Eligibility for Health Care Programs - Newfoundland Special Award Pensioners

Purpose

This policy provides direction on health care eligibility for those individuals who are recognized as Newfoundland Special Award pensioners under the Veterans Health Care Regulations.

Policy

General

1. Under the Veterans Health Care Regulations, a Newfoundland Special Award pensioner means a person who was not entitled to a pension in accordance with the terms of the union of Canada and Newfoundland, but was recognized by the Canadian government as entitled to the continuation of an award paid before that union in respect of a disability incurred during service in the First World War or Second World War.

Treatment Benefits – Pensioned Condition (Special Award)

2. Newfoundland Special Award pensioners are eligible to receive treatment benefits in Canada or elsewhere in respect of the disability for which they received the special award (see policy entitled Treatment in Respect of a Pensioned or Awarded Condition). These individuals are generally referred to as having A-line coverage.

Treatment Benefits – Any Health Condition (Seriously Disabled)

3. Newfoundland Special Award pensioners who are seriously disabled (sum of all their disability assessments is greater than 78%, of which at least 1% of the disability must relate to service in World War II or the Korean War), are eligible to receive treatment benefits in Canada, for any health condition, to the extent that those benefits and services are not available to them under a provincial health care system, or if applicable, from the Canadian Armed Forces as a member or former member, or if the cost of such benefits and services is not recoverable from a third party (see policies entitled Requirement to Access Provincial Programs and Costs Recoverable from Third Parties for additional information).

Supplementary Benefits

4. Newfoundland Special Award pensioners are eligible to receive supplementary benefits if they are in receipt of the following treatment benefits authorized by Veterans Affairs Canada:
   1. any medical, surgical or dental examination or treatment provided by a health professional; or
   2. the provision or maintenance of any surgical or prosthetic device or aid, or any home adaptations to accommodate the use of the device or aid.

Miscellaneous Benefits

5. Newfoundland Special Award pensioners who are hospitalized are eligible to receive treatment benefits for any health condition, until such time as it is confirmed whether the hospitalization was in respect of a pensioned condition or was necessary for a condition unrelated to the pensioned condition.
6. Newfoundland Special Award pensioners are eligible to receive reimbursement associated with a medical examination, including the cost of travel incurred, if the medical examination is requested by Veterans Affairs Canada or the Veterans Review and Appeal Board (see policies entitled Health-related Travel and Costs Associated with Requested Medical Examinations).
7. When a critically-ill Newfoundland Special Award pensioner is in receipt of acute care in a hospital and, in the attending physician’s opinion, a visit by a family member or other designated person would be beneficial to the health of the Newfoundland Special Award pensioner, that family member or other designated person is eligible to receive the transportation costs incurred, in Canada, for the visit.

References

Veterans Health Care Regulations

Treatment in Respect of a Pensioned or Awarded Condition policy

Requirement to Access Provincial Programs policy

Costs Recoverable from Third Parties policy

Health-related Travel policy

Costs Associated with Requested Medical Examinations policy