Coverage for services, prescriptions and devices

We all need healthcare services. Treatment benefits provide coverage for a variety of health products and services that help you live better, manage your health, and save you money. Find out how to manage the healthcare benefits you've earned.

About this program

We provide financial support to qualified Veterans for the healthcare services or benefits available through the 14 Programs of Choice.

We may also reimburse expenses incurred if you have to travel to receive treatment benefits and services.


Do you qualify?

You may qualify to receive financial support for treatment benefits, if you:


How to apply

You do not need to apply for treatment benefits or a VAC healthcare card. A VAC healthcare card will be sent directly to you when you qualify for one of the benefits listed above.

Get help

If you have questions about your healthcare card or about Treatment Benefits in general, contact Medavie Blue Cross. The staff at any VAC office can also assist you or call us at 1-866-522-2122.


Additional information

Information for still-serving regular members of the Canadian Armed Forces (excluding Reservists) and the RCMP (excluding civilian members) who have a VAC disability benefit.

Any treatment benefits you require for your disability will be provided through your home organization until you have released from service.

  • Releasing Canadian Armed Forces members – please ensure your discharge date/documentation has been provided to your Canadian Forces Health Services Centre (CF H Svcs C) so they may update their system. Incorrect release date information may impact your eligibility to access VAC’s treatment benefits.
  • Releasing RCMP members – please notify your local VAC Area office of your discharge date. If you are unsure which office is nearest to you, please contact us.

About your VAC Health Identification Card

Your healthcare Identification Card contains the following information:

  • Your name
  • Your client number

You should quote both of these whenever you contact VAC about your benefits and services.

Who can use your card

Your healthcare Identification Card can only be used to obtain benefits and services for you. It cannot be used to obtain benefits for anyone else, including your spouse or other family members.

If you qualify for one, or more, of VAC’s 14 treatment programs, you will receive a VAC healthcare Identification Card. You can find information about your coverage on the portal at www.medavie.bluecross.ca/MyInfo.


Using your card to get services

To obtain benefits or services, usually, all you will need to do is to present your VAC health card to a healthcare services provider. To ensure VAC coverage, the provider may also need a prescription from your doctor or medical professional and, if required, your pre-authorization from VAC.

Using a registered provider

If your provider is registered with VAC, they will bill us directly. For most benefits, your provider will need your signature to confirm that you received their services.

It is important that you only sign after you have received the service.

Using any other provider

You will need to pay this type of provider directly for their benefits or services. To receive reimbursement, you must submit your proof of payment (original receipt or paid invoice).

Frequencies and dollar limits

There are frequency and dollar limits for most of our treatment benefits. In some circumstances, your request for coverage may be declined or reduced in amount if the requested amount exceeds our frequency or dollar limits. For more information on specific limits for each program of choice, please see our benefit grids.

Is our coverage sufficient for your needs?

If you have exceptional health needs that require additional benefits or services please contact us.

Travel outside your province

Your VAC Health Identification card can be used in all provinces and territories. However, before you travel outside your home province, you should call us for advice on how to obtain your services outside your home province. If a provider in another province will not accept your card as payment, you may have to pay for the benefit and then request reimbursement.

Travel outside of Canada

If you are planning to travel outside of Canada, please call us to ensure you will qualify to receive treatment benefits and services outside of Canada.


Programs of choice overview

For a complete listing of what POC benefits and services may be covered and their respective requirements such as pre-authorizations, prescriptions, frequency and/or dollar limits, please visit the benefit grid.

POC 1 - Aids for daily living

POC 1 - Aids for daily living

Provides coverage for devices and accessories designed to assist in the activities with everyday tasks.

Necessary repairs and maintenance are also covered.

Examples of benefits that are covered include:

  • Walking aids, such as canes, walkers, ice grippers/rubber tips
  • Self-help aids for dressing and/or feeding
  • Bathroom aids, such as grab bars, raised toilet seats, bath boards, bathtub rails

For more information about the types of aids that are available and how they can help you live independently and with confidence, see Help yourself to assistive devices!

POC 2 - Ambulance/Medical Travel Services

POC 2 - Ambulance/Medical Travel Services

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

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

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

The program also includes coverage for costs related to travel when you receive treatment benefits. For more information please refer to the Health related travel guide.

POC 3 - Audio (hearing) services

POC 3 - Audio (hearing) services

Provides coverage for equipment and accessories related to hearing impairment.

Examples of benefits that are covered include:

  • Hearing aids
  • Telephone amplifiers, infrared devices
  • Hearing accessories
  • Dispensing and fitting fees for hearing aids

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

  • The standard hearing benefit(s) already tried;
  • The difficulty or lack of satisfaction experienced with the standard hearing benefit(s);
  • The proposed replacement hearing aid; and,
  • The rationale for the selection of the replacement hearing aid.
POC 4 - Dental services

POC 4 - Dental services

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

VAC dental program covers up to 100% of the rates in the Provincial Dental / Denturist Association fee guide.

Examples of services that are covered:

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

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

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

Examples of services that are not covered:

  • Gum surgery
  • Implants
  • Equilibrated/custom/semi-precision dentures
POC 5 - Hospital services

POC 5 - Hospital services

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

Examples of services that are covered:

  • In-patient and out-patient services in an accredited provincial hospital or health facility
  • Blood collection services
POC 6 - Medical services

POC 6 - Medical services

Provides coverage for services provided by a licensed physician for a condition for which a client holds disability entitlement.

It also covers the cost of medical examinations, treatment or reports specifically requested by VAC. For most VAC clients, physician services are the responsibility of the provincial healthcare insurance programs.

POC 7 - Medical supplies

POC 7 - Medical supplies

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

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

Examples of benefits that are covered:

  • Bandages / dressings
  • Bladder / bowel supplies
  • Diabetic supplies
POC 8 - Nursing services

POC 8 - Nursing services

Nursing services have three distinct components: assessments, foot care and visits.

Examples of services that are covered:

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

Examples of services that are not covered:

  • Acute care / specialized interventions
  • Private nursing provided in a long-term care facility (nursing home) or a clinic / hospital facility
  • Personal care
POC 9 - Oxygen therapy

POC 9 - Oxygen therapy

Provides coverage for oxygen (O2) and accessories as well as respiratory equipment and supplies.

Examples of benefits that are covered:

  • Oxygen concentrators
  • Oxygen compressors
  • Oxygen gas
  • CPAP and BiPAP machines
POC 10 - Prescription drugs

POC 10 - Prescription drugs

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

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

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

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

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

POC 11 - Prostheses and orthoses

POC 11 - Prostheses and orthoses

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

Examples of benefits covered:

  • Arch supports
  • Artificial limbs
  • Leg/arm braces
  • Modifications to ordinary footwear
POC 12 - Related health services

POC 12 - Related health services

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

Examples of services covered include:

  • Occupational therapy
  • Physiotherapy
  • Massage therapy
  • Chiropractic
  • Acupuncture
  • Speech language pathology
  • Psychological counselling
POC 13 - Special equipment

POC 13 - Special equipment

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

Examples of special equipment benefits covered:

  • Wheelchairs
  • Walkers
  • Power mobility devices
  • Transfer / lift devices
  • Hospital equipment
  • Ergonomic equipment
POC 14 - Vision (eye) care

POC 14 - Vision (eye) care

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

Examples of benefits covered:

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

Benefit grids

The benefit grids are comprehensive lists of the variety of services available, dollar and frequency limits and approval requirements for each program of choice.

Most VAC benefits and services have limits on the number of times a benefit can be covered in a specified period of time or how much VAC can pay toward a benefit or service. For many treatment benefits you may also need a medical prescription and pre-authorization from VAC.

For a complete listing of what POC benefits and services may be covered and their respective requirements such as pre-authorizations, prescriptions, frequency and/or dollar limits, please visit the benefit grid.


How to appeal a healthcare decision

If you are not satisfied with a healthcare decision made by Veterans Affairs Canada, you have the right to request a review of our decision.

There are two levels of review.

First level review

  • The decision letter (or your explanation of benefits document) each provides an address for you to submit a request for a first level review.
  • Your request must be made in writing within 60 days from the date the decision is made, unless circumstances beyond your control require an extension.

Second level review

  • The decision letter will indicate the address to submit a request for a second level review.
  • If you are not satisfied with the outcome of your first level review, you may submit a request for a second level review within 60 days of the receipt of the first level review decision, unless circumstances beyond your control require an extension.

Note: The second level review is your final level of review.


Common terms

Pre-authorization

Some benefits and services require prior approval from VAC before it is provided. If pre-authorization is required, it is indicated in the "Pre-authorization" column on the benefit grid. Your provider can call us for pre-authorization on your behalf. Most services will only require pre-authorization once. Please note: we may not be able to reimburse the cost for services you purchased without pre-authorization.

Prescriptions

You will need a prescription from a qualified healthcare professional for most benefits and services covered by VAC. This is to ensure that you are under the care of a healthcare professional and that the health benefit or service is the appropriate therapy for your health need. A prescription is valid for one year from the date it is written and must be provided by the type of healthcare professional identified in the benefit grid in the "prescriber required" column.

Registered providers

A variety of providers who deliver benefits and services such as housekeeping, grounds maintenance, massage therapy, pharmaceuticals, and medical equipment have pre-registered with Veterans Affairs Canada, through our contractor Medavie Blue Cross. When using a registered provider, you will not be required to pay them directly for their services. If you’re unsure if the provider is registered, call us.


Related programs

Disability benefits: compensation to recognize that your injury or illness is a result of your military service.

Veterans Independence Program: Payments for home and healthcare services that you need to remain independent at home.

Long-term care: Monthly payments to cover the cost of your long-term care.

War Veterans allowance: Monthly payments if you have a low household income.


Frequently asked questions

How can I get additional healthcare services or benefits added to my card?

If there is a specific healthcare benefit or service that you may require, please contact us. VAC will review your eligibility for this benefit and provide you with a decision.


Does my provider need to call VAC for pre-authorization each year, even if I am requesting the same benefit or service?

For most benefits and services, VAC only requires pre-authorization the first time you obtain a benefit or service. However, a few benefits still require pre-authorization each time you request the benefit. VAC registered providers can review our benefit grid to determine our requirements for providing a particular service.


Can I choose any supplier or provider of treatment benefits and services?

You may obtain treatment benefits and services from a supplier or provider of your choice.


Are there policies for this program?

Yes. Read more about the policies for Veterans.

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