Eligibility for Health Care Programs - Civilian Pensioners
Director General, Policy
May 18, 2012This policy replaces the following VPPM 2 policy: 1.ii Civilian Pensioners.
This policy provides direction on health care eligibility for those individuals who are recognized as CivilianPensioners under the
, namely:Canadian salt water fishers;i.Auxiliary Services Personnel, including the Newfoundland Overseas Forestry Unit;ii.Corps of (Civilian) Canadian Fire Fighters;iii.Air raid precautions workers;iv.Members of the Voluntary Aid Detachment;v.Overseas welfare workers;vi.Civilian members of Ferry Command; or;vii.a.the
Treatment Benefits (Pensioned Condition)
Civilian Pensioners are eligible to receivetreatment benefitsin Canada or elsewhere in respect of apensioned condition.2.Civilian Pensioners who are hospitalized and assert that the hospitalization is related to their pensionedcondition, shall receive treatment benefits in respect of that hospitalization, in Canada or elsewhere, for theperiod during which there is uncertainty as to whether the primary condition in respect of which thetreatment benefits are required is the pensioned condition.3.
Treatment Benefits (Any Health Condition)
Civilian Pensioners are eligible to receive treatment benefits in Canada for any health condition, to theextent that the treatment benefits are not available to them as insured services under a provincial healthcare system, if:they aremediumorseriously disabled;a.
they are eligible to receive Veterans Independence Program (VIP)home care,ambulatory health
care, orintermediate carein response to a need arising from theirwar-related pensioned condition;
b.they are in receipt of VIP services as ‘frail’ in accordance with the Frail Policy;c.
they were authorized to continue receivingadult residential care (ARC)in acommunity facilityARC
was provided as a VIP element until June 30, 1993. Those individuals who were already approvedfor ARC when it was terminated, effective July 1, 1993, were grandfathered; ord.they are in receipt of chronic carein a community facility, other than acontract bed, if the cost of
their care reduces their income below the applicable
Civilian Pensioners are eligible to receivesupplementary benefitsif they are in receipt of the followingtreatment benefits authorized by the Department:any medical, surgical or dental examination or treatment provided by a health professional or,a.the provision or maintenance of any surgical or prosthetic device or aid, or any home adaptations toaccommodate the use of the device or aid.b.5.
Civilian Pensioners are eligible to receive a “treatment allowance” in respect of a period of acute care for apensioned condition provided in a hospital or on an out-patient basis.6.
Civilian Pensioners are eligible to receive reimbursement associated with a medical examination, if themedical examination is requested by the Department or the Veterans Review and Appeal Board.7.Civilian Pensioners whose pensioned condition is blindness, or another disability that requires an escortwhen travelling, may have the cost of commercial transportation (other than by automobile) paid for anescort when on annual vacation or other authorized travel within Canada.8.Civilian Pensioners who are transferred from one health care facility to another for medical reasons areeligible to receive the costs of transportation incurred in Canada if they are eligible to receive any part of 9.