Reimbursement of Medical Expenses & Financial Aid

 

Maze - shutterstock_141012583Helpful information you will find below:

  • The RAMQ reimbursement  program for compression garments
  • The Canadian Cancer Society (CCS) financial aid program to LOW INCOME patients with cancer living with lymphedema in Québec
  • Private health insurance reimbursement
  • Strategies that can help

Compression Garments Reimbursement Program by the RAMQ to people living with primary or secondary lymphedema

On January 1, 2014, the new program regarding bandages and compression garments used to treat lymphedema has been made available in Québec.  To qualify for this program:

  • You are person affected by primary or secondary lymphedema.
  • You are covered by the Québec Health Insurance Plan (la Régie de l’Assurance maladie du Québec (RAMQ).
  • To qualify, you must obtain a prescription from a physician registered with the Collège des médecins du Québec.

The RAMQ will reimburse 75% of the total purchase cost, up to a maximum of an allowable amount for:

  • One compression garment per affected limb per 12 month period
  • Children under 18 are entitled to the above every 6 months
  • One set of multi-layer bandages
  • One accessory for compression garments.

For more details about this program please click here, or contact the RAMQ at www.ramq.gouv.qc.ca.

You may also obtain information by calling the RAMQ

In Québec: 418-646-4636

In Montréal: 514-864-3411

Elsewhere in Québec: 1-800-561-9749 

PLEASE NOTE: The provincial health insurance plan of the Régie de l’assurance maladie du Québec does not presently cover the cost of lymphedema treatment.

The options for full or partial reimbursement of such expenses and for the cost of additional compression garments and bandages may include

  • Private health insurance plans
  • The federal and provincial income tax credit for medical expenses.

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The Canadian Cancer Society (CCS) offers a financial aid program to LOW INCOME patients with cancer living with lymphedema in Québec:

  • Lymphedema treatment (up to $300)
  • No garment reimbursement is included in this program

To apply you must have a Financial Assistance Request form filled out by a health care professional and send it by post, fax, or e-mail to the to the attention of the person in charge of financial assistance at the Canadian Cancer Society’s divisional office at:

Financial Assistance
Canadian Cancer Society
5151 Boul.de l’Assomption
Montréal, Québec H1T 4A9
Phone number: 514 255-5151 extension 6004
Fax number: 514 255-2808
Email: aidefinanciere@quebec.cancer.ca

For more details about the program and eligibility criteria, visit the Canadian Cancer Society website at: www.cancer.ca/ccs or contact them by phone at 514-255-5151extension 6004

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*Private health insurance reimbursement

Objective: To find strategies and methods to maximize insurance and government reimbursement for Lymphedema related treatments and medical supplies
1. Treatment reimbursement
  • Combine different specialists covered under your policy, i.e. massotherapist, physiotherapist, naturopath, occupational therapist
  • Begin treatment at end of year
2. Garment (Orthèse) Reimbursement
  • Check insurance policy for wording
  • Obtain prescription to avoid taxes
  • Have compressive garment referred to as Orthèses / Orthotics
  • Most insurances cover 2-4 garments / Year (with prescription may obtain more than minimum)
3. Alternative Garment/Orthèse (Reid sleeve, Circ-aid, Solaris Med-assist Jovi-Pak etc.)
  • Prescription from M.D.
  • Add supporting documentation from company including photos
  • Add information regarding necessity for compression
4. Bandages / Orthotic Support
  • Prescription from M.D.
  • Letters from MD and your therapist
  • Add information necessity for compression
  • Photos

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Strategies that can help

1. Every private insurance policy is different depending on individual agreements
2. Don’t give up if refused
  • Contact an agent
  • Supply as much documentation as possible
  • Send all relevant prescriptions
  • Read carefully to see what is covered
  • Use sample letters such as NLN insurance refusal letter
  • Speak with your employer
  • Send photos
3. Other reimbursement or financial aid possibilities
  • Welfare
  • Breast Cancer Society see sheet for eligibility
  • Employer
  • Family members
  • Hospitals private funds
  • Insurance company ombudsman
  • Insurance regulators

Good Luck!