Medical Supplies

Effective:  August 28, 2018

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 as long as eligibility criteria are met. Unless changes are needed to their list of supplies or there is a change to their eligibility, the supplies renew each year on their birthday and the recipient can continue to place their order through the Product Distribution Centre (service provider for most medical supplies).

If the client is requesting a new item or there is a significant quantity change for an existing approved item, an updated prescription which includes medical justification for an increase or new item will need to be provided.

[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 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.]

Effective:  August 28, 2018

All requests for Medical Supplies are assessed by Health Assistance (HA).

The following procedures are to be used to determine eligibility for Medical Supplies.

 

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].
	3.	Ensure that the client has provided a written prescription and diagnosis, with detailed medical justification, 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].
	4.	Ensure the service request has all required documentation and is ready for adjudication, and forward to HA. No price quotes are required.
HA	1.	Assess application to ensure eligibility criteria are met.
	2.	If application is approved, an approval letter will be issued to the client and Product Distribution Centre (PDC) or Service Provider. If denied, a denial letter and decision summary outlining reasons for the decision will be sent to the client. Note: It is the client’s responsibility to contact PDC or other Service Provider to place their order.
	3.	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 Persons with Disabilities Designation

When applying for the Persons with Disabilities (PWD) designation and disability assistance, youth who are aging out of the Ministry of Children and Family Development’s (MCFD) At Home Medical Benefits Program may also authorize MCFD to disclose information to Health Assistance (HA) allowing HA to assess their eligibility for ongoing medical supplies.

Consent to disclosure of information is provided when the Persons with Disabilities Designation Application – Prescribed Class (HR3642) form is completed as part of the application process for the PWD designation and disability assistance [see Forms and Letters].

Upon receipt of the HR3642 form, HA will contact MCFD to obtain a complete list of medical supplies that have been provided to the applicant as part of their coverage under the At Home Medical Benefits Program.

HA reviews this list of supplies and will provide the recipient with a letter outlining the supplies that will now be covered through the Ministry of Social Development and Poverty Reduction (SDPR). As SDPR may not cover all items previously provided by MCFD, the recipient will be advised which items cannot be approved. The recipient would then have the right to reconsideration of any items denied by SDPR.

As long as all needed documentation is received prior to the applicant aging out from the At Home Medical Benefits Program, SDPR makes every attempt to provide the applicant with a copy of their PWD Designation approval and their Medical Supplies approval letter prior to their benefits stopping with MCFD.

Product Distribution Centre would continue to be the provider of these medical supplies.

[For more information on the application process for PWD designation, see Related Links – Designation Application.]

Effective:  August 28, 2018

Medical Supplies
Health Assistance	Assessing eligibility for all medical supplies.