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7.13 Eligibility for Health Care Programs - Entitled to a Disability Award (Regular and Reserve Force Services).pdf

7.13 Eligibility for Health Care Programs - Entitled to a Disability Award (Regular and Reserve Force Services).pdf

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Published by: Canadian_Veterans_Ad on Jan 06, 2013
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10/23/2013

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Eligibility for Health Care Programs - Entitled to a Disability Award(Regular and Reserve Force Services)
Issuing Authority:
Director General, Policy
Effective Date:
January 1, 2013
Purpose
This policy provides direction on health care eligibility for those individuals who areentitled to a Disability Awardunder the
(VHCR).
Policy
Treatment Benefits (Disability Award)
Former members orreserve force membersare eligible to receivetreatment benefits
 
, in Canada orelsewhere, in respect of the injury or disease for which they are entitled to a disability award, to the extentthat the treatment benefits are not available to them as former members or reserve force members of theCanadian Forces.1.
Supplementary Benefits
Former members or reserve force members who are entitled to a disability award are eligible to receivesupplementary benefitsif they are in receipt of the following treatment benefits authorized by theDepartment:any medical, surgical or dental examination or treatment provided by a health professional; ora.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.2.
Miscellaneous Benefits
Former members or reserve force members who are entitled to a disability award who are transferred fromone health care facility to another for medical reasons are eligible to receive the costs of transportationincurred in Canada, if they are eligible to receive any part of the cost of  intermediate careunder the Veterans Independence Program (VIP) orchronic careunder the long-term care program.3.When critically-ill former members or reserve force members who are entitled to a disability award are inreceipt of intermediate care, or chronic care, or acute care in a hospital and, in the attending physician'sopinion, a visit by a family member or other designated person would be beneficial to the health of theclient; that family member or other designated person is eligible to receive the transportation costsincurred, in Canada, for the visit.4.
Veterans Independence Program
Former members or reserve force members who are entitled to a disability award are eligible to receive VIPservices of  home care,ambulatory health care, andhome adaptations
 
, or intermediate care in acommunityfacilityother than acontract bedif the services or care is neither available to them as former members or reserve force members of the Canadian Forces nor available to them as an insured service under aprovincial health care system, if:they are resident in Canada; anda.an assessment indicates that the disability for which they are entitled to a disability award, impairstheir ability to remain self-sufficient at theirprincipal residencewithout those services, and theprovision of the services would assist them to remain self-sufficient at their principal residence; orb.the provision of the care is necessary for health reasons.c.5.Former members or reserve force members who are entitled to a disability award are eligible to receive VIPservices of home care, ambulatory health care, and home adaptations, or intermediate care in a communityfacility other than a contract bed, if:the services or care is neither available to them as former members or reserve force members of theCanadian Forces nor available to them as an insured service under a provincial health care system;a.they are resident in Canada;b.they meet the criteria of 'frail'; andc. an assessment indicates that the provision of those services will assist them to remain self-sufficientat their principal residence, or that the provision of care is necessary for health reasons.d.6.
Long Term Care
Members or former members who are entitled to a disability award are eligible to receive the cost to themof chronic care in respect of a disability for which they are entitled to a disability award, if:the care is received in Canada in a community facility, other than a contract bed;a.the care is received in a health care facility outside Canada that is of a standard equivalent to thecare that would have been provided under a) provided that the cost of such care does not exceed theusual cost of chronic are in the jurisdiction in which the care is received; andb.an assessment shows that the care is an appropriate response to their health needs.c.8.

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