National Defence and the Canadian Forces
www.forces.gc.ca
Common menu bar links
Backgrounder
Canadian Forces Health Care Identification Card
BG-05.023 - August 22, 2005
The Canadian Forces (CF) is mandated to provide a full range of health care services to its members. The level of health care provided to CF members is generally equivalent to that available to the civilian community under provincial health care plans.
In the vast majority of cases members of the Canadian Forces utilize the health care services provided at bases, wings and units across the country under the direction and authority of the Canadian Forces Health Services Group (CF H Svcs Gp). However, there are times and circumstances that require members of the CF to access civilian health care services.
To support those occasions the CF created a CF Health Care Identification card that is issued to all full time members of the regular force and certain other eligible persons. The distinctive card, commonly referred to as the Blue Cross Card, is specific to the cardholder and does not provide any health service coverage for family members or dependants.
Development of the CF Health Care Identification card grew in part out of a recommendation in the Chief of Review Services Report (mid 1990s) on the state of health care services provided to members of the CF. The recommendation related to improvements in the access to after hours and emergency health care services. Fiscal restraints experienced across government departments at that time also led to the exploration of options that might be available through the use of what is commonly referred to as third-party health services .
A series of options were explored and in 1998 the Medical Branch Council directed the CF H Svcs Gp to develop a central invoice payment and financial reporting system. This initiative was called the Designated Provide Plan (DPP) project. Further to an option analysis conducted by DPP, the CF H Svcs Gp executive, including the Environmental Chiefs of Staff medical advisors, directed DPP to among other things establish a partnership for health claims processing with Veterans Affairs Canada (VAC) which, since 1989, has used a third-party contractor for claims adjudication and processing.
The initial Memorandum of Understanding (MOU) agreement with VAC was signed in 1999 for the processing of health claims and came into effect for fiscal 2000-2001.The MOU was updated in 2004 and covers the period to July 31, 2008 with two extension options of two years each.
The agreement between DND and VAC did more than provide an efficient administrative service. It allowed the CF to gain better access to a network of health care providers and a proven mechanism to efficiently process health care claims.
Concurrent with the agreement between DND and VAC, all full time CF members and entitled persons were issued with a personalized CF Health Care Identification card to be presented, along with their official military identification card, at any time civilian health care services were being accessed. Along with the card , a written brochure is provided to members that outline the services and benefits available.
The CF Health Care Identification card is only good for services within Canada. Alternate programs of service are available for those posted to locations outside Canada or traveling outside Canada on temporary duty or leave.
The CF Health Care Identification card is designed to make access to services in civilian facilities easier and more efficient for CF members who, for the most part, are not eligible for and do not have provincial health care cards that civilians must present when accessing health services. Services can range from emergency care after hours to visits to specialists.
With presentation of the CF Health Care Identification card the majority of service providers will third-party bill for services to Blue Cross who is acting as the health claim administrator on behalf of the CF. Before the card was effective, the CF members were often require to pay for services on the spot in the civilian health care institutions. Providers who are not already part of the service providers program can call the phone number indicated at the back of the card for all information required including billing instruction.
The holder of the third-party administrative contract is Medavie Blue Cross. All claims are adjudicated by Blue Cross, which subjects them to a series of verification tests. When a claim passes the verification test Blue Cross pays it. If not the claim is referred back to the member's CF clinic for assessment and a decision on authorization of the claim.
Monthly, Medavie Blue Cross reconciles operational information with financial information and prepares and submit an invoice to CF H Svcs Gp for health claims paid. A breakdown of claims paid by CF base and treatment type is attached.
For additional information please contact the Canadian Forces Health Services Group Public Affairs at 613-945-6850.
RSS DND/CF News (What is RSS?)
