RCMP VAC Benefit Entitlements

 


A Guide To

RCMP VAC Benefit Entitlements

May 09, 2020

Dear Members of the Association,

We are very pleased to advise you that following on a request from Association President Steve Walker to the RCMP Director for VAC, Pierre Lebrun to provide information on what benefits are available to our members we have been given that information.

President Walker has noted that for many of our members the benefits that are available to them are not always clear and with this in mind the request for clarity was made.

RCMP – VAC Liaison Officer, Sgt. Kim Hendricken has provided the following document to help our members determine what is available to them. The Association Advocates under Chief Advocate Ruby Burns have also been provided with the document and questions about the benefits should be directed to your Divisional advocate or directly to the Chief Advocate – association.director2@rcmpva.org .

We regret that the document is not yet available in French, however as soon as it is translated it will be distributed.

It will also be uploaded to our website and notification of the link to that location will also be sent out.

James Forrest
Director of Communications
RCMP Veterans’ Association

RCMP VAC Benefit Entitlements

Contents

Part 1: Pension Act versus Veterans Well-Being Act. 1
POC 1 – AIDS FOR DAILY LIVING.. 2
Examples of devices or accessories covered include:. 2
POC 2 – AMBULANCE/MEDICAL TRAVEL SERVICES. 2
POC 3 – AUDIO (HEARING) SERVICES. 2
Examples of benefits that are covered include:. 2
POC 4 – DENTAL SERVICES. 3
Examples of services that are covered:. 3
Examples of dental services that require pre-authorization from VAC: (Before any treatment is received a dental treatment plan is to be submitted to VAC for preauthorization.). 3
Examples of services that are not covered.. 3
POC 5 – HOSPITAL SERVICES. 3
Examples of services that are covered:. 4
POC 6 – MEDICAL SERVICES. 4
POC 7 – MEDICAL SUPPLIES. 4
Examples of benefits that are covered:. 4
POC 8 – NURSING SERVICES. 4
Examples of services that are covered:. 4
Examples of services that are not covered:. 4
POC 9 – OXYGEN THERAPY. 5
Examples of benefits that are covered:. 5
POC 10 – PRESCRIPTION DRUGS. 5
POC 11 – PROSTHESES AND ORTHOSES. 5
Examples of benefits covered:. 5
POC 12 – RELATED HEALTH SERVICES. 6
Examples of services covered include:. 6
POC 13 – SPECIAL EQUIPMENT. 6
Examples of special equipment benefits covered:. 6
POC 14 – VISION (EYE) CARE. 6
Examples of benefits covered:. 6

Part 1: Pension Act versus Veterans Well-Being Act

On April 1, 2006 the Canadian Forces Members and Veterans Re-establishment and Compensation Act (CFMVRCA) came into force for new CAF disability pension applicants to VAC. 

The RCMP, however, chose to remain with the provisions of the Pension Act. A number of unmet needs of CAF Veterans have been identified by VAC since the transition out of the Pension Act.  VAC has responded to these with a focus on providing services and benefits that support the well-being of CAF Veterans and their families.  On April 1, 2018 the name of the CFMVRCA was changed to the Veterans Well-Being Act. 

The Department of Veterans Affairs Act (DVA Act) does not include the RCMP as a client of VAC. Therefore, as new legislation has been created by VAC, the RCMP has not been included as a client in these new supports.

Long Term Care and Veterans Independence Programs are covered under Parts 2 and 3 of the Veterans Health Care Regulations, of which the RCMP is not a mandated client. Therefore, the RCMP has no regulatory entitlements to these provisions.

Currently, Sec 32 of the RCMPSA and Sec 5 of the RCMPPCA give RCMP members entitlement to Pension Act Benefits.  Pursuant to an MOU between the RCMP and VAC, VAC administers the Pension Act benefits and treatment benefits to eligible RCMP serving and released members of the RCMP on behalf of the RCMP.  The money to fund the benefits under the Pension Act comes via a TB Grant.  The money that funds all treatment benefits for disabilities under the Pension Act for serving/released Civilian Members and for released Regular Members comes from the RCMP’s Operating Budget. 

The Pension Act provides the following benefits, indexed annually, to eligible RCMP Disability Pensioners:

1) Disability Pension (Amounts for eligible dependents are also paid.)
2) Survivor’s Pension (Amounts for eligible dependents are also paid.)
3) Attendance Allowance https://www.veterans.gc.ca/eng/health-support/physical-health-and-wellness/compensation-illness-injury/attendance-allowance
4) Exceptional Incapacity Allowance https://www.veterans.gc.ca/eng/health-support/hearing-loss-and-tinnitus/exceptional-incapacity-allowance
5) Clothing Allowance https://www.veterans.gc.ca/eng/financial-support/compensation-illness-injury/clothing-allowance
 
The Treatment Benefits which are available for the Disability Pensioners to treat their disability conditions are grouped into Programs of Choice: https://www.veterans.gc.ca/eng/health-support/physical-health-and-wellness/medical-costs/coverage-services-prescriptions-devices/programs-of-choice.  The information from the above website has been copied and pasted below to illustrate the many supports in place already for our disability pensioners, which many may not realize is already available to them.

POC 1 – AIDS FOR DAILY LIVING

Provides coverage for assistive devices and accessories that help people do everyday tasks and live independently. Repairs and maintenance are also covered.
Examples of devices or accessories covered include:

  • Wheelchairs or walking aids (such as canes, walkers, ice grippers/rubber tips);
  • bathroom aids (such as grab bars, raised toilet seats, bath boards, bathtub rails);
  • self-help aids that assist with getting dressed, preparing food and living safely in your home.

POC 2 – AMBULANCE/MEDICAL TRAVEL SERVICES

Provides coverage for the use of ambulance services required for an emergency situation or a specified medical condition.

For non emergency use a prescription/pre-authorization are required before the service is provided.

For emergency situations an authorization is required before VAC covers the cost however not before the service is provided.

The program also includes coverage for travel expenses incurred to receive healthcare services or benefits.

POC 3 – AUDIO (HEARING) SERVICES

Provides coverage for equipment and accessories related to hearing impairment
Examples of benefits that are covered include:

  • hearing aids
  • telephone amplifiers, infrared devices
  • hearing accessories
  • dispensing and fitting fees for hearing aids

If the benefits covered by VAC do not meet your particular needs, your hearing health professional may submit a request to VAC to provide coverage for a different type of auditory aid. The hearing health professional must provide, in writing, the following information:

  • the standard hearing benefit(s) already tried;
  • the difficulty or lack of satisfaction experienced with the standard hearing benefit(s);
  • the proposed replacement hearing aid; and,
  • the rationale for the selection of the replacement hearing aid.

POC 4 – DENTAL SERVICES

Provides coverage for basic dental care and some pre-authorized comprehensive dental services. Services provided should be both generally accepted practices and the most cost-effective treatment essential to your good oral health.

VAC dental program covers up to 100% of the rates in the Provincial Dental / Denturist Association fee guide.
Examples of services that are covered:

  • Annual basic treatments up to $1500 annually
    • Exams, polish and fluoride treatments every 9 months
    • Scaling (8 units per year)
    • Fillings and extractions
  • Standard dentures once every 7 years

Examples of dental services that require pre-authorization from VAC: (Before any treatment is received a dental treatment plan is to be submitted to VAC for preauthorization.)

  • Basic treatment exceeding $1500 annually
  • Crowns
  • Bridgework (x-rays required)
  • Specialist treatment (referral required)
  • Early replacement of dentures as determined by your dentist or denturist

Examples of services that are not covered

  • Gum surgery
  • Implants
  • Equilibrated/custom/semi-precision dentures

POC 5 – HOSPITAL SERVICES

Provides coverage for treatment services in an acute care, chronic care or rehabilitative care hospital and muliti-disciplinary clinics registered with VAC. As these services are generally a provincial responsibility, costs for these services are normally covered by VAC only if they relate to a condition for which a client holds disability entitlement. Costs for private or semi-private rooms are not normally covered by VAC.
Examples of services that are covered:

  • in-patient and out-patient services in an accredited provincial hospital or health facility.
  • Blood collection services

POC 6 – MEDICAL SERVICES

Coverage for services of a licensed physician (including medical examinations or treatments or for reports requested by VAC). Typically, these services are for a condition related to your VAC disability benefit or your application for a disability benefit.

POC 7 – MEDICAL SUPPLIES

Provides coverage for medical and surgical equipment and supplies normally used by an individual in a non-hospital setting.

Medical supplies are those items that are essential to effectively monitor or treat an illness or injury, are primarily used to serve a medical purpose and generally, not useful to a person in the absence of an illness or injury.
Examples of benefits that are covered:

  • Bandages / Dressings
  • Bladder / Bowel Supplies
  • Diabetic Supplies

POC 8 – NURSING SERVICES

Nursing Services have three distinct components: assessments, foot care and visits.
Examples of services that are covered:

  • Medication administration and management
  • Basic wound care
  • Health teaching
  • Basic and advanced foot care

Examples of services that are not covered:

  • Acute care / specialized interventions
  • Private nursing provided in a long-term care facility (nursing home) or a clinic / hospital facility
  • Personal care

POC 9 – OXYGEN THERAPY

Provides coverage for oxygen and accessories as well as respiratory equipment and supplies.
Examples of benefits that are covered:

  • Oxygen concentrators
  • Oxygen compressors
  • Oxygen gas
  • CPAP and BiPAP machines

POC 10 – PRESCRIPTION DRUGS

Provides coverage for drug products and other pharmaceutical benefits to those who have demonstrated a medical need and have a prescription from a health professional authorized to write a prescription in that province.

Your pharmacist can verify your eligibility for a benefit at the time that you present the prescription. Standard benefits and special authorization benefits are included in this program.

Standard benefits include many over-the-counter and prescription drugs that are considered by VAC to represent “common” therapies. These products are readily accessible for those who are eligible, have a prescription and present their VAC Health Care Identification card.

Special Authorization benefits include less common or higher cost therapies approved by VAC. A prescription is required and must be able to demonstrate a medical need that is most appropriately met with the requested therapy. You may be required to submit medical information prior to being approved for these benefits.

For a complete listing of what may be covered and respective requirements, please visit the VAC Drug Formulary search form.

POC 11 – PROSTHESES AND ORTHOSES

Provides coverage for prostheses, orthoses, and other related accessories. Necessary repairs and maintenance are also covered.
Examples of benefits covered:

  • Arch supports
  • Artificial limbs
  • Leg/arm braces
  • Modifications to ordinary footwear

POC 12 – RELATED HEALTH SERVICES

Provides coverage for the services provided by approved health professionals by VAC. In many cases, the service must be prescribed by a physician in order to be approved by VAC.
Examples of services covered include:

  • occupational therapy,
  • physiotherapy,
  • massage therapy,
  • chiropractic,
  • acupuncture,
  • speech language pathology and
  • psychological counselling.

POC 13 – SPECIAL EQUIPMENT

Provides coverage for special equipment required for the care and treatment for eligible Veterans. These benefits must be prescribed by a VAC approved health professional and in many cases supported by the recommendation of another health professional. In addition, VAC may provide coverage for home adaptations or modifications (ie. wheelchair ramps, door widening) to accommodate the use of the special equipment in the home.
Examples of special equipment benefits covered:

  • Wheelchairs
  • Walkers
  • Power mobility devices
  • Transfer / Lift devices
  • Hospital equipment
  • Ergonomic equipment

POC 14 – VISION (EYE) CARE

Provides coverage for eye examinations, lenses, frames and accessories to correct sight impairments as well as low-vision aids.
Examples of benefits covered:

  • Glasses
  • Retinal imaging
  • Regular eye exams
  • Fees for low vision evaluation
  • Magnifiers
  • White Canes

Note: The information for POC 1-14 cited above was taken directly from https://www.veterans.gc.ca/eng/health-support/physical-health-and-wellness/medical-costs/coverage-services-prescriptions-devices/programs-of-choice

If our RCMP veterans are searching for limits of frequency or fees for treatments in their province, please encourage them to visit the VAC Benefit Grids at
https://www.veterans.gc.ca/eng/financial-support/medical-costs/treatment-benefits/poc_search

The VAC Assistance Service at 1-800-268-7708 is a confidential service providing mental health supports 24/7 to former RCMP members and their family members. This is provided through an MOU between the RCMP, VAC, and Health Canada. See https://www.veterans.gc.ca/eng/contact/talk-to-a-professional for more information.

VAC also has expended the provision of Lifespeak to former members of the RCMP and their families. This program provides self-help videos and information about mental health, nutrition, and other issues important to this population. See https://www.veterans.gc.ca/eng/health-support/mental-health-and-wellness/understanding-mental-health/lifespeak for more information.

In summation, as VAC adds new services to its supports for CAF veterans via legislative or regulatory changes, the RCMP has not been included in these changes because the RCMP is not a mandated client of VAC.  Through an MOU, VAC administers the provision of Pension Act Benefits and treatments for eligible disability pensioners.  Any additional benefits awarded to RCMP members will most likely form part of a negotiated collective agreement going forward. 

Kmh/2020-05-05


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