $5 million |
| Travel days per trip | |||
| Travel days per trip | 30 | 45 | 60 |
| Travel plan discount (additional coverage) | |||
| Travel plan discount (additional coverage) | 15% | 20% | 25% |
| Stability clause | |||
| Stability clause | 90 days | 90 days | 90 days |
*"Terminates at age" references the age when a benefit is no longer available for that specific individual
**Underwritten by Blue Cross Life Insurance Company of Canada.
| Level A | Level B | Level C | |
| Accidental Death and Dismemberment | |||
| Accidental Death and Dismemberment (AD&D)** | $15,000 | $20,000 | $25,000 |
*Underwritten by Blue Cross Life Insurance Company of Canada.
| Level A | Level B | Level C | |
| Basic and preventive care (2-month waiting period) includes checkups, cleanings, fillings, extractions and root canals | |||
| Basic and preventive care includes checkups, cleanings, fillings, extractions and root canals | 70% | 75% | 80% |
| Dentures | |||
| Dentures | - | 50% | 50% |
| Periodontics | |||
| Periodontics | - | 50% | 80% |
| Extensive includes crowns, bridges and implants | |||
| Extensive includes crowns, bridges and implants | - | - | 50% |
| Combined annual dental maximums | |||
| Combined annual dental maximums | $750 | $1,500 | $2,000 |
| Level A | Level B | Level C | |
| Coverage level direct bill | |||
| Coverage level direct bill | 70% | 75% | 80% |
| Prescription drug maximum (includes diabetic supplies, contraceptives, smoking cessation and vaccines)*** | |||
| Prescription drug maximum (includes diabetic supplies, contraceptives, smoking cessation and vaccines)*** | $1,000 | $2,000 | $3,000 |