Services Outside Community (Treatment Benefits)

This policy replaces the following VPPM 2 policy: 2.2.2 POCs and Treatment Benefits Provided Outside the Client’s Community or Outside Canada.

Purpose

This policy provides direction on the provision of treatment benefits to clients outside their normal community.

Policy

1. The Veterans Health Care Regulations authorize the provision treatment benefits to eligible clients.  For administrative purposes, these benefits are included in fourteen “Programs of Choice” (POCs).
2. Clients are expected to choose health professionals and providers close to or within their immediate community.
3. Clients who move to other communities are expected to change health professionals (e.g., family physician, dentist, prosthetist) and access professionals in their new community.
4. When a health professional prescribes or recommends a provider that is not nearest the client’s residence but within Canada (i.e. another health professional, institution or service provider in another city or province), the request may be approved by the appropriate decision maker in the District Office, based on the recommendation of a Departmental medical officer.
5. If the request is medically justified, approval may be granted; if not medically justified, the requested benefit may be paid only to the extent that it would have been paid had the client used the nearest suitable provider.
6. For information on services to clients living or travelling outside Canada, see the policy on Out of Canada Clients and Veterans of Other Countries.

References

Veterans Health Care Regulations, section 4

Out of Canada Clients and Veterans of Other Countries