Eligibility for Health Care Programs - Red Cross Pensioner

Purpose

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

Policy

General

1. Under the Veterans Health Care Regulations, a Red Cross pensioner means a Red Cross worker who is entitled to a pension pursuant to the Memorandum of Agreement between Her Majesty the Queen and The Canadian Red Cross Society made on October 17, 1952.

Treatment Benefits - Pensioned Condition

2. Red Cross pensioners are eligible to receive treatment benefits in Canada or elsewhere in respect of a pensioned condition.

Treatment Benefits - Any Health Condition (Seriously Disabled)

3. Red Cross 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. Red Cross pensioners are eligible to receive supplementary benefits, including the cost of travel and escort fees (see policy entitled Health-related Travel), 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.

Treatment Allowances

5. Red Cross pensioners are eligible to receive a treatment allowance in respect of a period of acute care for a pensioned condition provided in a hospital or on an out-patient basis (see policy entitled Treatment Allowances).

Miscellaneous Benefits

6. Red Cross 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 (see policy entitled Treatment in Respect of a Pensioned or Awarded Condition).
7. Red Cross 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).
8. When a critically-ill Red Cross 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 Red Cross 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

Treatment Allowances policy

Health-related Travel policy

Costs Associated with Requested Medical Examinations policy