Author Topic: health insurance Canada  (Read 8324 times)

scrubbyfish

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health insurance Canada
« on: August 29, 2015, 08:01:26 AM »
Age 43, with a 10 year old, it suddenly occurred to me that we have no health insurance. I never got it because I assumed the schtick about "Canada's free health care system" was, um, true. Oops!

I have no employer, so no plan there.

Anyone here purchasing their own insurance through Blue Cross or wherever else?
What are you paying?
Things to look out for?
Tips for when researching this?

choppingwood

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Re: health insurance Canada
« Reply #1 on: August 29, 2015, 09:32:16 AM »
I researched this in April, before leaving my last contract.

I thought that the options would be pretty cookie cutter, but there was a lot of difference in coverage by the different carriers. So, you need to look at your own situation: do you or do you anticipate using a lot of prescriptions? need much dental coverage? would you need home care if injured or sick? do you need different kinds of therapies? do you mind sharing a hospital room with more than one person? do you travel outside the country? do you travel outside the province? And then look at the plans according to that.

It will make a difference that you don't have insurance now. Usually it just means you need a medical. That makes it cheaper, though, than carrying on an existing plan.

Preexisting conditions are a big deal, though. The plans have very different coverage -- from none, to limited coverage.

I am single and quite a bit older, so what I pay isn't very relevant. It is not very expensive , though. I opted high on prescriptions and wanted something that provides home care. I opted out of dental, since I could self-insure for the same price. I opted for short travel out of the country.

I have two regular prescriptions. What I would have to pay for them if I were buying them 100% is a good proportion of the premium.

 Good luck! (Researching it became a bit of a hobby for a while.)

Shinplaster

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Re: health insurance Canada
« Reply #2 on: August 29, 2015, 10:37:06 AM »
Sorry, I'm not understanding why you don't qualify for provincial health insurance.  Are you not a Canadian citizen?  Or have resident status?

Every province has different criteria as to waiting periods if you have moved, etc., but if you have citizenship you should be able to apply for it.  Check out the provincial health page, and they will tell you what is required. Plus LF should be covered too.

Private insurance can be very expensive, and yes, they won't cover for pre-existing conditions.  If someone has any heart problems, private insurance will not cover you at all.

ETA - you do not need an employer to have coverage.  Higher income earners usually pay an amount on their annual taxes (at least in Ontario), but low income citizens usually don't pay anything extra.
« Last Edit: August 29, 2015, 10:40:15 AM by Shinplaster »

KMMK

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Re: health insurance Canada
« Reply #3 on: August 29, 2015, 11:17:50 AM »
Yes, I have some coverage through Blue Cross. I got it when I left my husband so was off of his group plan through his employer. It's not the greatest coverage, but at least I have something in place. I pay $57/month for myself - late 30s. Some dental, some drug, some vision I think. Moderate limits, which is fine at the moment, as I'm pretty healthy. I lost some of the physio-type stuff that I had under the better employer group plan. That either wasn't available as an individual plan or was too expensive.

This will all be different in each province, of course. If I ended up needing a lot of drug coverage, our provincial drug coverage might kick in because my income is quite low now, but hopefully I won't have to find out about that.

KMMK

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Re: health insurance Canada
« Reply #4 on: August 29, 2015, 11:20:32 AM »
Sorry, I'm not understanding why you don't qualify for provincial health insurance.  Are you not a Canadian citizen?  Or have resident status?

Every province has different criteria as to waiting periods if you have moved, etc., but if you have citizenship you should be able to apply for it.  Check out the provincial health page, and they will tell you what is required. Plus LF should be covered too.

Private insurance can be very expensive, and yes, they won't cover for pre-existing conditions.  If someone has any heart problems, private insurance will not cover you at all.

ETA - you do not need an employer to have coverage.  Higher income earners usually pay an amount on their annual taxes (at least in Ontario), but low income citizens usually don't pay anything extra.

Yes, I'm assuming Scrubbyfish just means the extended health benefits. I don't see why the provincial wouldn't apply in her case, but if it's like Manitoba that's no drug, dental, vision, or ambulance coverage, among other things.

Shinplaster

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Re: health insurance Canada
« Reply #5 on: August 29, 2015, 11:53:40 AM »
Sorry, I'm not understanding why you don't qualify for provincial health insurance.  Are you not a Canadian citizen?  Or have resident status?

Every province has different criteria as to waiting periods if you have moved, etc., but if you have citizenship you should be able to apply for it.  Check out the provincial health page, and they will tell you what is required. Plus LF should be covered too.

Private insurance can be very expensive, and yes, they won't cover for pre-existing conditions.  If someone has any heart problems, private insurance will not cover you at all.

ETA - you do not need an employer to have coverage.  Higher income earners usually pay an amount on their annual taxes (at least in Ontario), but low income citizens usually don't pay anything extra.

Yes, I'm assuming Scrubbyfish just means the extended health benefits. I don't see why the provincial wouldn't apply in her case, but if it's like Manitoba that's no drug, dental, vision, or ambulance coverage, among other things.

OK - that makes more sense.  When she said she didn't have any insurance, I thought she meant she didn't have ANY insurance!   Yeah, the list of exclusions is pretty long here in Ontario too.

choppingwood

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Re: health insurance Canada
« Reply #6 on: August 29, 2015, 01:09:15 PM »
Yes, I'm assuming Scrubbyfish just means the extended health benefits. I don't see why the provincial wouldn't apply in her case, but if it's like Manitoba that's no drug, dental, vision, or ambulance coverage, among other things.

Scrubbyfish, we're assuming you have provincial health insurance. If not, you need to contact them and enrol. Depending on the province you may or may not have to pay a premium.

scrubbyfish

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Re: health insurance Canada
« Reply #7 on: August 29, 2015, 01:09:47 PM »
Yes, I'm assuming Scrubbyfish just means the extended health benefits. I don't see why the provincial wouldn't apply in her case, but if it's like Manitoba that's no drug, dental, vision, or ambulance coverage, among other things.

Yep, that's right. We can walk into a walk-in clinic (and wait three hours) or emerg (and wait longer), then walk out unassisted, but that's about it. I think now they just stop bleeding. This year, we have the following costs not covered:
  • braces to prevent jaw surgery due to kid's congenitally missing teeth $10,000
  • $500+ in physio after a sudden injury
  • orthotics for kid
  • orthotics for me
  • usual autism therapies
All not covered, even though avoiding them results in being unable to eat, walk, etc.

I've ruled out basic dental a couple of times, as the insurance seems to cost the same as the appointments. But I am wondering if Past Self should have gotten insurance at least for my kid when he was first born. That's my warning, I guess, to all residents of Canada: Provinces cover little; get insurance early, especially for your kid.

Goldielocks

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Re: health insurance Canada
« Reply #8 on: August 29, 2015, 01:42:34 PM »
Scrubby fish, I have pretty good insurance but it has only covered $2 k for braces, each, $200 every 2 years for glasses, 80 % of dental and half of the other stuff like physio and chiro and learning assistance to $500 per year per type.  Plus $200 other and pays about half of the meds.

On your list, you may get back only $300? Total, and not for ortho plans already started. May cost a lot too.

Make sure you are registered for pharmacare as on low income it works out just as good as blue cross for meds and is free.

Ask at benefits office too.. I think you have disability and may need to go there once a year?  They will have good referrals. Also cknw orphans charity gives money for exactly your situation. Ask there about help for autism treatments.

KMMK

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Re: health insurance Canada
« Reply #9 on: August 29, 2015, 01:45:13 PM »
I'm sure you know but just in case, and for others, make sure you claim all those expenses on your taxes, too, unless your income is too high.

choppingwood

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Re: health insurance Canada
« Reply #10 on: August 29, 2015, 01:55:26 PM »
Yes, I'm assuming Scrubbyfish just means the extended health benefits. I don't see why the provincial wouldn't apply in her case, but if it's like Manitoba that's no drug, dental, vision, or ambulance coverage, among other things.

Yep, that's right. We can walk into a walk-in clinic (and wait three hours) or emerg (and wait longer), then walk out unassisted, but that's about it. I think now they just stop bleeding. This year, we have the following costs not covered:
  • braces to prevent jaw surgery due to kid's congenitally missing teeth $10,000
  • $500+ in physio after a sudden injury
  • orthotics for kid
  • orthotics for me
  • usual autism therapies
All not covered, even though avoiding them results in being unable to eat, walk, etc.

I've ruled out basic dental a couple of times, as the insurance seems to cost the same as the appointments. But I am wondering if Past Self should have gotten insurance at least for my kid when he was first born. That's my warning, I guess, to all residents of Canada: Provinces cover little; get insurance early, especially for your kid.

I know what you are saying, but I would differ with you on saying that provinces cover little. It covered my older sister's congenital liver disease and transplant for many years, and my father's open-heart surgery, and many costs related to my mother's years with dementia. Hundreds of thousands of dollars of health care. It tends to cover hospital-type expenses, but also being able to go see doctor when you are sick and many vaccinations. It doesn't cover everything, but we do not have to pay the gigantic insurance costs that Americans on this forum talk about.

scrubbyfish

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Re: health insurance Canada
« Reply #11 on: August 29, 2015, 01:57:27 PM »
Scrubby fish, I have pretty good insurance but it has only covered $2 k for braces, each, $200 every 2 years for glasses, 80 % of dental and half of the other stuff like physio and chiro and learning assistance to $500 per year per type.  Plus $200 other and pays about half of the meds.

On your list, you may get back only $300?

Yeah, that's what I keep finding, that the insurance doesn't seem to help much. I've been duped a few times by insurances policies, and am reluctant to be duped again. As with professional, house, and investment insurances, I'm only finding medical ones that don't seem great.

We are on BC's medical services plan, but it doesn't cover anything we need/use. (Neither of us requires prescription medication.) I find it silly (on every level) that the province would cover the jaw surgery he would require if he doesn't have the braces, but not the (cheaper than surgery, plus vastly safer) braces to prevent it. Oh well.

Unfortunately, none of the disability offices we have ever interacted with have good referrals/leads. It's not what they do.

I started looking into a couple of foundations some months back, most said they don't cover jaw stuff but one said it would consider an application since it's necessary to be able to eat. Orthodontist said he would write a letter stating this is the case (e.g., functional, not cosmetic). I think CKNW Orphans is one I checked out. I'm just really reluctant to receive from a charity if there's any other option, and am concerned about what else is going to surprise us in future. I've spent tens of thousands so far on his disability care, and wondering if there's another path (insurance) I should be looking at for him and for my own future needs.


Cathy

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Re: health insurance Canada
« Reply #12 on: August 29, 2015, 02:03:53 PM »
...This year, we have the following costs not covered:
  • ...
  • usual autism therapies
All not covered...

This is actually the subject of a well-known case from the Supreme Court of Canada. According to the Court, it is not discriminatory for a province to have a general public healthcare program but refuse to cover various treatments for Autism. Auton (Guardian ad litem of) v. British Columbia (Attorney General), 2004 SCC 78, [2004] 3 SCR 657. The logic behind the judgment is that the healthcare legislation was targeted at only a narrow range of benefits, so it wasn't discriminatory for the government to refuse to fund something outside of the legislation. If taken to its extreme, this reasoning means that almost no legislation is ever discriminatory because the government can just say that it didn't intend to cover whatever benefit it is withholding on a discriminatory basis.

Governments routinely rely on Auton and its progeny when opposing discrimination cases. There have always been ways around it but it's been an obstacle. Fortunately, the Court has withdrawn a bit from the position announced in that case in recent years. In Moore v. British Columbia (Education), 2012 SCC 61, [2012] 3 SCR 360, the Court considered the case of one "Jeffery Moore" who had certain disabilities that prevented him from receiving an education in the public school-system. The school district and the Court of Appeal for BC took the position that that was just tough luck for him and that his parents would have to pay out of pocket for private school. According to the Court of Appeal for BC, there was no freestanding right to "special education" and BC's education legislation was not intended to provide that benefit, so the failure of the school district to provide that benefit was not discriminatory. Fortunately, the Supreme Court saw through that extreme formalism and reversed the BC Court of Appeal and ordered the school district to reimburse the parents for the costs of Jeffery's private school plus other remedies.
« Last Edit: August 29, 2015, 02:12:47 PM by Cathy »

scrubbyfish

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Re: health insurance Canada
« Reply #13 on: August 29, 2015, 02:08:56 PM »
I know what you are saying, but I would differ with you on saying that provinces cover little. [...] It doesn't cover everything, but we do not have to pay the gigantic insurance costs that Americans on this forum talk about.

I agree that it covers some treatments for some issues: birthing, broken bones, chemotherapy, etc. And I'm very grateful both that he and I have had no need for chemo, etc, and for its care of some family members' direct (but not indirect) cancer care. But almost nothing for anything related to autism, congenital defects, mental health care, etc. (i.e., There's a difference between a province "funding" millions of dollars in "services" and actual provision of effective care.) Families who have the money spend hundreds of thousands on those. I've spent about $60,000. I'm very happy to have my kid, and very grateful I've had the luck to be able to cover his basic needs so far, but there are a lot of people in BC financially devastated by health needs that aren't covered. That's my warning. We're extremely lucky in Canada, yes, to have things like heart surgery, bleeding care, and chemotherapy covered, but medical needs extend far beyond those and lots of issues are being left to the individuals to cover, and on that count, we need to be as aware as our American friends.

scrubbyfish

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Re: health insurance Canada
« Reply #14 on: August 29, 2015, 02:18:42 PM »
Fortunately, the Supreme Court saw through that extreme formalism and reversed the BC Court of Appeal and ordered the school district to reimburse the parents for the costs of Jeffery's private school plus other remedies.

I followed this case with great interest, and was thrilled with the results for Jeffery (though the results could not go back and change what he went through as a kid). We were all also excited that the effects of this decision were to impact education in BC. They haven't so far. I'm already a wreck about the upcoming school year, bah. All the lobbying I will need to do. (Several of us are discussing a class action, but have so far been discouraged by a legal group from going this route. They believe our class action would be dismissed because none of our situations are identical. Their opinion was that to have it even heard, we need to create classes much narrower than just "autism", with all the variation of needs within that.)

I totally don't mean to sound so complainypants. I had a kid, that was my choice, no one else is responsible for him. I'm just trying to find any tips around the medical pieces that I may have missed for both him and I. I hadn't known that so many of the "recommended" or "necessary" physical therapies were not covered (or "covered" but with a three year wait list to get a few hours of service), so I just need to rectify this as well as I can this far down the road.

Cathy

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Re: health insurance Canada
« Reply #15 on: August 29, 2015, 02:48:30 PM »
...Several of us are discussing a class action, but have so far been discouraged by a legal group from going this route. They believe our class action would be dismissed because none of our situations are identical. Their opinion was that to have it even heard, we need to create classes much narrower than just "autism", with all the variation of needs within that...

Why do you think a class action would be helpful? Aggrieved persons often think a class action is what they need to obtain redress, and I think their non-legal reasoning is intuitively understandable. They want to make things better for everybody, not just themselves. And there is strength in numbers -- surely you can put on a better case with a band of allies, rather than just yourself.

However, none of those considerations are relevant for a constitutional case in Canada because "[a] claimant who otherwise has standing can generally seek a declaration of invalidity ... on the grounds that a law has unconstitutional effects either in his own case or on third parties". R. v. Ferguson, 2008 SCC 6 at para 59, [2008] 1 SCR 96 (emphasis added); accord R. v. Nur, 2015 SCC 15 at para 51. In other words, even if you are the only plaintiff, assuming you have standing in your own right, you can still file evidence and make arguments about the rights of third parties, and you can still win on the basis that the law violates their rights, rather than yours. A class action is not necessary. For that reason, class actions are fairly rare in Canadian constitutional jurisprudence, although not unheard of.
« Last Edit: August 29, 2015, 02:57:59 PM by Cathy »

scrubbyfish

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Re: health insurance Canada
« Reply #16 on: August 29, 2015, 03:08:54 PM »
re: Medical costs, I just had an idea that left me feeling a lot better. I can accept gifts from charities if needed, and then name the charity for more than that amount in my will. That seems reasonable, yes? Right now, my will is written that everything goes in Trust for my son but that if he doesn't survive me, it is split amongst my siblings. There's no rhyme or reason that it would go to my siblings (except maybe some to one). This path would allow me to: get some of the most crucial resources for him, feel safe that we still have savings, continuing building those, still leave a bunch in Trust for him, while also giving back to the charities (for other families) when it's safe to do so.

I also noticed I had a big wave and sigh of relief when I read that CKNW Orphan's fund will cover a maximum of $5000 for equipment. If braces are equipment, I would still be paying half myself, which I would feel really good about. Again, very reluctant to receive charity for various reasons including that I have savings, but also wanting to be careful that I don't blow all our savings on these ongoing and very expensive medical things, leaving us entirely dependent on exactly that. For my sanity, I need to know we'll still have something set aside for items no source can help with.

Does this seem like a fair and wise path?

And, I'm left curious: In which situations has your extended insurance more than paid for itself? choppingwood has two regular prescriptions that justify the cost of the premiums. Has anyone else seen their years of premiums justified?

choppingwood

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Re: health insurance Canada
« Reply #17 on: August 29, 2015, 04:34:02 PM »
On the employee benefit side, insurance companies aim for a 92% payout of premiums on all members of the plan. I imagine it is the same on the consumer side.

Goldielocks

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Re: health insurance Canada
« Reply #18 on: August 29, 2015, 05:05:50 PM »
Cknw often helps with the autism support, as well as equipment. If you don't get help for braces, maybe for the autism or disability help?

In delta, I know that Delta Assist can and does direct people needing things like hearing aids to a charity that receives money from residents specifically to help low income seniors and people like you and your son.  Maybe your region has something special too?  If it helps, I know from your journal that you are exactly the type of person most people who give intend to help out.   As long as you are appreciative and use it for something needed, of course.

If you want to give back, why not offer to volunteer?  Many orgs need canvassers and phone support and whatnot.

Jschange

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Re: health insurance Canada
« Reply #19 on: September 01, 2015, 06:18:45 PM »
Because of preexisting conditions, your best option might be to go to school, or get a job with extended benefits, leave and continue the benefits. my premium this way is $130/month and defeats a $200/month prescription, plus picking up tiny pieces of glasses and other expenses. However, if you're expecting that treatment for preexisting conditions wouldn't bother covered anyway (autism treatments and physio) you could check prices on a plan requiring a physical.

Although, since I think BC is more generous than Ontario - if I recall, your prescriptions are covered. So you may not need anything.

From my research, it's cheaper to opt out of dental and self insure. Orthodontics could be an exception.

Good luck

KMMK

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Re: health insurance Canada
« Reply #20 on: September 01, 2015, 06:27:03 PM »
Because of preexisting conditions, your best option might be to go to school, or get a job with extended benefits, leave and continue the benefits. my premium this way is $130/month and defeats a $200/month prescription, plus picking up tiny pieces of glasses and other expenses. However, if you're expecting that treatment for preexisting conditions wouldn't bother covered anyway (autism treatments and physio) you could check prices on a plan requiring a physical.

Although, since I think BC is more generous than Ontario - if I recall, your prescriptions are covered. So you may not need anything.

From my research, it's cheaper to opt out of dental and self insure. Orthodontics could be an exception.

Good luck

That's a good thought but it doesn't always work. My husband had a plan through school for 2 years, and we just wanted to switch to an individual plan when he graduated, with the same company (Great West Life) and they refused to give him coverage for anything at all, because we were honest on the disclosure and said he had an MRI scheduled. Just for a shoulder issue that he'd never received any medications for, barely affected him, started while he had coverage, and ended up being nothing. So yes, you would think transferring a policy would work, but there's a big difference between group plans and individual plans, and they don't necessarily carry-over.

Jschange

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Re: health insurance Canada
« Reply #21 on: September 01, 2015, 08:47:36 PM »


That's a good thought but it doesn't always work. My husband had a plan through school for 2 years, and we just wanted to switch to an individual plan when he graduated, with the same company (Great West Life) and they refused to give him coverage for anything at all, because we were honest on the disclosure and said he had an MRI scheduled. Just for a shoulder issue that he'd never received any medications for, barely affected him, started while he had coverage, and ended up being nothing. So yes, you would think transferring a policy would work, but there's a big difference between group plans and individual plans, and they don't necessarily carry-over.
[/quote]

That's too bad. I'm very fortunate that mine has a 30 day window to re enroll without a physical or questionnaire. This one is sunlife though.

scrubbyfish

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Re: health insurance Canada
« Reply #22 on: September 02, 2015, 02:27:31 PM »
Because of preexisting conditions, your best option might be to go to school, or get a job with extended benefits, leave and continue the benefits. my premium this way is $130/month and defeats a $200/month prescription, plus picking up tiny pieces of glasses and other expenses.

I really like this kind of creative thinking!

Yeah, so much wouldn't be covered -both our brains, both our feet, my shoulder (bike accident + former job), now my hip, his teeth- but I wonder if it's worth it for things we've (thankfully) never had to deal with, like cancer.

I wonder if we could ever have gotten coverage for orthodontics, since his tooth issue is congenital, so inherently pre-existing even if I'd bought insurance the day he was born. That's where I'm uneasy about insurance. With this issue identified at 10, I could have been paying premiums for 10 years and then they maybe claim preexisting condition.

In BC, some prescriptions are covered by various means, and many aren't. Some people are paying hundreds of dollars per month for them (I've seen people pay over $2000/mo, but in those cases, the manufacturers started supplying them free).

totoro

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Re: health insurance Canada
« Reply #23 on: September 02, 2015, 03:39:21 PM »
What autism treatments are not covered?  The Autism Funds: Ages 6 – 18 may be used for:

• Behaviour consultants
• Speech-language pathologists, occupational therapists, physiotherapists
• Behaviour interventionists
• Life skills and social skills programs
• Out-of-school support/tutoring (not part of regular school program)
• Specialized therapeutic activities and camps designed to address your child’s ASD
• Dietary or nutritional counselling from a registered dietician/nutritionist
• Family counselling/therapy
• Other interventions recommended by a professional/specialist* (pre-approval suggested)

As for the tooth issue - we have that one too and braces are expensive.  Our health coverage had a $2000 limit on it so we paid out of pocket for quite a bit of it.

And I think it is just fine to accept help from a charity for medical issues for your son.  I would be very pleased if someone who needed money I had donated put it to good use and it made their lives a little easier.

scrubbyfish

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Re: health insurance Canada
« Reply #24 on: September 02, 2015, 04:27:29 PM »
What autism treatments are not covered?

Anything for the incontinence aspect (now resolved in our case through another therapy), EMDR, and nutrition (as opposed to nutrition tips), a.k.a., the only therapies that have made a difference in his autism, and that brought him from lower functioning to high functioning. Thousands and thousands out of pocket. Lots of families have reported the same (effectiveness but no coverage) for other therapies (neurofeedback, etc), as well as for support animals. Anything AFU deems a "medical service" is also not covered. We've also been turned down for using it for weighted blankets, tracking devices for independence, camps, keyboard even though he is assessed to not handwrite and to type re: pain, caregiver respite, etc.

Also, that note is a bit misleading. It will cover up to $6000/yr, and most therapies (OT, SLP, assessments, etc) are billed to AFU at $120-$160/hr. At $150/hr, that's 40 hours per year, or less than one hour per week...when BC recommends they have 10-40 hours of therapy per week. All of that is not covered. Practitioners also like us to use $2000-$3000 every 2-3 years for a new assessment.

And then there is the issue of the many therapists that won't use Autism Funding because of AFU's nightmare payment system (it doesn't allow reimbursements to families).

And...that "insurance coverage" cost me $2000 up front. Worth it, but not quite as it seemed when I first learned about it.

totoro

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Re: health insurance Canada
« Reply #25 on: September 02, 2015, 07:12:52 PM »
I advocate for family friends with a child on the spectrum and have done so for many years - he is now 15 and was diagnosed at 4.   He did have 40 hours a week of ABA early on but the family hired and trained their own interventionists at $15-$20/hour.  They still hire their own and as long as the funding agreement is signed and forms are in for the provider they get direct pay from AFU.   

I'm surprised that the assessment is $2000-$3000 every 2-3 years.  That is a lot of the funding.

The program has really changed over the years from family to ministry administered but we've been able to get coverage for many items with professional recommendation by a behavioural consultant.  They were even able to get a trampoline paid for (wouldn't fly now) and assistive devices like computers/keyboards are covered every 3 years, but they can be obtained from SET-BC for free on loan. 

I would suggest meeting with Elizabeth Sparling at Pivot Point if you are anywhere near Victoria BC as she was really helpful and has gotten coverage for alternate therapies such as neurofeedback.

You are hooked in with ACT BC already I assume but here is a website about benefits: http://asdfunding.com/

Support dogs are free and their expense is tax deductible: http://asdfunding.com/autism-support-dogs/

Here is a list of charities: http://asdfunding.com/charities/

Sorry if you already know all that! 

scrubbyfish

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Re: health insurance Canada
« Reply #26 on: September 02, 2015, 08:14:50 PM »
Retyping, as first go got eaten :(

Thanks, Totoro! It's so good that family got the dx well before age 6, as they will fund way more before that age. (Though our assessor made a comforting case for why it was better that my son didn't.)

Yeah, a family can apply for the reimbursement system once the child turns 12 (not before). It will be helpful because I'll be able to track exactly what's being billed, what's available, etc. It will also open up the pool of service providers available.

I and others have made some fabulous efforts in advocating (I used to do it professionally), and a few things have flown but most haven't. That means we end up with essentially what we started with, but lost time and reduced energy. So, now I generally allocate the whole amount to one counsellor and let her do her thing. It had proven ineffective, anyway, to break the 40-50 therapist hours into, say, 20 hours per year for SLP and 20 hours per year for OT. Yeah, I've trained myself to provide most of his therapies...but even I figured I should stop short of attaching braces to his face  ;)

My best workaround with AFU so far has been to locate registered clinical counsellors that are trained to offer EMDR. This way, we can access the therapy that works, while it fits their billing system. I've been hoping to find an RCC that does neurofeedback. We're not near Victoria, but I'll contact Elizabeth anyway. Sometimes people can work their magic over a distance, or provide leads.

Yeah, so far I've just refused to get updated assessments until they provide him with one of the free spots. I mean, everyone (school, etc) is ignoring the one we have, so why would I spend $2000 or more on another document they ignore? I won't.

Yep, in regular contact with ACT :)

The support dog agency that came in to give a presentation to us said the waitlist for a dog was 5-20 years, and for most people closer to the latter. I'd been hoping to get him one when he was little. (Very interesting field. Volunteers house and train the dogs, but the funding still only allows training of too few dogs per year.)

Thank you for the list of charities helping with ASD stuff! Also thanks for caring in general, as well as for helping that family long term! I'm sure they're very grateful! (I have a neighbour who, as of two hours ago, is on the hunt to find me a spouse that will do paperwork, admin, advocacy, etc. Hee.)

All this noted, it's more future surprises I'm considering insurance for. I might try another thread on that specifically (and not throw any red herrings into it).

Endersmom

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Re: health insurance Canada
« Reply #27 on: September 03, 2015, 03:30:16 PM »
I have found for our family of 3 we are better off just paying out of pocket and that is even with the option of using my husbands company group plan ( we get an annual amount to allocate as we see fit dental, prescription, eye care, HSA, RRSP, etc.) but when I do the math we don't even break even with the premiums because of all the restrictions ( maximums amounts,amount of time between appointments) I thing you need larger families for there to be a cost saving or to come out ahead. We just put the money in a RRSP and HSA  to save on the taxes. We would come out ahead if we needed a root canal or something big for one year but over the last 8 years we opted out we have come out ahead and having to pay out of pocket for a big expense would suck but we still will have come out ahead over monthly premiums paid over 8 years

 

Wow, a phone plan for fifteen bucks!