FAQ: Cost of Care
COST OF CARE
Can a family member claim for caring for the HCV Infected Person?
Yes, by completing Section D, page 3 of the GEN 4 form. You must provide dates, a description of the care and the number of hours per week care was provided. For personal care in the home, you can claim up to a maximum of 20 hours per week at $12 per hour ($240/week) indexed from 1999 dollars. No receipts are required.
My mother/father requires 24 hr nursing care. Can I claim for this?
For personal care provided by the family you can claim for 20 hrs/week. In addition, you must submit receipts for nursing care and/or respite care. You will be reimbursed up to a maximum of $50, 000 per year for Costs of Care.
If the HCV Infected Person has died, why would I have VON complete the forms?
VON has been designated as the care provider to assist with form completion, case management and nursing. The fee charged by VON to complete the forms is reimbursed through our plan by submitting the paid invoice with the completed GEN 4 form. Instructions on how to contact VON are provided on page two of the Instruction letter that accompanies the GEN 4 package.
Can I contact a service provider other than VON to complete the GEN 4 form?
VON is the only designated care provider that can submit invoices for services. If the Primarily HCV Infected Person lives in an area where VON services are not available, VON can make a referral to another agency.
Why can’t the Claims Centre complete the forms if they have the information on file?
There are several reasons why the Claims Centre cannot complete the form:
- According to the Settlement Agreement the Dr. must recommend/support the care;
- The date we have on file may differ from other supporting documentation the Doctor may have; and/or
- It may be the Doctor’s opinion that HCV level 6 diagnosis may have been present prior to the test result we have on file.
My father was at level 6 but was not diagnosed with HCV until he was hospitalized and dying. What do I indicate as the date or year of level 6 diagnosis?
The Doctor will need to answer the question based on his medical opinion and any medical documentation he may have regarding the file.
If you rent a TV in a hospital for an extended period of time is this covered under Costs of Care?
This expense is covered under Out-of-Pocket expenses. In order to be reimbursed for this expense, it must be recommended by your HCV specialist and you must complete the Gen 3 form.
On my income tax return, I have claimed for that portion that was not covered by my insurance company. How do I calculate the amount that I can claim under Costs of Care?
You do not have to calculate this amount, but you may be asked to provide income tax receipts if the amount exceeds $50,000 per calendar year.
What amount will be covered if I place my mother/father in a long-term care facility?
The cost is covered to a maximum of $50,000 per calendar year. Expenses such as television, cable, telephone, etc. are not reimbursed under Costs of Care and will be deducted.
If the Doctor is unable to complete the level 6 date ( Question 4 on the GEN 4) can the Doctor contact the Claims Centre?
Yes, the Doctor can contact the toll-free number and speak with the Cost of Care processor if he/she has any questions; however, the claimant’s file must include the signed authorization allowing us to speak to the Doctor.
Can a Doctor other than the one who completed the TRAN 2 form, complete the GEN 4 forms?
Yes, as long as the Doctor has known the Primarily-Infected Person or the family and has knowledge of the Primarily-Infected Person’s medical history.
What is the difference between a long-term nursing care facility and a retirement home?
Long Term Care Centres, also known as nursing homes and homes for the aged, are available for the HCV Infected Person on the recommendation of a physician. They are available for people who are not able to live independently in their own homes and who require 24 hour nursing service due to their HCV level 6 medical condition. Some Long Term Care Centres offer short-term respite services.
Retirement residence is a housing complex designed for older adults. People living in retirement communities are generally able to take care of themselves.
Is the cost of equipment i.e. hospital bed, walkers, bathroom aids etc., covered under Costs of Care?
This type of expense is covered under Out-of-Pocket. In order to be reimbursed for this expense, it must be recommended by your HCV specialist and you must complete the Gen 3 form.
My son took a day off work to accompany me to a Doctor’s appointment. Will I be able to claim this under Costs of Care?
No.
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