Enhancements Made to Medical Transportation Assistance Program

Health and Community Services
June 11, 2007
Enhancements Made to Medical Transportation Assistance Program

New enhancements to the Medical Transportation Assistance Program will provide increased financial assistance for residents who incur substantial costs when travelling for insured medical services, such as cancer treatment or surgery. The cost to implement these changes is approximately $525,000, with a total budget for the program of $1.7 million.

"We recognize the financial burden on individuals and families that comes as a result of travel expenses for medical services," said the Honourable Ross Wiseman, Minister of Health and Community Services. "Through these new enhancements to the Medical Transportation Assistance Program, we are providing further financial assistance to individuals with substantially high travel costs for medical services and improving the equity of the program."

The program improvements are:

As announced in the Northern Strategic Plan, effective May 1, residents of Labrador will now be reimbursed the first $1,000 for eligible travel expenses during a 12-month period. This is compared to $500 before the changes, resulting in a savings of $500 to individuals.
Effective July 1, 2007, residents of the island portion of the province will receive a greater level of assistance with the annual deductible reduced from $500 to $400 for eligible expenses incurred during a 12-month period. In addition, for residents of the island portion of the province, the first $100 in excess of the $400 deductible will be fully reimbursed. There is no deductible for Labrador residents.
All residents of the province currently receive a reimbursement for eligible expenses over the deductible amount (or over the first $1,000 for Labrador residents) at a cost-shared rate of 50 per cent. Effective July 1, 2007, eligible expenses greater than $5,000 incurred in a 12-month period will be cost-shared at a rate of 65 per cent by the Provincial Government (as opposed to 50 per cent), resulting in an additional savings of 15 per cent to the claimant.
Effective July 1, 2007, caps on eligible expenses will be increased for eligible patients and escorts. The daily rate for registered accommodations will be increased to $125 (up from $75); the monthly cap on registered accommodations will be increased to $1,500 (up from $1,000); and, the monthly cap on meal allowances (when registered accommodations are purchased) will be increased to $700 (up from $650).
In recognition of the out-of-pocket costs incurred by individuals who travel via bus, effective July 1, 2007, registered bus services are now considered an eligible expense.

"In addition to the enhancements we are making to the Medical Transportation Assistance Program, we are also improving access to health care services so that residents can benefit from treatment closer to their home communities," said Minister Wiseman. "Investments in infrastructure, medical equipment and new communications technologies are all playing a role in providing accessible and timely services for the people of Newfoundland and Labrador."

The Medical Transportation Assistance Program was implemented in 1998 to assist residents who incur substantial costs when travelling via commercial air to access insured health services which are not available within their health region and/or within the province.

Questions on the Medical Transportation Assistance Program can be directed to the Department of Health and Community Services at 709-729-3108 or mwall@gov.nl.ca.

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Media contact:
Tansy Mundon
Director of Communications
Department of Health and Community Services
709-729-1377, 685-1741
tansymundon@gov.nl.ca

BACKGROUNDER

Medical Transportation Assistance Program

1. What is the Medical Transportation Assistance Program?
The Medical Transportation Assistance Program assists residents who incur substantial costs when travelling to access insured health services which are not available within their health region and/or within the province. The program assists with the costs associated with air travel or registered bus service, registered purchased accommodations and meal allowances.

2. Who qualifies for the program?
Residents of Newfoundland and Labrador who travel by commercial air or bus and/or who purchase registered accommodations when travelling a distance greater than 200 km (one way) to access medically necessary insured services:

Within the province when an insured service is not available in the area of residence; and

Outside the province when an insured service is not available within the province.

Escort as recommended by the referring physician.

3. What are eligible expenses?

Airfare
Cost of ticket (official ticket receipt and boarding passes required)

Taxis/Bussing Services
Taxis and/or registered bussing services utilized to access insured medical services.

Accommodations

Up to a maximum of $125 daily (official receipt required) when accommodations are provided by a registered accommodations provider.

Patients medically required to take up residence in another region of the province or another province/territory while receiving specialized medical treatment or awaiting transplantation can claim up to a maximum of $1,500 (official receipt required) for each period of 31 consecutive days

If an escort is required, the escort is expected to share the same accommodations as the medically-referred person unless the medically-referred person is hospitalized.

Registered accommodations provider would be a hostel, hotel, motel and/or a licensed apartment provider, such as an apartment building.

Meal Allowance
When accommodations are provided by a registered accommodations provider the following meal allowance provisions apply:

In-province to a maximum of $29 daily per person

Out-of-province to a maximum of $43 daily per person

Patients medically required to take up residence in another area of the province or another province/territory while receiving specialized medical treatment or awaiting transplantation can claim up to a maximum of $700 for meal allowances each period of 31 consecutive days.

If an escort is required to accompany a patient while residing in another area of the province or another province/territory, the escort' s maximum meal allowance is $700 for each period of 31 consecutive days.

4. What expenses are not eligible?

What expenses are not eligible?

Accommodations provided by family/friends

Private vehicle expenses, such as gas and car mileage

Personal care items, utilities, and long-distance telephone calls

5. How much can I be reimbursed?

For residents of the island portion of the province - A $400 deductible applies in any 12-month period from the date of the initial travel. The first $100 of eligible expenses in excess of $400 will be reimbursed and the balance of remaining eligible expenditures will be reimbursed at 50 per cent. Eligible expenses in excess of $5,000 during a 12-month period will be cost shared at 65 per cent.

For Labrador residents - The first $1,000 of eligible expenses in any 12-month period from the date of initial travel will be fully reimbursed and the balance of remaining eligible expenditures will be reimbursed at 50 per cent. Eligible expenses in excess of $5,000 during a 12-month period will be cost-shared at 65 per cent.

6. How does the program work?

Patients are required to pay medical travel costs up front and make application for reimbursement of allowable expenses. Allowable expenses will be assessed based on travel dates in relation to medical appointment/service date(s).

Applicants must provide official receipts (and boarding passes for air travel) for eligible expenses. Claims must be submitted on a monthly basis for residents who require travel in excess of 31 consecutive days. Claims for duration less than 31 days must be submitted within 12 months from the travel date.

7. Are you still eligible for the program if you have private insurance?

The Provincial Government becomes the payor of last resort. If the patient has private health insurance benefits, travel claims must be assessed by the private insurance prior to submitting to the department for assessment. Eligible expenses under the program will be reduced by the amount paid by the private insurance plan prior to assessment under this program. The balance of eligible expenses will be assessed based on the criteria/guidelines of the program. A copy of the private insurance assessment must be included with the application form.

Similarly, if medical travel costs are funded through an employer, travel claims must be assessed by the employer first and any remaining eligible costs will be assessed by the program.

8. Are there any individuals excluded?

Yes, the following individuals may be excluded based on eligibility under other programs:

Individuals in receipt of Income Support, or who demonstrate financial need, may be eligible to have medical travel costs funded through the Department of Human Resources, Labour and Employment.

Bone marrow/stem cell and organ donors are eligible for financial assistance through the Eastern Regional Integrated Health Authority.

Persons who receive medical travel assistance from federal and/or Provincial Government department(s), agency(ies) or regional health authority(ies).

2007 06 11 1:45 p.m.

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