Veterans Affairs Canada - Anciens Combattants Canada
   
FrançaisContact UsHelpSearchCanada Site
Ministère
Clients Fournisseurs et Professionels Les jeunes et les éducateurs Le Canada se souvient
Veterans Affairs Canada - Clients
Home Clients Veterans Services Veterans Independence Program A Guide to Access VAC Health Benefits and the Veterans Independence Program

A Guide to Access VAC Health Benefits and the Veterans Independence Program

Download PDF

How To Contact Us

For further information on Programs and Benefits, please contact Veterans Affairs Canada at the following toll free numbers. Office hours are Monday to Friday 8:30 to 4:30 local time.

  • 1-866-522-2122 (English)
  • 1-866-522-2022 (French)

General Information

Health Benefits

Programs of Choice (POC)

Veterans Independence Program

Veterans Affairs Canada Health Benefits

In recognition of the sacrifices made by Canadians in war and peacekeeping efforts, Veterans Affairs Canada (VAC) offers benefits and services to qualified Veterans, released or still-serving Canadian Forces (CF) members, Royal Canadian Mounted Police (RCMP) members, and certain civilians, as well as, their dependants or survivors.

This guide provides information on the benefits and services available through the VAC Health Program and the Veterans Independence Program and explains how you may be qualify to receive these benefits. It also explains how to use your VAC Health Identification card.

The guide is available on audio cassette or compact disc (CD), please contact VAC at 1-866-522-2122 (English) or 1-866-522-2022 (French) to obtain your copy.

Health Benefits Program

Veterans Affairs Canada offers health benefits and services through 14 Programs of Choice:

  • medical, surgical or dental examinations
  • treatment provided by health professionals
  • surgical or prosthetic devices or aids and their maintenance
  • home adaptations to accommodate the use of devices or aids
  • preventative health care; and
  • prescribed drugs.

In addition, clients may qualify to receive supplementary benefits. Supplementary benefits are the travel costs required to receive an approved health treatment paid by VAC. It includes travel costs for escorts, meals, and accommodations and costs associated with medical examinations requested by the Department.

To obtain a VAC benefit or service using your VAC Health Identification card, present it to a participating VAC provider. The provider will confirm eligibility, obtain pre-authorization and supply the benefit. The provider will submit receipts/invoices for payment. You do not need to be out of pocket for the approved benefits or services.

To be reimbursed for a VAC benefit or service from a non-participating VAC provider, please pay for the benefit or service up front and submit your original receipts/invoices to the appropriate address (listed on pages 27 & 28) for the Program of Choice benefit or service received.

Please note: It is necessary to obtain pre-authorization from Veterans Affairs Canada to ensure that the benefits and or services you need will be reimbursed by Veterans Affairs Canada. You can contact VAC for details on how to request pre-authorization.

Veterans Independence Program

The Veterans Independence Program (VIP) is a national home care program that helps eligible clients to remain healthy and independent in their own homes or communities by offering a variety of services and programs, such as housekeeping or personal care. VIP works with other federal, provincial, or municipal programs. The services an eligible client may receive depend on individual circumstances and health needs. All benefits and services must be pre-authorized by VAC.

To find out if you qualify for VIP services, contact VAC. A written message will be sent to staff at your local District Office, and they will contact you and your family to assess your needs and determine which VIP services may be approved, provided, and paid.

There are 3 payment methods available and will be discussed with you by your Area Counsellor. See pages 35 - 36 for information on methods of payment for VIP.

Confirmation of Benefit or Service

Once you have received a benefit or service from VAC, you may be required to sign a claim form, to confirm that you have received a benefit or service. It is important that you do not sign a claim form until the benefit or service has been received and you are satisfied with it. If you are unsatisfied with the benefit or service you have received, please contact VAC.

Frequency and Dollar Limits

There are established financial and frequency limits for VAC benefits and services. These limitations apply to both the Veterans Independence and Health Benefits Programs. In some circumstances, your request for a benefit or service may be denied or reduced if you exceed the frequency and/or financial limits established by VAC.

Participating VAC providers are informed of the frequency and dollar limits that apply to your individual benefits. The provider must verify you qualify prior to providing a benefit or service. Providers must not charge VAC clients more than other cash paying customers who live in the same province/territory.

In the case of VIP, amounts that have been approved for each VIP service will be discussed with you. Your approved amounts will be confirmed with you verbally or in writing.

When You Travel

If you are planning to travel outside of your home province, you should call the toll free number on the front of your VAC Health Identification card.

Your VAC Health Identification card is valid only in Canada. It cannot be used while you are outside of the country. If you are planning to travel outside of Canada you should call VAC's Foreign Countries Operations for advice on how to obtain benefits while travelling.

  • 1-888-996-2242 (Canada & United States)
  • (613) 996-2242 (collect, all other countries)
  • 00-800-996-22421 (Toll free from the United Kingdom, Germany, France & Belgium)

Veterans Independence Program benefits are not paid for clients travelling or living outside of Canada.

Review Process

If you are denied a VAC benefit for which you believe you qualify for, you may request a review of the decision. This request for review must be submitted in writing within 60 days from the date of receipt of the unfavourable decision. The decision letter provides direction regarding the review process.

Still-serving CF members or Regular RCMP members who are in receipt of a VAC disability benefit must seek all treatment from the Canadian Forces or RCMP organizations first. (All still-serving Civilian RCMP members who receive disability benefits, may receive treatment from VAC for their VAC entitled condition(s)).

Appeal requests are to be sent to the:

Director, Program Policy
Veterans Affairs Canada
PO Box 7700
Charlottetown PE C1A 8M9

Your VAC Health Identification Card

You are the only person who can use your VAC Health Identification card. In order to protect you and the use of your card, please sign the back of your card.

Client Name and Identification Number

VAC Health Identification card

Your VAC Health Identification card issued in your name is an efficient and effective method of identifying the benefits and/or services you qualify for . Your client number begins with the letter "K". Whenever you call or write to VAC about your benefits, you should provide this number. Client Info provides the toll free number that you should use if you have questions or need to speak with someone from VAC about your VAC benefits and services.

Identifying Your Eligibility for Health Benefits

Health benefits and services are offered through 14 Programs of Choice (POC). On the reverse of your VAC Health Identification card you will find the names of all the Programs of Choice and their corresponding numbers. These Programs are described in detail on pages 16 - 26. In order to identify the programs you qualify for, look on the front of your VAC Health Identification card. If you have an "A" or "B" (or both) under the Program of Choice numbers, you may qualify for these programs.

Group "A"

When the letter "A" is shown under a Program of Choice (POC), ONLY benefits directly related to the condition(s) for which you have VAC disability entitlement will be covered by VAC. All payments for benefits under this group require pre-authorization from VAC before they can be provided.

Certain Programs appear on all VAC Health Identification cards ("A" clients) regardless of the condition for which you have entitlement. These benefits and services are: (2 - Ambulance / Medical Travel Services, 5 - Hospital Services, 6 - Medical Services, 10 - Prescription Drugs.)

In order to ensure payment of the requested benefit/service (ie. prescription drugs), the benefit/service must be related to your entitled condition and must have pre-authorization from VAC.

Group "B"

When the letter "B" is shown under a Program of Choice (POC), you may qualify for a VAC benefit or service provided you have a clearly demonstrated health need and that these benefits/services are not covered by a provincial or private health plan. This demonstrated health need must also meet criteria based on VAC policy.

VAC may be able to cover any remaining amounts for eligible benefits. If you are a "B" client, you or your provider must bill the appropriate provincial health program for the portion of the benefit that is covered by the province where you live. If you have private health insurance, either you or your provider(s) must submit your claim for payment through your private health plan.

When both "A" and "B" are shown, your eligibility for benefits will depend on several factors such as your entitled condition, your overall health issues, the benefit or treatment requested or required, and provincial and private health coverage.

If neither "A" or "B" are shown under the specific Program, you do not qualify for the benefits under that program.

Veterans Independence Program Indicator

In addition to health benefits, you may qualify to receive benefits and services through the Veterans Independence Program (VIP.) VAC will determine if you qualify for benefits/services though the Veterans Independence Program. If you qualify for VIP, the level of support and help you receive through the program is dependent upon your assessed health and social needs. If you qualify to receive benefits and services through the Veterans Independence Program, the letters VIP will appear directly below the word "Group" on the front of your VAC Health Identification card.

Veterans Affairs Canada is pleased to offer your Health Identification card in your official language of choice. The card is available in either English or French. If your card is not in your official language of choice please contact VAC.

VAC also offers a low glare Health Identification card designed for clients who are visually impaired.

If you require additional information regarding the use of your VAC Health Identification card or the health benefits available, please contact VAC at the toll free number listed on the front of your VAC Health Identification card.

Health Benefits

Do I Qualify?

Two groups of clients qualify for health benefits through Veterans Affairs Canada (VAC) - Group "A" clients and Group "B" clients.

Group "A"

Group "A" clients may use their card to obtain approved benefits directly related to a condition for which there is VAC disability entitlement.

If you have an entitled condition you may qualify as a:

  • Veteran or civilian, including a retired CF or RCMP member or a regular serving civilian member of the RCMP; and;
  • have been awarded a disability entitlement by Veterans Affairs Canada.

Still-serving CF members and regular serving RCMP members who have VAC entitled disabilities must continue to receive all benefits and services exclusively from the Department through which they are employed until released.

Once released from the Canadian Forces or RCMP, a disability pensioner or award recipient will start receiving their benefits/services directly through Veterans Affairs Canada. In order for this to occur the member should ensure they are removed from the CF or RCMP Member Enrollment System (MES.) Once removed from MES a VAC Health Identification card will be issued to obtain benefits and services authorized and approved by VAC. CF and RCMP members are encouraged to notify VAC upon release from service. To assist with the transition process, a copy of the member's release certificate should be forwarded to VAC.

Group "B"

Group "B" clients may use their card to obtain approved benefits based on demonstrated health need where it is not covered either through provincial or private health coverage.

Who is eligible:

  • Income qualified Veterans and civilians, meaning those persons who receive the War Veterans Allowance benefit, or would receive it if not for also receiving Old Age Security Act benefits.
  • Prisoners of War (POW) in receipt of services through the Veterans Independence Program.
  • Veterans, civilians, and Special Duty Services Veterans who are receiving services through the Veterans Independence Program.
  • Canada Service Veterans receiving services through the Veterans Independence Program.
  • Veteran pensioners or Overseas Service Veterans receiving care in a Departmental or contract care facility.

Peacetime Military Service Pensioners or Award Recipients are not covered in the Provision for B line benefits or services.

Frequency and Dollar Limits

There are established financial and frequency limits for VAC payment of benefits and services. These limitations apply to both the Veterans Independence Program and the Health Benefits Program. In some circumstances, your request for a benefit or service may be denied or reduced if it exceeds the limitations. Participating VAC providers are informed of VAC's frequency and dollar limits that apply to your individual benefit / service. The provider must verify your eligibility prior to providing a benefit or service. If approved, your provider will be given pre-authorization and the requested benefit/service will begin.

If you have exceptional health needs you may request a review of your current condition by submitting the request to VAC (Please see page 27 - 28 for the appropriate address.)

Health Benefits - Programs of Choice

Please note: Purchasing or accessing a benefit / service without pre-authorization does not guarantee VAC will pay for the full or partial amount submitted.

1. Aids for Daily Living

This program provides devices and accessories, including necessary repairs, designed to assist the activities of your daily living.

Examples of covered devices/accessories are:

  • walking aids such as canes;
  • self-help aids for dressing and/or feeding;
  • bedroom aids such as foot boards or over-bed tables;
  • bathroom aids such as raised toilet seats or bath benches.

For a complete listing of what may be covered, please visit our VAC Web site at www.vac-acc.gc.ca.

2. Ambulance / Medical Travel Services

Ambulance - This program provides use of ambulance services to or from a medical facility when it is needed because of an emergency or medical condition.

Some services require a prescription from your doctor and/or pre-authorization from VAC before payment can be made. In non-emergency cases, you should verify these requirements with your provider or VAC before the service is provided.

Medical Travel Services - This program provides Health Related Travel costs incurred in order to receive a benefit/service. All Health Related Travel costs must be pre-authorized by VAC. VAC is responsible for the payment of treatment travel benefits for:

  • VAC Clients in receipt of disability benefits where the treatment/travel is directly related to the entitled condition.
  • VAC "Group B" clients where the travel is not related to an entitled condition and the benefit/service is not insured by a provincial or private health plan.

If you require an escort to travel to obtain treatment, please contact VAC. Travel expenses incurred by clients to receive treatment benefits require pre-authorization from VAC. If the benefit/service is not pre-authorized payment may not be made.

3. Audio (Hearing) Services

This program provides benefits to help with hearing impairment. Your provider has a detailed list of available benefits.

Examples of covered benefits are:

  • analog hearing aids
  • basic digital hearing aids
  • basic programmable analog aids
  • telephone amplifiers, infrared devices
  • hearing aid accessories (eg. batteries)
  • dispensing and fitting fees

Provision of other models of programmable and digital aids will be considered by VAC on an exceptional basis if your hearing needs cannot be addressed by the standard benefit technology. Special authorization is required for non-standard hearing aids.

Examples of special authorization benefits are:

  • Multi-channel programmable analog and digital aids
  • Completely-in-the-canal aids

4. Dental Services

This program provides basic dental care and some pre-authorized comprehensive dental services. You are also entitled to receive dentures once every 7 years. Procedures will not be approved where there are more conventional evidence based treatments which are both acceptable and cost-effective alternatives.

Examples of covered benefits are:

  • annual basic treatment – cleanings, exams and fluoride treatments (once every 9 months)
  • fillings

Examples of excluded benefits are:

  • implants
  • equilibrated/custom/semi-precision dentures
  • gum surgery

Some forms of dental treatment require pre-authorization by VAC, for example:

  • any annual basic treatment exceeding $800
  • crowns
  • bridgework
  • specialist treatment (referral required)

No matter which dental treatment is suggested, always ask your dentist how much of the cost will be covered under your dental benefits. Our dental program covers 90% of the rates in the Provincial Dental/Denturist Association fee guide and you may be expected to pay the difference.

For additional information regarding dental benefits, please contact VAC.

5. Hospital Services - Inpatient & Outpatient Services

This program provides benefits for treatment services provided in an acute care, chronic care, or rehabilitative care hospital. It includes both inpatient and outpatient services provided to a Veteran in an accredited provincial hospital or health facility. Costs for acute care or for private or semi-private rooms are not normally covered by Veterans Affairs Canada.

6. Medical Services

This program offers medical services provided by a licensed physician. The costs of medical examinations, treatment or reports specifically requested by VAC are also covered by this program.

Eligible clients who are in receipt of disability benefit(s) may access this program to obtain medical services for demonstrated health needs that pertain directly to their entitled condition(s).

Eligible clients who required medical services for non-entitled conditions may only access this program in those instances where there is a clearly demonstrated health need for the service and the service is not offered and / or paid for by the appropriate provincial health care program.

7. Medical Supplies

This program provides medical and surgical equipment and supplies normally used by an individual in a non-hospital setting.

Examples of covered medical and surgical equipment:

  • bandages
  • incontinence supplies

8. Nursing Services

This program provides services for nursing assessments, basic or advanced footcare administered by participating providers such as a registered nurse, or a qualified licensed/certified nursing assistant.

Examples of covered services:

  • administering medications
  • application of dressings
  • counselling Veterans or caregivers in the use of medical supplies and health care
  • foot care

Examples of excluded services:

  • continuous nursing (i.e., on-going care of more than two hours per day by a registered nurse)
  • private nursing provided in a long-term care facility or hospital

9. Oxygen Therapy

This program offers oxygen and accessories, as well as the rental or purchase of other respiratory supplies and equipment.

Examples of covered benefits are:

  • oxygen concentrators
  • compressors
  • oxygen gas

10. Prescription Drugs

This program provides drug products and other benefits dispensed by a pharmacist. Included under the VAC programs are:

  • Standard Benefits which include many over-the-counter and prescription drugs, plus medical devices that are considered by VAC to represent "common" therapies. All products on this formulary are readily accessible to eligible clients who have a prescription. Prescriptions may be written by your physician, dentist, or other person authorized to prescribe pharmaceuticals under the laws in force in the province or the country where the pharmaceuticals are provided.
  • Special Authorization Benefits provide eligible clients with less common or higher cost therapies approved by VAC. Clients must have a prescription and be able to demonstrate a medical need that is most appropriately met with the requested therapy. Clients may be required to submit medical test results prior to being approved for these benefits. Alternatively, clients may be asked to try more common therapies before receiving special authorization products.

Your pharmacist can verify if you qualify for a benefit at the time that you provide the prescription from your doctor or dentist. Your pharmacist is aware of the available benefits.

Examples of covered benefits:

  • prescription drugs
  • some over-the-counter medications
  • some medical supplies

Pharmaceutical products which VAC does not generally cover:

  • Rogaine
  • Glucosamine
  • Dextronex
  • Visudyne Kit
  • Xenical caps

For additional information regarding pharmacy benefits, please contact VAC.

11. Prosthetics and Orthotics

This program provides necessary prosthetics or orthotics in addition to accessories and repairs for these benefits.

Examples of covered benefits:

  • prosthetic and orthotic appliances
  • custom-built footwear
  • modifications to regular footwear
  • necessary accessories and repairs

Examples of excluded benefits:

  • off-the-shelf footwear

12. Related Health Services

This program offers alternative benefits and services provided by health professionals. These health professionals must be licensed by a licensing authority recognized by the province or territory in which these services are provided, or approved by VAC.

Examples of covered services (requiring referral by physician):

  • occupational therapy
  • physiotherapy
  • massage therapy
  • acupuncture
  • hearing & speech therapy
  • psychological counselling

The following is an example of a covered service that does not require a referral by your physician.

  • chiropractic

Examples of excluded benefits:

  • homeopathic services
  • naturopathic medicines and therapies

13. Special Equipment

This program provides special equipment required for the care and treatment of VAC clients. These benefits must be prescribed by a VAC approved Health Professional (ie. Physician, occupational therapist, etc.), and supported by other health documentation as required by VAC. The majority of benefits in this program require pre-authorization from VAC before the benefit can be provided.

Examples of covered benefits:

  • hospital beds
  • walkers
  • lifts
  • home adaptations
  • wheelchairs
  • driving aids

Examples of excluded benefits:

  • mattresses for a regular bed
  • "Craftmatic-type" adjustable beds

14. Vision (Eye) Care

This program offers lenses, frames, and accessories to correct sight impairments. Low-vision aids are available from the Canadian National Institute for the Blind.

Examples of covered benefits:

  • basic single, bifocal lenses
  • frames
  • eye examinations

Examples of excluded benefits:

  • "second pair free " promotions
  • sunglasses

Methods of Payment for Health Benefits

Direct Payment

Clients using a registered provider do not need to worry about being out of pocket for services. Registered providers will submit invoices to receive payment for authorized benefits.

Reimbursement

For reimbursement or pre-authorization of health benefits and services for the following, please submit your original invoices / receipts or request/estimate to the office location nearest you (refer to the addresses that follow).

For Programs of Choice:

1. Aids for Daily Living,

2. Ambulance / Medical Travel Services,

5. Hospital Services - Inpatient & Outpatient

6. Medical Services

8. Nursing Services

9. Oxygen Therapy

12. Related Health Services

13. Special Equipment

14. Vision (Eye) Care

Veterans Affairs Canada
Treatment Authorization Centre
10 Barters Hill, 2nd Floor
PO Box 5068
St. John's, NL A1C 5V4

Veterans Affairs Canada
Treatment Authorization Centre
Place Bonaventure, South-West Portal
6505 - 800 de la Gauchetière St. West
Montreal, QC H5A 1L8

Veterans Affairs Canada
Treatment Authorization Centre
PO Box 5600, 900-605 Robson St.
Vancouver, BC V6B 5G4

For Reimbursement or pre-authorization of health benefits and services for Programs of Choice 4 & 10 - Dental Services & Prescription Drugs, please submit your claims with original receipts to:

Veterans Affairs Canada
Treatment Authorization Centre
PO Box 7700, 161 Grafton St.
Charlottetown, PE C1A 8M9

For reimbursement or pre-authorization of health benefits and services for Programs of Choice 3, 7 & 11 - Audio (Hearing) Services, Medical Supplies and Prosthetics & Orthotics, please submit your original receipts or claims to:

Veterans Affairs Canada
Treatment Authorization Centre
PO Box 6200 STN LCD 1
Moncton, NB E1C 8R2

Veterans Independence Program

Do I Qualify?

The following clients may be qualify for VIP services:

  • All disability benefit recipients who require VIP for their entitled condition(s)
  • Wartime pensioners who are seriously disabled (pensioned at 78% or higher) and medium disabled (48-77%) who require VIP services for any health condition
  • Disability benefit recipients who have multiple health conditions, which, when combined with their VAC entitled condition places them at risk. VAC clients meeting this criteria may be provided VIP services for any health related need
  • War Veterans who qualify because of low income; the income levels are established under the War Veterans Allowance Act
  • Totally disabled Veterans in receipt of Prisoner of War Compensation/Detention benefits
  • Overseas service Veterans who are at home awaiting admission to a Priority Access Bed
  • Canada Service Veterans (Veterans who served in Canada only during World War I or World War II, are over age 65 and who are income qualified)
  • Primary caregivers of Veterans who have died since 1981 and who were receiving VIP housekeeping and /or grounds maintenance services at the time of death may qualify to receive these services for lifetime
  • Primary caregivers of Veterans who received VIP housekeeping and / or grounds maintenance services at the time of admittance to a health care facility, since 1981, may qualify to continue to receive VIP housekeeping and/ or grounds maintenance services.

*VAC disability benefit recipients whose entitlement is related to Regular Force Special Duty Services or Military Service are not included in the "Medium or Seriously Disabled Veterans" provision. *If you are an RCMP member you are not entitled to services through the Veterans Independence Program.

Determination of VIP Services

VAC staff will visit you to carry out a comprehensive assessment with your help to determine your health and social needs. Requests for VIP services are considered on the basis of your needs.

VIP is not intended to duplicate or replace existing provincial or community services. When provincial or local services are not sufficient to meet your needs, VIP services may be approved to complement or "top up" the services provided by the province or local agency.

Based on your health assessment, VAC will work with you to determine the services to be provided and the amount to be paid. If your circumstances or health needs change, please contact VAC to arrange for a review of the VIP services.

VIP Elements

The Veterans Independence Program is designed to assist with the costs of certain services provided at the clients' home such as:

Grounds Maintenance - Grounds Maintenance includes activities regularly required to maintain the grounds immediately surrounding the client's principal residence.

Examples of services covered by this program:

  • snow removal from steps, walkways, and driveways to allow safe access to the principal residence.
  • snow and ice removal from roofs and eavestroughs when such conditions pose a threat to safety and access
  • lawn mowing and raking

Examples of excluded services:

  • lawn planting or seeding
  • material and labour costs for spraying and fertilizing
  • pruning trees not posing a threat to safety and access

For a more complete list of eligible grounds maintenance services, see Appendix A at the back of the booklet.

Housekeeping - Housekeeping services are routine tasks or domestic chores required to support the client in remaining self-sufficient at their principal residence. Certain non-routine tasks or domestic chores may also be covered, with pre-authorization by VAC, and only if they are required as a result of the client's health and safety being at risk.

Examples of services covered by this program:

  • laundry, including ironing and mending
  • vacuuming
  • cleaning floors (sweeping, washing, waxing, etc.)
  • dusting and general picking up
  • meal preparation

For a more complete list of eligible housekeeping services, see Appendix A at the back of the booklet.

Personal care - Personal care services are approved services provided by individuals such as VAC approved Health Care Providers or Professionals. These services include assistance in the performance of the activities of daily living and supervision required by clients who cannot be left unattended.

Examples of services covered by this program:

  • assistance with eating
  • assistance with dressing
  • assistance with washing
  • assistance with grooming
  • adjusting prosthetic appliances
  • attending to toileting
  • ambulation
  • respite care

Examples of excluded services:

  • administration of medication
  • any services beyond those identified as covered services

To provide personal care services, personal care workers must have completed a recognized personal care training program consisting of a minimum of 120 hours, be bonded or have liability insurance. Personal care workers should be VAC registered providers.

Home Adaptations - Home adaptations can be made to a client's principal residence. For example, bathrooms, kitchens, and doorways can be modified to provide access for basic everyday activities such as food preparation, personal hygiene, and sleep. Home adaptations do not include general renovations or repairs. All home adaptations must be pre-authorized by VAC before payment can be made.

Examples of services covered by this program:

  • handrails on stairways
  • ramps

Examples of excluded services:

  • general renovations or repairs
  • house additions

Access to Nutrition - Access to nutrition services provides access to nutritional food, whether it is delivered to the client's home, offered in the community, or served at a local restaurant.

Examples of services covered by this program:

  • the cost of delivering food to the home
  • transportation cost to bring the client to a local restaurant or community facility to obtain meals i.e. taxi to restaurant

Examples of excluded services:

  • services of professional dietitians or nutritionists
  • meal service as the result of the terms and conditions of a rental agreement
  • cost of the meal itself
  • homemaker charges for meal preparation

Health and Support Services Provided by Health Professionals - Health and support services are health assessments and diagnostic services, care, maintenance, and related personal care provided by health professionals and approved by VAC. These can be provided only when they are not insured services under a private health care system or available to clients as residents of a province (provincial covered service).

Ambulatory Health Care - Ambulatory health care covers certain health and social services provided outside the home (by and under the supervision of a health professional) such as adult day care and travel costs to access these services.

Intermediate Care Services - Intermediate Care Services may be provided when living at home is no longer practical and a greater level of nursing and personal assistance is needed in a Long Term Care Facility (LTC). Eligible clients may also qualify for assistance with chronic care. For more information concerning intermediate care and chronic long-term care, please contact VAC. A written message will be sent to staff at your local District Office, and they will contact you and your family.

Social Transportation - Transportation service may be approved to allow clients to participate in social activities, in response to the client's basic social, recreational, or personal needs. These may include transportation to: church services, occasional visits to friends/relatives, community centres, banks, and grocery stores, when transportation is not otherwise available.

"A" coverage clients do not qualify for Social Transportation through the Veterans Independence Program.

Methods of Payment for VIP

Direct Payment

Clients using a registered VIP provider do not have to worry about being out-of-pocket for services. Registered providers will submit invoices directly for payment.

Advanced Payment

Clients who are currently on advance payment method for services will continue to receive advance pay, however, are expected to maintain and provide receipts for all services as required by VAC. New clients will not be provided with this payment option.

Reimbursement

For reimbursement of VIP services from non-registered providers please complete the claim form and submit original invoice(s) / receipt(s) to:

National Veterans Independence Program
Reimbursement Centre
120-90 University Avenue
Charlottetown PE CIA 9S2

For more information on the Veterans Independence Program and how to apply, please contact VAC or visit our website at www.vac-acc.gc.ca

Other Services

Employees of Veterans Affairs Canada work closely with provincial and local agencies to provide clients with the greatest possible range of services and benefits to meet their physical, social, and psychological needs.

Questions and Answers

General

Q. I lost my VAC Health Identification card. What do I do?

A. Please call VAC and a replacement card will be sent within 4-6 weeks.

Q. I have moved. Do I have to notify VAC of my change of address?

A. Yes. When you move you should let VAC know by phoning the toll free number indicated on the front of your card.

Q. Can I use my VAC Health Identification card in another province?

A. Yes, you may use your card anywhere in Canada.

Q. I am travelling outside of Canada. Can I use my VAC Health Identification card?

A. Please contact VAC Foreign Countries Operations at 1-888-996-2242 (Canada & United States), (613) 996-2242 (collect, all other countries) or 00-800-996-22421 (toll free from the United Kingdom, Germany, France and Belgium) for details on how to access health benefits while travelling outside of Canada.

Health Benefits

Q. What should I do if I do not know or can not find a registered provider?

A. If you do not know any registered VAC providers, call the toll free number on the front of your VAC Health Identification card.

Q. If I have been approved for a benefit or service and my provider will not accept my VAC Health Identification card what should I do?

A. If your provider does not accept your card, you will be required to pay for the item then submit your receipts for reimbursement along with your prescription, to the appropriate Treatment Authorization Centre. (See addresses on pages 27 & 28). You may wish to let VAC know that the provider is not accepting the VAC Health Identification card by calling VAC.

Q. My health care provider is asking that I sign a consent form. Do I have to sign the form?

A. On January 1st, 2004 the Personal Information Protection and Electronic Document Act (PIPEDA) was brought into law to protect the privacy of personal information. As a result of this legislation, your health care provider may ask that you sign a consent form to allow your provider to share information about you to VAC.

VAC cannot advise you to sign or not sign the consent form. If you have questions or concerns and need more information about whether you should sign the consent form, you need to discuss your concerns with your health care provider. Providers must not charge VAC clients more than other cash paying customers who are residents of the province/territory.

Q. Can I still use my own doctor or dentist for the treatment I need?

A. Yes. You are free to use the doctor or dentist/denturist of your choice providing they are licensed health professionals in the province where they are providing services. If you use a doctor or dentist outside your region, or one that is not registered with VAC you should contact Veterans Affairs Canada before obtaining services.

Q. Can I use my card to obtain prescribed medications, benefits, or services for my spouse and/or children?

A. No. Your card is to be used for benefits and services prescribed or approved for you only.

Q. I believe that I should qualify for benefits that are not on my card. What should I do?

A. Call the toll free number on the front of your card, provide your client number, and explain your situation. Please be specific about what benefit or service you believe you should receive and why.

Q. I have been denied a benefit or service from Veterans Affairs Canada. What do I do?

A. You have the right to request a review of the decision and can submit a request for review or appeal of a decision as per the information provided in your decision letter. Please see page 8 for details.

Q. Will Veterans Affairs Canada pay for special treatment by a doctor or hospital not covered by my provincial health plan?

A. Normally your doctor will direct you to receive necessary treatment through the provincial health care system. There may be some circumstances where VAC would pay for non-insured services. However, in order to determine this, your doctor will have to submit a report to VAC. Contact Veterans Affairs Canada before treatment begins.

Q. My dentures do not fit. How do I obtain a new pair?

A. If your original dentures were paid for by VAC within the last seven years and your dentist or denturist determine that replacements are necessary, then a treatment plan with a written explanation must be sent to VAC for consideration.

Q. My dentist says I need a bridge. Will VAC pay for it?

A. Bridges are not a standard benefit. A detailed pre-authorization request with x-rays is required to determine if there is a less costly treatment to address your needs.

Q. I need new eyeglasses. Do I get the form from my VAC District Office?

A. No. You can use your VAC Health Identification card to obtain your glasses from a licensed provider in your area.

Q. My provider says that VAC will only pay a certain amount for frames for my eyeglasses. May I pay the difference for a more expensive pair?

A. Yes, you may pay the difference, but VAC will not reimburse you for the difference.

Q. What happens if I do not use my VAC Health Identification card to obtain a benefit covered by VAC?

A. If you pay for a benefit or service yourself, keep your receipt(s) and call VAC for direction on how to obtain reimbursement. It is preferred that you use your VAC Health Identification card to pay for benefits or services at the time of receiving the benefit or service. This makes sure that you are not out of pocket for expenses covered by your VAC Health Identification card and you do not have to submit receipts for reimbursement and wait for payment. It is faster, more efficient and no cost to you to use your VAC Health Identification card for health benefits or services at the time of receipt of the benefit or service.

Please note: Purchasing or accessing a benefit / service without pre-authorization does not guarantee VAC will pay for the full or partial amount submitted.

Veterans Independence Program

Q. My provider does not accept my card. What can I do?

A. Call the toll free number on the front of your VAC Health Identification card to verify that you qualify for the benefit. If you qualify, you will be given information about other providers in your area, or you can pay for the services yourself, obtain a receipt, and claim reimbursement by submitting a claim form and your receipt to: National Veterans Independence Program Reimbursement Centre (Please see Page 36 for address).

Q. What happens if I don't use my VAC Health Identification card to obtain a service under the Veterans Independence Program?

A. If at any time you pay for an approved service yourself, please keep your receipts and call the toll free number for direction on how to obtain reimbursement.

Q. How do I know whether my provider is registered?

A. Contact Veterans Affairs Canada for a list of registered providers within your area.

Q. Can I use the services of a non-registered provider? How do I get reimbursed?

A. Yes, you can use the services of a non-registered provider for all VIP services except for personal care. There are some exceptional situations for personal care - contact Veterans Affairs Canada for more information.

Services provided by non-registered providers can only be paid by reimbursement. For reimbursement of VIP benefits and services please refer to Page 36.

For reimbursement of VIP services from a non-registered provider, complete the claim form and submit original receipts for the services received to:

National Veterans Independence Program
Reimbursement Center
120-90 University Ave
Charlottetown PE C1A 9S2

Appendix A - Detailed list of eligible and ineligible services for Housekeeping and Grounds Maintenance Services:

Routine Housekeeping - covered services:

  • laundry, ironing, and mending
  • making and changing beds
  • vacuuming
  • cleaning floors (sweeping, washing, waxing, etc.)
  • dusting and general picking up
  • kitchen and bathroom cleaning
  • meal preparation, other than meals provided in seniors' apartments and complexes or adult residential care facilities as part of a rental agreement
  • bringing water inside when plumbing is absent
  • appliance cleaning (stove and ovens, refrigerators)
  • washing and changing windows
  • errand service to purchase food, do banking and pay bills when client is unable to do so (contributions for errand service should be limited to transportation costs and, if required, a remuneration fee paid at a nominal rate i.e., $10-$20)

For any housekeeping services not on the above list, contact Veterans Affairs Canada for pre-authorization.

Housekeeping- Non Routine

In exceptional circumstances Non-Routine Housekeeping may be approved by your local VAC District Office.

Examples include:

  • washing walls and ceilings (when environmental pollution is a factor e.g., wood or coal is primary fuel source)
  • shampooing/steam cleaning carpets and furniture and professional drapery cleaning
  • chimney cleaning
  • furnace and duct cleaning
  • cleaning attics, basements, and garages
  • extermination/fumigation
  • industrial cleaning

All non-routine housekeeping elements must be pre-authorized by Veterans Affairs Canada.

Ground Maintenance - examples of services covered by this program:

  • tilling ground to enable client to plant a small flower or vegetable garden
  • snow removal from steps, walkways, and driveways to allow safe access to the principal residence
  • snow and ice removal from roofs and eavestroughs when such conditions pose a threat to safety and access
  • periodically cleaning leaves and debris from eavestroughs
  • lawn mowing and raking
  • sweeping leaves from pathways, trimming hedges, shrubs, and trees when failure to do so would pose a threat to the client's safety and access
  • blocking, splitting, and stacking firewood when wood is and continues to be the main source of heat and the work was previously performed by the client

For any grounds maintenance services not on the above list, contact Veterans Affairs Canada for pre-authorization.

Examples of Excluded Grounds Maintenance Services:

  • lawn planting or reseeding
  • material and labour costs for spraying and fertilizing
  • pruning trees not posing a threat to safety and access
  • planting and maintaining flowers and vegetables
  • removing dead trees not posing a threat to safety and access
  • maintaining swimming pools
  • grounds maintenance portion of condominium fees
  • cost of firewood or labour for cutting and hauling it to the home
  • snow removal when client is not actively living in the primary residence (i.e., spends winter in Florida)
 

Site Standards

XHTML 1.0
CSS

This site validates as XHTML and CSS standards compliant. Learn more at the W3C.

Updated: 2006-5-15