Closing the Seam - Alignment of Treatment Benefits

Q1. What is Alignment of Treatment Benefits?

A1. Alignment of Treatment Benefits is a new service that will enable CAF members to make informed decisions on their future healthcare needs after release, without delay or administrative burden. This service will help approximately 2500 CAF members who release each year.

Q2. Why do benefits need to be aligned?

Q2. CAF members releasing from service do not always know what treatment benefits will be covered once they release. Aligning treatment benefits removes the need to go through a process to obtain coverage for a treatment benefit that was covered by CAF and will be covered by VAC.

Q3. Do I qualify?

A3. To qualify for the alignment of treatment benefits service, you must:

• be a Canadian Armed Forces (CAF) member within six months of your anticipated release date, and;
• have an existing VAC Disability Benefit.

Q4. How can I request this service?

A4. You can request this service online through the Federal Health Claims Processing Service (FHCPS) client portal or by calling Medavie Blue Cross at 1-833-494-0661. Results of the review will be sent to you via letter within 30 days.

Q5. What information do I need to provide with my request?

A5. When you contact Medavie Blue Cross, you will need to provide the following required information:

• VAC file number (K number)
• Member number (M Number)
• Mailing address
• Telephone number
• Anticipated release date
• Email address
• List of health related treatments and services you are currently receiving, such as physiotherapy, mobility aids, eyewear, etc.

A list of these treatments and services may be uploaded directly to the FHCPS client portal while submitting the request.

Please Note:You are not required to submit prescription drug information as this information is on your Medavie Blue Cross file.

Q6. How will the review be conducted?

A6. Medavie Blue Cross will review the information you provide as well as your treatment benefits history, for the previous 12 months, on your Medavie Blue Cross file. This information will be examined against your current VAC disability benefit to determine what may be covered by VAC after you release.

Q7. How will this help my transition to life after service?

A7. This service will help releasing CAF members be better informed. Members will know what may be covered by VAC before they release and this will also allow time to arrange for treatment benefits that may not be covered.

Q8. I applied for Pain and Suffering Compensation, will the treatment benefits associated with my pending application be included as part of the review?

A8. No, the review will only include benefits related to your approved disability benefits. If you receive the results of your Pain and Suffering disability application before your release date, you can contact Medavie Blue Cross and request another review.

You may be eligible for Mental Health Benefits the day after you release if you applied for a mental health condition and are still waiting for your Pain and Suffering Compensation decision. Mental Health Benefits coverage includes treatment for service-related mental health conditions such as anxiety and depressive disorders, or trauma-and-stressor-related disorders. It also includes related prescription drugs and mental health services like examinations and treatment by psychologists, counsellors, social workers, or other mental health professionals.

Q9. I received my review letter from Medavie Blue Cross. Why does it say I have to contact my health care provider after my release in order to confirm my eligibility with VAC?

A9. If the review determines that your treatment benefit may be covered once you release, you will need to visit your healthcare provider. This allows your healthcare provider to confirm the services they provide are for your approved situation. This also ensures they can submit their bill directly to Medavie Blue Cross and prevents you from paying.

Q10. My review showed that several of my treatment benefits will not be covered by VAC once I release. What are my options?

A10. If you have questions about the results of your review, please contact your Transition Centre. The Transition Centre will assist you in exploring alternative options for treatment benefit coverage.

Note for NCCN analysts and field staff:

Information on treatment benefits received while in service is on a need to know basis and until a member releases and begins working with VAC, there is no need for VAC officials to have access to this information.

If the member states they have service-related conditions for which they have not yet applied, please follow the business process for a new Pain and Suffering Compensation application and/or other benefits.

Q11. My review said further analysis will be required. What does this mean?

A11. If your review results indicate that further analysis is needed, this means more information will be required after your release, to determine if your treatment benefit may be covered. In most cases, this means we need more information to connect the treatment benefit you receive to your existing VAC disability benefit. Once you release, please talk to your health care provider. They will contact Medavie Blue Cross and provide additional details to determine your eligibility.

Q12. What if I receive a new treatment benefit after the initial review was completed?

A12. If you receive a new treatment benefit, you may request another review from Medavie Blue Cross following the same process as the initial request.

Q13. What if I am not satisfied with the results of my review?

A13. If you are not satisfied with the results of your review, please contact your Transition Centre to discuss your options.

Q14. How does this new service affect VAC’s delivery of Treatment Benefits?

A14. This new service will not change the delivery of the Treatment Benefits Program.