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CMAJ - July 14, 1998JAMC - le 14 juillet

What's covered? What's not?

CMAJ 1998;159:120

© 1998 Canadian Medical Association

Provincial Hospital and Medical Plans Canada, which is published by Metropolitan Insurance Companies, reports that publicly funded supplementary benefits available to Canadians vary significantly across the country. These are benefits, such as vision care, that extend beyond basic hospital and medical services.

Most of the 7 provinces that provide vision care restrict it to children or those aged 65 or older. In Ontario and BC, all residents are eligible but adults who are under 65 are restricted to 1 examination every 2 years.

Dental care provided in hospitals is covered in all provinces, while out-of-hospital coverage is usually restricted to children, seniors and welfare recipients. Similarly, drugs provided to hospital patients are covered in every province but out-of-hospital drug programs tend to apply eligibility requirements. The Atlantic provinces, Ontario and BC cover only some residents, such as seniors and AIDS patients, but all residents of Manitoba, Saskatchewan and Quebec are eligible for out-of-hospital drug programs that apply variable deductibles and levels of reimbursement.

Public Supplementary Health Benefit
  Dental Drugs
Province Vision In-
BC ** ** * ** *
Alberta * ** * **  
Saskatchewan * ** * ** **
Manitoba * **   ** **
Ontario ** **   ** *
Quebec * ** * ** **
NB   **   ** *
NS * ** * ** *
PEI   ** * ** *
Newfoundland   ** * ** *
* some residents are eligible (e.g. children, seniors, welfare recipients)
** all residents are eligible

This column was written by Lynda Buske, chief, physician resources information planning, CMA. Readers may send potential research topics to Patrick Sullivan (sullip@cma.ca; 613 731-8610 or 800 663-7336 x2126; fax 613 523-0937).

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