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7.19 Eligibility for Health Care Programs - Medium Disabled Veteran and Civilian Pensioners.pdf

7.19 Eligibility for Health Care Programs - Medium Disabled Veteran and Civilian Pensioners.pdf

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Published by: Canadian_Veterans_Ad on Jan 06, 2013
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Eligibility for Health Care Programs - Medium Disabled Veteran andCivilian Pensioners
Issuing Authority:
Director General, Policy
Effective Date:
May 18, 2012This policy replaces the following VPPM 2 policy: 1. xi Medium Disabled Veteran Pensioners and Civilian Pensioners.
Purpose
This policy provides direction on health care eligibility for thoseVeteran PensionersorCivilian Pensionerswho are recognized as "medium disabled" under the
.
Policy
General
"Medium disabled" is the term used to describe those Veteran Pensioners or Civilian Pensioners whoseextent of disability, in respect of the aggregate of all of their disability assessments under the 
and the
is equal to orgreater than 48%.1.Effective November 6, 2003, the VHCR were amended to provide access to health care benefits to thoseVeteran Pensioners or Civilian Pensioners whose extent of disability is equal to or greater than 48%. Healthcare benefit access for these clients is based on need; not a requirement that the need be related to apensioned condition.2.
Treatment Benefits (Any Health Condition)
Veteran Pensioners or Civilian Pensioners who satisfy the criteria to be recognized as AMedium Disabled@are eligible to receive treatment benefits in Canada for any health condition, to the extent that thetreatment benefitsare neither available to them as members or former members of the Canadian Forces noravailable to them as insured services under a provincial health care system.3.
Supplementary Benefits
Veteran Pensioners or Civilian Pensioners who satisfy the criteria to be recognized as "Medium Disabled" areeligible to receivesupplementary benefitsif they are in receipt of the following treatment benefits authorizedby 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.4.
Veterans Independence Program
Veteran Pensioners or Civilian Pensioners who satisfy the criteria to be recognized as AMedium Disabled@are eligible to receive the services of home care,ambulatory health care, andhome adaptations, or intermediate carein acommunity facility, other than acontract bed, to the extent that those services or that care is not available to them as an insured service under a provincial health care system, if:they are resident in Canada; anda.an assessment indicates that the provision of those services will assist them to remain self-sufficientat theirprincipal residence, or that the provision of care is necessary for health reasons.b.5.
Long Term Care (Any Health Condition)
Veteran Pensioners or Civilian Pensioners who satisfy the criteria to be recognized as "Medium Disabled" areeligible to receive the cost to them of chronic care received in Canada in a community facility, other than acontract bed, to the extent that the chronic care is not available to them as an insured service under aprovincial health care system.6.
References
METADATAReference Number:
 
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