Eligibility
Veterans’ Affairs Canada provides health benefits for two groups.
Group A clients
These individuals can use their card to receive approved benefits directly related to a condition which has VAC disability entitlement. With an entitled condition and a VAC disability entitlement, individuals can qualify as a veteran or civilian, including retired CF or RCMP members or regular serving civilian member of the RCMP.
Group B clients
These clients can use their card to access approved benefits based on a demonstrated health need which is not covered through provincial or private health coverage. The following are eligible Group B members:
- income-qualified Veterans and civilians (ie: those who receive the War Veterans Allowance, or would be if they were not receiving Old Age Security benefits)
- prisoners of war receiving services from the Veterans Independence Program
- Veterans, civilians and Special Duty Services Veterans receiving services from the Veterans Independence Program
- Canada Service Veterans receiving services from the Veterans Independence Program
- Veteran pensioners or Overseas Service Veterans receiving care in a Departmental or contract care facility
Coverage
Group A clients are only able to access benefits directly related to the condition(s) for which they have VAC disability benefits. All benefits for this group require pre-authorization.
Group B clients are eligible for benefits for which there is a clearly demonstrated health need and no coverage from a provincial or private health plan. If provincial or private plans only cover part of the cost of a particular benefit, VAC may cover the remaining cost.
It is necessary to obtain pre-authorization from to be sure that the service, drug or treatment you need will be reimbursed. There are frequency and dollar limits to benefits, although they vary widely.
Still-serving members of the CF or RCMP receing VAC disability benefits must seek treatment and coverage from CF or RCMP organizations first.
Costs
Registered providers do not charge clients; instead, they invoice VAC for authorised benefits. For reimbursement or pre-authorization of benefits, receipts or requests should be sent to the VAC Treatment Authorization Centre nearest you.
For reimbursement of dental services and prescription drugs, original receipts should be sent to the VAC Treatment Authorization Centre in Charlottetown. For reimbursement of audio services, medical supplies or prosthetics and orthotics, original receipts should go to the VAC Treatment Authorization Centre in Moncton.
Supplementary Benefits
Clients can apply to receive benefits for travel costs associated with VAC health treatments. These costs can include escorts, meals, accomodations, and costs for medical services requested by VAC.
Review Process
If a VAC benefit is denied, and the client feels they qualify, a review of the decision can be made. Requests for review must be made in writing within 60days of receipt of the decision.
Benefits
VAC provides benefits under the following 14 programs:
- aids for daily living (e.g. canes, bathroom aids)
- ambulance or medical travel services
- audio (hearing) services (e.g. hearing aids)
- dental services (e.g. cleanings, fillings)
- hospital in- and out-patient services
- medical services
- medical supplies (e.g. bandages)
- nursing services (e.g. application of dressings)
- oxygen therapy
- prescription drugs (standard and special authorization benefits)
- prosthetics and orthotics
- related health services (e.g. physiotherapy, speech therapy, etc.)
- special equipment (e.g. wheelchairs, lifts)
- vision care
Some additional benefits may be available to those in the Veterans Independence Program.
Some excluded benefits
In-patient hospital care involving the following is NOT covered:
- acute care
- private rooms
- semi-private rooms
Nursing care
- continuous nursing (e.g. more than 2 hours per day)
- private nursing in a long-term care facility
Related health services
- homeopathic services
- naturopathic medicines and therapies
Ostomy Supplies
VAC will cover ostomy supplies with pre-authorization and a prescription from a medical doctor, enterostomal therapist or registered nurse. Note that some other medical supplies may not be covered equally across provinces or territories.
Contact Information
General Inquiries
Toll Free (English): 1 866 522 2122
Toll Free (French): 1 866 522 2022
For pre-authorization of treatment or request for reimbursement, mail to one of the following:
Veterans Affairs Canada
Treatment Authorization Centre
10 Barters Hill, 2nd Floor
PO Box 5068
St. John
