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How many people who have ostomies have coverage from their provincial Medicare? In BC, you have to be low income to quality under the “Pharmacare” program. I spend about $900 a year for pouches. I’m retired and don’t have a medical plan. I understand in Ontario, there is partial coverage with no income test. I’ve written to my MLA and the BC Health Minister, but the answer is there is no plan to provide coverage other than through the income-tested Pharmcare.
David Kirkham
Victoria
Hi David,
You’ve seen some of the responses via email, but I am posting here so others can benefit from the response you received.
”Here in Ontario, people with an ostomy can apply for “Application for Funding Ostomy Grant” from the Ontario Government. If you are approved, you are eligible for a yearly grant of $975 annually that is paid by cheque from the Ontario Government for $487.50 every 6 months through the Assistive Devices Program.
There are certain conditions I am sure as on the form, it asks if you are on Ontario Works Program, Ontario Disability Program or Assistance to Children with Severe Disabilities. It also asks if you are eligible to receive coverage from other sources, Workplace Safety & Insurance Board, Veterans Affairs, if you are a resident of a Long Term Care Home or if you are a patient of an acute or chronic care hospital.
I am fortunate that I have a health plan that will cover 80% of costs for most ostomy related items above the government grant. I must submit the original invoices/sales slips as well as the stub from the cheque and I do this every 6 months.
I currently spend over $1000 on flanges and bags and then you need all of the associated items like adhesive remover, silver powder, other wipes, barrier film, etc.”Hi David,
I am glad you have brought up the ostomy coverage issue. I am very interested in knowing the coverage in each province. I have listed the link to the coverage in different provinces below.
I live in Vancouver and we have been discussing Pharmacare coverage in the past few months in our support group. Actually, I have found that BC Pharmacare provides a comprehensive coverage of urostomy supplies compared to other provinces. Just to clarify that Pharmacare covers urostomy supplies. You do not need to be a recipient BC Income Assistance program. But, BC government expects you to pay from your own pocket up to about 3% of your net income ( you or you and your spouse combined) for prescriptions and urostomy appliances. This 3% is taken in account as deductible for Fair Pharmacare in BC. When you prepare tax return, you will qualify for non-refundable tax credit for your medical expenses for the portion which exceeds 3% of your net income. It is a similar concept.
If you spend less than 3% of the net income for ostomy supplies and prescription combined, you will not get the benefit from Fair PharmaCare or non-refundable tax credit for medical expenses. The other option is to apply for Disability Tax Credit (DTC). This is what our support group is focused on now. Since we do not have a support group in Victoria at this time, I suggest you to contact Victoria Ostomy Peer Support Group, President: Marney Ellis Telephone: 778-426-4576
President Email: marnreg@shaw.ca. They should be able to give you advise on DTC.the coverage in different provinces below.
https://www.ostomycanada.ca/wp-content/uploads/2019/01/Canada-Wide-Reimbursement-ProgramsR.pdf
Hope it helps.
Joe
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