Upon receipt of required information the application is reviewed by a Financial Assessor. Any changes resulting in the reassessment is entered to adjust the co-pay amounts. After completion of the reassessment, the applicants are notified in writing within 2 days of the results and further notified of their right to appeal if they are dissatisfied with the decision. There will be no emergency cards given under the Access Plan as eligibility is based on net family income as confirmed by CRA.
The Department of Health and Community Services re-evaluates financial entitlement annually and re-evaluates drug costs every 6 months. Recipient s may notify the Assurance Plan of any changes that could affect their eligibility for and degree of coverage under the program. The following table outlines the various changes which could affect coverage under the Assurance Plan and the documentation required in order to verify these changes.
Any changes resulting in the reassessment are entered to adjust the co-pay amounts. There will be no emergency cards given under the Assurance Plan as eligibility is based on net family income confirmed by CRA and documented eligible drug costs. There is no Program specific application to be completed for coverage unless the resident is a landed immigrant.
This is usually after the resident has received their first GIS payment. Otherwise, the applicant will be required to provide the following information:.
The Program is notified by Eastern Health that a resident has been diagnosed with Cystic Fibrosis or Growth Hormone Deficiency and meets the medical criteria.
The following describes the steps to take if you are not satisfied with any decision made by an employee of the Department. If you are dissatisfied with the decision the office has made, the Processing Manager can review the decision at your request.
The issue may be resolved at this level. If you do not agree with the decision of the Processing Manager, you can forward an Application for Review to the Stephenville Office to request an Internal Review within 60 days of the decision. Applications received after 60 days shall not be accepted. You should submit all relevant information with your Application for Review for consideration during the Internal Review.
The Internal Review will consist of an examination of written documentation, but may include direct contact with you via telephone. Service Standard : Upon receipt of an application and all necessary documentation for the Assurance Plan, a letter of eligibility will be posted by mail within 7 business days for 90 per cent of cases.
The Select Needs Plan provides per cent coverage for disease specific medications and supplies for residents with Cystic Fibrosis and Growth Hormone Deficiency. When the Department of Health and Community Services is notified by Eastern Health that a client has been diagnosed with Cystic Fibrosis or Growth Hormone Deficiency they are given eligibility to the benefits offered under this plan. Are my drugs covered? What can patients do to help?
Information regarding the dental coverage can be obtained by calling The program covers a variety of drugs that require a prescription, plus a small number of other over-the-counter items that do not legally require a prescription. In addition, some drugs are covered under special authorization, meaning that certain medical criteria must be met. These require written requests by the prescriber which are then assessed by the Department of Health and Community Services.
This program is only for coverage of eligible prescription drugs and a limited number of over-the-counter drugs. The new program will provide drug coverage on a co-pay basis to individuals and families with incomes that fall within certain thresholds.
Applications are now available on the Department of Health and Community Services web site and will be mailed to all households in the coming weeks. The program will provide drug coverage to an additional 97, individuals, bringing the total covered under the provincial drug program to almost 40 per cent of the population. Applications and information sheets for the new program can be printed from the Department of Health and Community Services we site at www.
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