If Treatment and Medication Costs Incurred Outside of Canada (top)Section
4.06
of Schedule
A (Transfused Plan) and section
4.06 of Schedule
B (Hemophiliac Plan) provide that the Administrator
will pay compensation equal to the amount payable if the costs
had been incurred in the Province or Territory where the HCV
Infected Person resides. Subsequent Claims for Compensation by the Same Claimant (top)After completing your initial claim for uninsured treatments and medications, you are entitled to claim again. Subsequent claims will be processed only after the Approved HCV Infected Person has incurred costs amounting to $250.00 or more. The Administrator will require a valid receipt for every expense claim.
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The Court Approved Protocol "Uninsured
Medical Expenses and Out-of-Pocket Expenses"
provides that the Administrator must compile lists of generally
accepted medications and treatments, which are recommended/prescribed
for persons who have Hepatitis C. These lists, which are prepared
by the Administrator in consultation with HCV medical specialists,
shall be updated from time to time.
Please consult the HCV
Medication List if you would like to know
which medications, to date, have been approved by the Administrator.
Alternative treatments or medicines costs may be eligible
but only if they were incurred on the recommendation of one
of the medical specialists listed below:
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Please consult the HCV
Alternative Medicines and Treatments List if you
would like to know which alternative treatments and medications
have been approved, to date, by the Administrator.
A number of treatments and medications associated with Disease
Level 6 may be eligible for reimbursement but only if they
were incurred on the recommendation of one of the medical
specialists listed below:
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The Court Approved Protocol "Uninsured Medical Expenses and Out-of-Pocket Expenses" provides that the Administrator must compile lists of generally accepted medications and treatments, which are recommended/prescribed for persons who have Hepatitis C. A list of treatments and medications for the seven (7) medical conditions associated with disease level 6, which is prepared by the Administrator in consultation with HCV medical specialists, shall be updated from time to time.
Please consult the HCV
Medication List for Conditions Associated with Disease Level
6 if you would like to know which medications
have been approved, to date, by the Administrator.
If your claim meets the approval criteria outlined in this
section and the treatments or medications that you have paid
for are due to your HCV infection, please complete the following
claim forms and return them to the Administrator.
Complete, sign and date the GEN
3 Form. Be sure to attach all original receipts
and indicate your claim ID number on all receipts.
The Administrator may determine that your claim for uninsured treatments and/or medications must be rejected. If you disagree with the Administrator's determination, you must submit a letter to the Centre explaining your objections to the Administrator's decision. The Administrator will then mail a letter about this determination to you and further advise that you have the opportunity to appeal its decision by completing and returning a Request for Review Form. This will entitle you to submit your argument and evidence to an independent arbitrator or referee for final determination.
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