As Canadians prepare to observe Remembrance Day, some military personnel, veterans and their families say they feel forgotten amid the complicated transition from the Public Service Health Care Plan (PSHCP) to Canada Life.
The Winnipeg-based insurance company took over Sun Life’s plan on July 1. The plan provides medical and drug coverage to approximately 1.7 million federal public servants and retirees, their spouses and dependents.
However, despite assurances of a smooth transition, thousands of PSHCP members have been denied coverage without notice or reason, and many have described frustrating experiences trying to regain their benefits.
In some cases, PSHCP members who have not been able to resume their coverage have been forced to pay out of pocket for necessary medications, treatments and medical supplies.
Some say they face the difficult choice between paying for their prescriptions or paying for groceries.
It’s causing a lot of emotional distress, a lot of financial distress; It is very difficult.– Lindsay Walker, wife of a CAF veteran
A significant portion of the people covered by the PSHCP who have reached out to share their experiences with CBC are members of the Canadian Armed Forces (CAF), veterans and their families.
Our Begging for Benefits series featured some of their stories.
Canada Life has since resolved some of those cases and says it is working hard to reduce the pending cases.
Earlier this week, The company launched a “process of escalating urgent needs” to help PSHCP members facing especially desperate circumstances.
Veteran’s wife denied coverage
Among those still fighting is the Walker family of Ottawa.
Paul Walker, 36, was medically discharged from the CAF in February after a 13-year career as a signals operator.
His wife Lindsay Walker, 33, was permanently disabled in a traffic collision in June 2019. As a result of the accident, she developed a functional neurological disorder and a condition known as “drop foot,” a weakness or paralysis of the muscles necessary to lift objects. the foot.
He was later diagnosed with a second rare condition called complex regional pain syndrome (CRPS) in his right leg and foot.
Your treatment plan includes intensive physical therapy, chiropractic care, massage therapy, and weekly nerve block injections. He is also on a waiting list for a device called a spinal cord stimulator that uses an electrical current to distract the brain from pain signals caused by his condition.
“I’m hopeful about it,” Walker told CBC earlier this week. “It has been a long journey living with CRPS and it is a very debilitating condition, just with very high levels of intense and constant pain.”
Currently, Walker’s medications cost between $800 and $1,000 a month. Until recently, everything was covered by her husband’s health insurance plan.
However, when she went to fill her prescriptions on October 23, her pharmacist had bad news for her.
“It just came in as ‘coverage done,’ with no answers,” Walker said.
Without explanation
Despite spending hours on hold and speaking with several Canada Life agents over the next few days, neither Walker nor her husband were able to discover why their benefits had been suddenly cut.
“Everything was correct, but they couldn’t give us an explanation as to why it had been cancelled, simply that nothing was happening,” he said.
There were promises to escalate the case and find a solution, but that never materialized. An officer gave the couple a contact number that turned out to be a Veterans Affairs Canada (VAC) helpline, but the department was also unable to help resolve their situation.
Thanks to a sympathetic pharmacist, Walker has enough medication to keep her symptoms at bay until next week, but then she fears the bounty will run out and pain will take over.
“We are in a situation where we cannot pay between $800 and $1,000 out of pocket each month for these medications and at the same time be able to pay our other monthly expenses, such as the mortgage and utilities,” he said.
“It’s causing a lot of emotional and financial distress; it’s very difficult.”
Some emergency help available
The Walkers, who have an eight-year-old daughter with autism, are now looking for emergency grants or loans to help their situation.
VAC veterans emergency fund provides financial support to veterans and their families who “are facing an unforeseen financial emergency that threatens their health and well-being,” the department said in an email to CBC.
Among the essential items covered by the fund are medical expenses. As of Thursday, VAC had received two requests for emergency financial assistance related to the PSHCP change. Both were approved.
According to VAC, the department “continues to monitor Veterans Emergency Fund approvals related to the transition to Canada Life from July 2023.”
Neither the Department of National Defense (DND) nor the CAF currently provide similar emergency assistance.
In an email, DND said public servants and CAF members have the right to file coverage appeals and claims through the established process identified by the Public Service Health Care Plan.
A spokesperson for the Royal Canadian Legion said that while it has heard from some members who have been denied benefits under the PSHCP, the poppy background remains your primary source of emergency assistance for veterans.
According to the Treasury Board Secretariat, some 44,000 active CAF members, including reservists, and another 91,000 retired members are currently covered by the PSHCP. Their dependents who are also eligible for plan benefits number nearly 150,000.
Together, military members, veterans and their families represent approximately 17 per cent of all Canadians covered by the PSHCP.
