PARTICULAR TERMS AND CONDITIONS

PARTICULAR TERMS AND CONDITIONS

Particular Terms and Conditions Policy validity period...3 Personal Details...3 Form of Payment...3 Information in connection with the insurance policy you have chosen...4 Premium Amount...4 Guarantees and limits of the policy...6 Policy qualification periods...18 Pre-existing pathologies...19 Other features of the policy...19 Personal data protection...19 2-21 Índice

Guarantees and limits of the policy Geographical area of coverage The benefits of this policy are applicable worldwide except in the USA, where only emergency assistance is luded for up to 28 days of your stay in the USA, providing the assistance does not refer to an illness known before your arrival in the country. Assistance in the US must be pre-authorised with the dedicated team in our call centre within 48 hours of admission, or as soon as reasonably possible. Expenses coverage Coverage of 100% of the medical expenses, according to the covers of the Policy, in any of the following modalities: In Sanitas medical network in Spain. In Bupa Global worldwide network of participating hospitals, centers and professionals, with the corresponding pre-authorisation from our customer service team. In any other hospital, medical centre or medical professional. SANITAS will only pay for reasonable and customary costs. This means that the costs charged by the Insured s treatment provider should not be more than they would normally charge and be representative of charges by other treatment providers in the same area. Guidelines for fees and medical practice (luding established treatment plans, which outline the most appropriate course of care for a specific condition, operation or procedure) may be published by a government or official medical body. In such cases, or where published insurance industry standards exist, SANITAS may refer to these when assessing and paying claims. Charges in excess of published guidelines or reasonable and customary costs may not be paid. Benefit limits There are two kinds of benefit limits shown in this table. Firstly, the overall annual maximum which is the maximum we will pay for all benefits in total for each person, each policy year. Secondly, some benefits also have a limit applied to them separately; for example Out-patient Preventive Treatments benefits. All benefit limits apply per person. If a benefit limit also applies each year, this means that once a benefit limit has been reached, that benefit will no longer be available until your plan is renewed. If a benefit limit is a lifetime limit, once this benefit limit has been reached, no further costs will be covered for this benefit regardless of the renewal of your plan, for example in-patient psychiatric treatment. 6-21

Description of Benefits and Limits of the Policy Overall annual maximum limit: 2.100.000 All benefits below, even those paid in full will contribute to the overall annual maximum limit. IN-PATIENT CARE No sub-limit In-patient care covers all in-patient and day-patient treatment costs as described in the General Terms and Conditions and is paid in full up to the overall annual maximum limit. OUT-PATIENT CARE 34.000 / each policy year This limit is applied to assistance on an outpatient basis, luding: 1. Consultations with Family doctors and other medical specialists detailed in the General Terms and Conditions 2. Anatomical pathology, scans, radio diagnosis and diagnostic tests when recommended by your specialist or doctor to help diagnose or assess your condition However, the following benefits are paid in full up to the overall annual maximum limit, and the previous sublimit is not applied: 1. Out-patient surgical operations when carried out by a specialist or a doctor. 2. Advanced Imaging when recommended by your specialist to help diagnose or assess your condition, luding: magnetic resonance imaging (MRI) computed tomography (CT) positron emission tomography (PET) 3. Cancer treatment and services Once cancer is diagnosed, we pay fees that are related specifically to planning and carrying out treatment for cancer. This ludes tests, scans, consultations medication (such as cytotoxic drugs or chemotherapy) and costs of oncology specialists in the terms established in the General Terms and Conditions. 7-21

MEDICATION AND VACCINES No sub-limit. Prescribed medicines, dressings and vaccinations as described in the General Terms and Conditions HIV DRUGS. INCLUDING ANTIRETROVIRAL 9.500 / each policy year PREVENTIVE EXAMINATIONS No sub-limit. Preventive examinations as described in the General Terms and Conditions AMBULANCE Local land ambulance HOME NURSING 4.600 / each policy year Midwife for non convencional childbird: 900 HOSPICE AND PALLIATIVE CARE 45 days / for the lifetime of the policy IN-PATIENT CASH BENEFIT 200 / each night up to 25 nights each policy year ODONTOSTOMATOLOGY No sub-limit. Benefits as described in the "General Terms and Conditions" MATERNITY 8-21

25.000 / each policy year Maternity services lude: Pregnancy Normal childbirth and delivery Caesarean section Routine care for your baby for up to seven days following birth from the mother s / father s maternity benefit. Any non-routine care, if eligible, is paid from the baby s newborn care benefit. NEWBORN CARE 110.000 maximum benefit for all treatment received during the first 90 days following birth This benefit is paid instead of any other benefit for all treatment required by a newborn child during the first 90 days following birth. Children must be covered under their own policy before you can claim for this benefit. REPATRIATION COVER Expenses of one companion: 3.900 Travel expenses of the people dependent on the insured evacuated: 2.500 Travel expenses of the people dependent on the insured whose mortal remains are repatriated to the country of origin: 1.900 Total financial limit for the repatriation of mortal remains: 13.000. COMPLEMENTARY THERAPIES No sub-limit. SPEECH AND LANGUAGE THERAPY No sub-limit. REHABILITATION No sub-limit. PSYCHIATRIC TREATMENT 23.000 / each policy year OPHTHALMOLOGY COSTS REFUND 230 / each policy year 9-21

INFERTILITY TREATMENT 16.000 / for the lifetime of the policy AUXILIARY DEVICES 3.300 / each policy year DENTISTRY (ADD-ON) 2.700 / each policy year This cover complements and is in addition to the dentistry (standard) cover. It ludes the treatments detailed below with the percentage of reimbursement of expenses shown. Sanitas Dental PREVENTATIVE DENTISTRY General consultation: screening and diagnosis Topical fluoridation Dental cleaning Treatment for tooth sensitivity Sealant of fissures ORAL SURGERY - EXTRACTIONS Extraction (single tooth) Non-molar tooth extraction luding periapical cysts * Third molar extraction (wisdom tooth) not luded * Third molar extraction (wisdom tooth) luding periapical cysts* Root extraction Extraction by sectioning Postoperative check-up (luding suture removal) - MINOR SURGERY 100% 80% 10-21

Frenectomy (lingual or labial frenulum) Mucocoele removal Periapical cyst removal or extraction Gum abscess drainage Apicectomy - PRE- PROSTHESIS SURGERY Vestibuloplasty (per quadrant) Alveolar ridge adjustment (per quadrant) Torus removal (per quadrant) - ORTHODONTIC SURGERY 48,50 112,50 112,50 112,50 80% 80% Orthodontic fenestration (per tooth) 80% RESTORATIVE DENTISTRY Filling Reconstruction Direct pulp capping Indirect pulp capping Temporary filling ENDODONTICS Symptomatic treatment consultation (opening, instrumentation, drainage) Retro obturation material (MTA) Single root endodontic treatment Dual root endodontic treatment Multi-root endodontic treatment Fiberglass or carbon post Single root endodontic re-treatment Dual root endodontic re-treatment Multi-root endodontic re-treatment COSMETIC DENTISTRY - WHITENING 36,00 46,00 14,50 9,50 16,50 85,00 79,00 109,00 149,00 50,00 96,00 126,00 166,00 100% 80% Teeth whitening with splints for home use (per treatment) Photoactivated tooth whitening (per treatment) Photoactivated tooth whitening (per tooth and session) Mixed teeth whitening photoactivation + splint (per treatment) Internal teeth whitening (per tooth and session) - COSMETIC RECONSTRUCTION 220,00 280,00 53,50 350,00 53,50 Not luded in your cover 11-21

Porcelain veneer Injected veneer Zirconia veneer Composite veneer Temporary veneer Composite veneer polishing (1 to 3 teeth) Composite veneer polishing (4 or more teeth) Composite veneer reconstruction (per tooth) Intraoral porcelain repair (per tooth) PAEDIATRIC DENTISTRY (children under 15) Consultation Oral health Intraoral x-ray Topical fluorination Sealant of fissures Dental cleaning Primary tooth filling Oral screen Primary tooth extraction Pulpotomy without reconstruction Pulpectomy without reconstruction Pre-formed metal crown Apexification (full treatment) Fixed space maintainer Removable space maintainer Removal of bridge/crown/space maintainer (per tooth) Occlusion guide or stop (per tooth) Dental re-implant PROSTHESES Assembly and study of semi-adjustable articulator Occlusion analysis Customisation Diagnostic wax-up (per tooth) 214,00 235,50 267,50 110,00 99,00 25,00 50,00 51,50 66,50 36,00 45,00 45,00 75,00 53,50 64,50 75,00 90,00 11,50 40,00 41,50 43,00 25,00 Not luded in your cover 100% 80% 12-21

- FIXED PROSTHESES Removal of bridge/crown/space maintainer (per tooth) Insert Combination insert (composite and porcelain) Temporary resin crown Crown or bridge unit over tooth Cosmetic crown or bridge unit over tooth Precious material supplement Single root castable abutment Multi-root castable abutment Maryland support (unit) Ceramic Maryland support (tooth) Fibreglass Maryland support Attachments Rebonding - REMOVABLE PROSTHESES Removable acrylic (1-3 teeth) Removable acrylic (4-6 teeth) Removable acrylic (6+ teeth) Hypoallergenic resin supplement (per arch) Repair Repair (rebasing) (per apparatus) Repair (retainer addition) Metal reinforcement Repair (tooth added to removable acrylic) Temporary full set (one arch, upper or lower) Permanent set with metal reinforcement Lingual plate (per tooth) Lingual plate (base structure) Flexible removable (1-3 teeth) (Flexite, Valplast, etc.) Flexible removable (4-6 teeth) (Flexite, Valplast, etc.) Flexible removable (6+ teeth) (Flexite, Valplast, etc.) Ceramic shoulder or neck (per tooth) 11,50 128,50 190,00 25,00 246,50 342,50 SPC 80,50 96,50 64,50 130,00 99,00 128,50 182,00 249,00 289,00 39,00 35,00 60,00 41,00 29,00 40,00 280,00 395,00 49,00 187,50 397,00 420,00 454,00 30,00 13-21

PERIODONTICS Periodontal assessment (periodontal chart) (per arch) Periodontal x-ray series Root planing and scaling (per tooth) (curettage) Root planing and scaling (per quadrant) (curettage) Periodontal splinting (per tooth) Gingivectomy (per quadrant) Flap surgery (per tooth) Regeneration with biomaterials (per 0.5 gr. unit) Membrane (unit) Crown lengthening Apical flap repositioning (per quadrant) Free gingival graft Connective tissue graft Periodontal maintenance (both arches) Peri-implantitis treatment (per implant) ORTHODONTICS (1) Initial consultation Examination and diagnosis for personalised treatment plan Orthodontic x-ray exam TREATMENT FOR FIXED APPLIANCES - METAL BRACES Dental arch treatment (one arch) Dental arch treatment (both arches) - CERAMIC BRACES Dental arch treatment (one arch) Dental arch treatment (both arches) - SAPPHIRE BRACES Dental arch treatment (one arch) Dental arch treatment (both arches) - SELF-LIGATING BRACES Dental arch treatment (one arch) Dental arch treatment (both arches) COSMETIC SELF-LIGATING BRACES 9,00 49,00 39,00 29,00 175,00 214,00 130,00 198,00 130,00 295,00 40,00 120,00 64,50 1.760,00 1.960,00 2.386,50 2.600,50 2.550,00 2.980,00 2.440,00 2.707,50 80% 14-21

- PARTIALLY CERAMIC SELF-LIGATING BRACES Dental arch treatment (one arch) Dental arch treatment (both arches) - FULLY CERAMIC SELF-LIGATING BRACES Dental arch treatment (one arch) Dental arch treatment (both arches) TREATMENT FOR REMOVABLE APPLIANCES - WITH INVISALIGN 2.640,00 2.907,50 3.500,00 3.897,50 Design of Invisalign treatment plan 390,00 Invisalign Full (more than 14 aligners): treatment both arches 4.800,00 Invisalign Lite (up to 14 aligners): treatment one arch 2.900,00 Invisalign Lite (up to 14 aligners): treatment both arches 3.600,00 Invisalign I7 (up to 7 aligners): treatment one arch 1.400,00 Invisalign I7 (up to 7 aligners): treatment both arches 1.800,00 Invisalign Teen (more than 14 aligners): treatment both arches 4.800,00 - WITH INVISILINE Up to 12 months of treatment (both arches) More than 12 months of treatment (both arches) TREATMENT FOR REMOVABLE OR FIXED APPLIANCES - INTERCEPTIVE TREATMENT Up to 12 months of treatment Up to 18 months of treatment 3.210,00 4.280,00 1.150,00 1.658,50 15-21

ANCILLARY TREATMENTS Consultation in latency period Replacement apparatus due to breakage or loss Apparatus repair due to breakage 1st replacement of metal braces 2nd replacement of metal braces (unit) 1st replacement of ceramic braces 2nd replacement of ceramic braces (unit) 1st replacement of sapphire braces 2nd replacement of sapphire braces (unit) 1st replacement of self-ligating braces 2nd replacement of self-ligating braces (unit) 1st replacement of cosmetic self-ligating braces 2nd replacement of cosmetic self-ligating braces (unit) Invisalign refinement apparatus Invisalign replacement apparatus Orthodontic microscrew Fixed or removable auxiliary apparatus Extraoral apparatus (ludes chin support or face mask) Retainer with Invisalign splint (completion of treatment) Retainer with splint (conclusion of treatment) (per arch) Retainer with lingual bar (conclusion of treatment) (per arch) Orthodontic mouth guard (for treatments conducted at the same clinic) IMPLANTS Implant study Implant maintenance for Milenium-guaranteed treatments Implant maintenance for treatment not covered by Millennium guarantee 125,00 35,00 2,00 5,00 10,00 8,00 12,00 390,00 140,00 150,00 250,00 250,00 480,00 128,50 128,50 50,00 16-21

- IMPLANT SURGERY Osseointegrated implant (unit) Closed sinus lift Open sinus lift Regeneration with biomaterials (per 0.5 gr. unit) Regeneration with biomaterials (block graft) Membrane (unit) X-ray splint (one arch) Placement of osteosynthesis material on jaws (ludes osteosynthesis screws and tacks) Removal of osteosynthesis material (per operation) - GUIDED SURGERY Guided implant surgery study Guided implant surgery supplement (unit) Guided surgery x-ray splint Guided surgery surgical splint PROSTHESES OVER IMPLANTS Crown over implant Cosmetic crown over implant Temporary crown over implant Temporary crown for immediate loading Implant overdentures (per apparatus)) Hybrid prosthesis (per arch) Metal finishing: supra- and meso-structure (per repaired tooth) Precious material supplement Prosthetic attachments (per tooth) Cosmetic prosthetic attachments (per tooth) Prosthetic attachment for immediate loading Locator (per implant) (ludes attachment) Micro-milled bar (1-5 implants) Micro-milled bar (6+ implants) Ackerman-type clips (per implant) (ludes attachment) Attachment over implant (ludes anchors) 599,00 64,50 187,50 175,00 485,00 214,00 48,00 210,00 79,00 300,00 150,00 500,00 850,00 299,00 349,00 135,00 200,00 520,00 1.796,00 96,50 SPC 430,00 530,00 215,00 695,00 2.250,00 2.550,00 340,00 187,50 17-21

RADIOLOGY Periapical/bitewing/occlusal radiography Lateral cranium x-ray Orthopantomography (panoramic) Cephalometry Photographs and slides 100% CAT scan (dental) 80% Radiological study for orthodontics TEMPOROMANDIBULAR JOINT PATHOLOGY Assembly and study of semi-adjustable articulator Occlusion analysis Customisation Muscle relaxation splint (Michigan-type complex) (first adjustment luded) Stabilisation splint (simple) (first adjustment luded) Splint adjustment EMERGENCIES Visit in case of emergency Emergency video consultation (weekend) 43,00 230,00 150,00 32,50 : Services luded in insurance cover with no co-payment charged / APL: according to provial limit / APQ: according to price and quotation. (1) For all orthodontics treatments, the price listed is stated per patient and finished work. This price does not lude subsequent checkups. According to the particular terms & conditions of the policy, these services may be associated with a co-payment amount. *In extractions: An embedded tooth is a tooth that once it has completed its development fails to come fully out of the mouth, finding itself partly or wholly in the interior of the bone, covered or not by the gum. A non-embedded tooth is a tooth that is in a normal or abnormal position in the mouth once it has completed its development. 80% Policy qualification periods What are the qualification periods? The qualification periods indicate the time that must lapse between arranging your health insurance and the possibility of requesting the use of stated healthcare services. 18-21