Medical Supplies

Overview

The least expensive, appropriate medical or surgical supplies may be provided to eligible clients in order to avoid an imminent and substantial danger to health.

Medical supplies are available under the Employment and Assistance Regulation and Employment and Assistance for Persons with Disabilities Regulation.

Policy

Effective:  October 1, 2012

Medical or surgical supplies are provided only to clients who are eligible for general health supplements.  [see Related Links - Health Supplement Summary]

Medical or surgical supplies may be provided to eligible clients when the ministry is satisfied that all of the following requirements are met:

  • the supplies are prescribed by a medical practitioner or nurse practitioner
  • the supplies are the least expensive and appropriate for the purpose
  • the supplies are disposable or reusable where appropriate
    • reusable where appropriate means a reusable medical supply may be considered when its purpose and use is more suitable than a disposable supply.  Reusable medical supplies may have a lower environmental impact and be more cost effective in the long term.  For example, cloth diapers may be more appropriate in some circumstances than disposable diapers.
  • the request is pre-approved by the ministry (the ministry does not accept payment responsibility, except in cases of a life-threatening emergency, for medical supplies purchased prior to approval)
  • only the following can be considered:  
    • wound care
    • ongoing bowel care required due to loss of muscle function
    • catheterization
    • incontinence
    • skin parasite care
    • limb circulation
    • food thickeners
    • lancets
    • needles and syringes
    • ventilator supplies
    • tracheostomy supplies
  • the supplies are necessary to avoid an imminent and substantial danger to health
    • imminent and substantial danger to health refers to an immediate need for medical supplies where, without the medical supplies, the person is at risk for compromised health.  For example, a person requires bandages for a serious burn.  The bandages are required immediately, and without them the person is at risk for infections and poor healing. 
  • no resources are available to the family unit to cover the cost of the supplies (for details see below)

Clients are responsible for providing required documentation. The ministry is not responsible for any fees associated with documentation.

Medical supplies may be approved for the period of time indicated on the prescription, up to a maximum of 2 years.  For ongoing medical supply requests, the ministry’s Health Assistance Branch will assign a review date at the time of approval.  Three months prior to this review date, clients will receive a letter requesting confirmation to renew their request for ongoing medical supplies.  Additional medical documentation will only be requested where necessary (for example, a new medical supply item is required or there is a significant change in quantities). 

[For information on medical supplies required for clients in receipt of the tube feed supplement (for example tubes or bags) see Related Links – Tube Feed Supplement.]

Effective:  April 1, 2010

By regulation, the ministry is the payer of last resort and requires that all other available resources must first be considered before requesting funding.  For income assistance and disability assistance clients, other resources include (but are not limited to) accessing medical supplies or funding through:

  • other government programs (e.g., Fair PharmaCare, Health Authorities, ICBC, WorkSafeBC, Veterans Affairs Canada)
  • private insurance
  • publicly subsidized residential care facilities (when it is the client’s place of residence).  Clients living in facilities funded by the Ministry of Health (MoH) are not eligible for medical supplies from the ministry.  These needs must be met through the facility.  Facility staff should be contacted to determine the funding source.

If there are other resources available, the individual is not eligible for medical supplies from the ministry. 

Co-funding may be considered when other resources cannot pay the entire cost.  For example, if an insurance company will pay $500 for an item that costs $1,000, the ministry may consider funding the remaining $500 if all other eligibility criteria are met.

Note: When assessing medical supplies eligibility for income or disability assistance clients, exempt assets are not considered.  When assessing other resources for persons with a life-threatening health need or persons who are medical services only, see Related Links – Life Threatening Health Need and Medical Services Only.

Effective:  October 1, 2012

The following medical or surgical supplies may be considered when all eligibility criteria are met. This is a general guide and is NOT all-inclusive.

Note: Rubber gloves may be provided to either the client or a non-employed care provider when required as part of the care of the client.

  • Wound care
    • Bandages and dressings may be considered for wound care including, but not limited to, skin ulcer products, gel pads, protectors, burn treatment garments.  Wound care supplies do not include band aids for minor wounds.
  • Ongoing bowel care required due to loss of muscle function
    • Bowel stimulants may be considered for persons with impaired bowel function.  For example, a person who is quadriplegic may have lost use of bowel muscles requiring laxatives.  Items include, but are not limited to, dulcolax, lactulose, senokot, fleet enemas, and skin care products.  Bowel stimulants are not intended for persons requiring laxatives due to an insufficient diet.
  • Catheterization
    • Medical supplies required for draining the bladder may be considered.  Items include, but are not limited to, catheters, urinary drainage bags, skin care products, and powder.
  • Incontinence
    • Medical supplies required for involuntary excretion of urine and the inability to control bowels may be considered.  Items include, but are not limited to, diapers, pads, leg bags, and skin care products.
  • Skin parasite care
    • Medicated shampoo may be considered for parasitic skin infections, such as scabies and lice.
  • Limb circulation
    • Compression stockings may be considered to support limb circulation.
  • Food thickeners
    • Food thickeners may be considered to thicken food texture to assist with swallowing difficulties.
  • Lancets
    • Lancets may be considered for obtaining blood samples for persons with diabetes. Fair Pharmacare provides other diabetic supplies, including needles, syringes, test strips, and insulin.
  • Needles and syringes
    • Needles and syringes may be considered for delivering medication and feeding. Needles and syringes for persons with diabetes are provided by Fair Pharmacare, and are therefore, not provided by the Ministry of Social Development and Poverty Reduction.
  • Ventilator supplies
    • Items such as vinegar, hydrogen peroxide, and distilled water may be considered for the essential operation or sterilization of a ventilator.
  • Tracheostomy supplies
    • Items such as tubes and bandages may be considered for persons with a tracheostomy.

Effective:  April 1, 2010

The ministry does not provide medical or surgical supplies that do not meet the eligibility criteria above, including the following:

  • nutritional supplements
  • food
  • vitamins or minerals
  • prescription medications

[For more information, see Related Links - Monthly Nutritional Supplement, Nutritional Supplements, or Diet Supplements.]

Procedures

Effective:  October 1, 2012

Medical Supplies Under $500 or Required for Less Than 90 Days

To assess eligibility for medical supplies costing under $500 or required for less than 90 days, run the Assisted Eligibility tool which will include these steps:

EAW

1.

Confirm that the applicant is eligible for general health supplements or assess for eligibility under life-threatening health needs. [See Related Links – Life-Threatening Health Needs.]

2.  Verify that there are no other resources available. [see Policy]

EAW

3.

Ensure that the client has provided a written prescription, a diagnosis from a medical practitioner or nurse practitioner and a price quote for the medical supplies.  The Information Required - Medical letter (HR3237) may be used to request documentation from clients.  [see Forms and Letters] 

EAW

4.

Ensure the requested item meets all eligibility criteria.

EAW

5.

Provide payment using the Purchase Authorization on the Health Case.

EAW

6.

Note details.  Details include substantive reasons explaining what is requested and why the eligibility criteria are met (or not met).  If the medical supplies are approved, include the cost of the medical supplies and the name of the service provider.

Emergency Medical Supplies Between $500 and $1,000

To assess eligibility for emergency medical supplies costing between $500 and $1,000, run the Assisted Eligibility tool which will include these steps:

EAW

1.

Discuss the request with the Supervisor

Supervisor

2.

Consult with Health Assistance Branch (HAB) to review the options prior to giving approval.

Medical Supplies Over $500 or Required for More Than 90 Days

To assess eligibility for medical supplies costing over $500 or required for more than 90 days, follow these steps:

EAW

1.

Confirm that the applicant is eligible for general health supplements or assess for eligibility under life-threatening health needs. [See Related Links – Life-Threatening Health Needs.]

2.  Verify that there are no other resources available. [see Policy]

EAW

3.

Ensure that the client has provided a written prescription and diagnosis from a medical practitioner or nurse practitioner, including the quantities required and expected duration of the need.  The Information Required - Medical letter (HR3237) may be used to request documentation from clients.  [see Forms and Letters]

EAW

4.

If the supplies are required for more than 90 days, immediately forward the Service Request and documentation to HAB for an eligibility decision.  No price quotes are required.

EAW

 

 

HAB

5.

 

6.

While eligibility is being determined, the EAW can issue one month’s supply on a Purchase Authorization on the Health Case, if eligibility criteria appear to be met.

Ensure the requested item meets all eligibility criteria.  If approving the request, notify the service provider to set up a standing order and assign a review date.

 

HAB

7.

Note details.  Details include substantive reasons explaining what is requested and why the eligibility criteria are met (or not met).  If the medical supplies are approved, include the cost of the medical supplies and the name of the service provider. 

Medical Supplies Transition for 17-Year-Old At Home Medical Benefits Program Recipients Applying for the PWD Designation

Special procedures have been developed for 17-year-old recipients of At Home Medical Benefits Program recipients.  [For details, see Related Links – Designation Application.]

Effective:  December 1, 2006

To renew an existing approval for ongoing medical supplies, follow these steps:

Health Assistance Branch (HAB)

1.

Three months prior to approval review date, send a medical supply review letter to the client requesting confirmation of need to renew existing medical supply approval.

EAO

2.

If the client brings in a signed renewal letter, review documentation for completeness and forward to Health Assistance Branch. 

HAB

3.

If the client returns signed letter confirming there is minimal or no change to the approval, notify the contracted service provider to set up a standing order and reset review date.

 

4.

If the client is requesting a new item or there is a significant quantity change for an existing approved item and an updated prescription has not been provided, request supporting documentation from client.

Authorities and Responsibilities

Effective:  October 1, 2012

Medical Supplies

Employment and Assistance Worker

  • Assessing eligibility for medical supplies under $500 or required for less than 90 days

Supervisor

  • Assessing eligibility for emergency medical supplies between $500 and $1,000 (after consultation with Health Assistance Branch)

Note: In the unlikely event that medical supply costs exceed $1,000, Health Assistance Branch will expedite.

Health Assistance Branch

  • Assessing eligibility for medical supplies over $500 or required for more than 90 days