Print Page   |   Contact Us   |   Sign In   |   Join Us
Community Search
LATEST NEWS
Canadian Health System resources
Share |

The Canadian Healthcare System - How it Works

Health Care in Canada is delivered through Medicare, which is a national publicly funded health care system made up of 10 provincial and 3 territorial programs administered and delivered by each provincial & territorial government. Each program is required to meet the general guidelines laid out in the federal Canada Health Act.  If a patient wishes to see a specialist or is counseled to see a specialist, a referral can be made by a GP.

There are no co-pays except in British Columbia. Private insurance is available to Canadians to cover drugs, optometry and dentistry if they do not qualify for coverage under their provincial/territorial plans.

Hospitals are publicly funded although there are some specialized private hospitals and eating disorder treatment providers which Canadians may access with private insurance coverage or pay out of pocket.

Out of Province Treatment

All 10 provinces have similar policies for out of province care.

 

Eating Disorder treatment is considered elective treatment, and to obtain treatment out of province, prior approval by your provincial health care system is required.

 

For emergency care, most physicians in other Canadian provinces and territories (except Quebec) participate in reciprocal billing and will bill their own provincial health plan for services provided when you present your valid provincial health care card. The provinces recover the funding monthly.

Out of Country Treatment

“There must be documentation that the requested services are not available in Canada and the health services available in Canada have been fully utilized.”

 

Psychiatrists/ED experts in Ontario liaise with the Ministry of Health officials who oversee the out of country applications to devise/streamline a process to optimize appropriate referrals and decrease the inappropriate ones.  For example, on some occasions, an OCC referral is made by a physician who is not aware of the provincial network of specialized eating disorder services when in fact there is a bed/inpatient spot available in Ontario. The MOHLTC (Ministry of Health and Long Term Care) is working towards a future goal of having a bed registry in Ontario for eating disorders and a provincial coordinator who can be a liaison person between the community (families, physicians etc.) and eating disorder services to improve communication and flow of referrals/discharges back into the community.

 

This may be similar in other provinces/territories.

Relevant Websites by Province

Ontario:  Ontario Health Insurance (OHIP)

http://www.health.gov.on.ca/en/public/programs/ohip/outofcountry/ 

http://www.ontla.on.ca/library/repository/mon/22000/281246.pdf\

http://www.health.gov.on.ca/english/providers/program/ohip/outofcountry/us_preferred_providers/restreatment_facilities.html

British Columbia: Health Insurance BC

http://www.health.gov.bc.ca/msp/infoben/leavingbc.html#outofp 

http://www.health.gov.bc.ca/msp/infoben/ooc_funding_guidelines.pdf 

Alberta: Alberta Health (AHCIP)

http://www.health.alberta.ca/AHCIP/outside-coverage.html

http://www.health.alberta.ca/AHCIP/Out-of-Country-HS-Committee.html 

Saskatchewan: Saskatchewan Health Benefits

http://www.health.gov.sk.ca/out-of-province 

http://www.health.gov.sk.ca/HSRC-factsheet 

Manitoba: Manitoba Health

http://www.gov.mb.ca/health/mhsip/oop.html 

Quebec: Regie de l’assurance maladie (RAMQ)

http://www.ramq.gouv.qc.ca/en/citizens/health-insurance/healthcare/Pages/reimbursement.aspx 

For Quebec residents on work or student visa abroad: 

http://www.ramq.gouv.qc.ca/en/citizens/health-insurance/registration/Pages/agreements-other-countries.aspx


New Brunswick: Medicare

http://www.gnb.ca/0394/coverageOut-e.asp 

http://www.gnb.ca/0394/coverageOutCanada-e.asp#prior 

 

Nova Scotia: MSI

http://www.gov.ns.ca/health/msi/MSI%20Out%20of%20Province.pdf 


Prince Edward Island: Health PEI - Medicare

http://www.healthpei.ca/index.php3?number=1020789 

http://www.healthpei.ca/index.php3?number=1020449&lang=E 


Newfoundland: Medical Care Plan (MCP)

http://www.health.gov.nl.ca/health/mcp/outofprovincecoverage.html 

Yukon: Yukon Health Care Insurance Plan

http://www.hss.gov.yk.ca/health_care_card_coverage.php


Leave of Absence from Employment for Caregivers

1.  Compassionate Care Benefits (Unemployment Insurance):

http://www.servicecanada.gc.ca/eng/ei/types/compassionate_care.shtml#Who

“Compassionate care benefits are Employment Insurance (EI) benefits paid to people who have to be away from work temporarily to provide care or support to a family member who is gravely ill and who has a significant risk of death within 26 weeks (six months).” It provides for a maximum of 6 weeks of benefits only.

A physician treating the ill family member must sign a “Medical certificate for Employment Insurance Compassionate Care Benefits” and confirm significant risk of death within 26 weeks.

The usual rules for Unemployment Insurance apply: you need 600 insured hours of work in the last 52 weeks, a 2 week unpaid period must be served first. What’s different is that the benefits can be shared between different family members. Only the first family member to claim benefits must serve the unpaid period.

Benefits: 55% of your average insurable earnings up to a maximum payment of $485/wk. Over 8 weeks, the maximum benefit is $2,910. Not a lot of money! 

2.  Sick Benefits from an Employer:

For Canadians who are eligible for sick benefits from their employer, it would seem that a better option would be to apply for sick or stress leave benefits while caring for their loved one.

Involuntary Admission to Hospital

Each Provincial Mental Health Act aims to strike a balance between two sets of principles:

  • the rights given to all citizens under The Canadian Charter of Rights and Freedoms; and,

  • Society’s obligation to provide care and treatment to those individuals who, at times, may not appreciate their need for treatment due to their mental illness.

An adult patient may be admitted involuntarily to a psychiatric facility on a Form due to a mental illness, with a designated substitute decision maker. Each province may have a different procedure for an involuntary admission and a different time frame for holding a patient.  

The hospital emergency is used for patient stabilization only, not for eating disorder treatment.

 

Canadian Pediatric Hospitals and Emergency Room Guidelines

Canadian Pediatric Hospitals:

http://www.aboutkidshealth.ca/en/healthaz/testsandtreatments/resources/pages/childrens-hospitals-in-canada.aspx

Pediatric emergency room eating disorder guidelines & management from BC children's hospital:

http://www.childhealthbc.ca/guidelines/category/45-eating-disorders

 

Government Funded Provincial Eating Disorder Programs and Services

British Columbia:

http://www.bcmhas.ca/ProgramsServices/Eating%2BDisorders/default.htmhttp://www.keltyeatingdisorders.ca/http://www.bcmhas.ca/ProgramsServices/Eating+Disorders/Referrals.htm  (Referrals by physician only)

Alberta:

http://www.albertahealthservices.ca/services.asp?pid=service&rid=1002115

Alberta Disordered Eating service, prevention & counseling:

http://www.albertahealthservices.ca/services.asp?pid=service&rid=1024109

http://www.albertahealthservices.ca/ps-1018201-eating-disorder-referral-form.pdf (Referrals by physician includes required lab/medical tests)

https://myhealth.alberta.ca/find-health-care/services/Pages/profile.aspx?SERVICEID=5777  (Alberta Zones)

Saskatchewan:

http://www.health.gov.sk.ca/health-regions-map

Manitoba:

https://www.gov.mb.ca/health/mh/eatingdisorders/inventory.html

Ontario:

http://www.ocoped.ca/dnn/AboutUs.aspx

Quebec:

http://www.anebquebec.com/html/en/home/home.html

 

New Brunswick:

http://www.gnb.ca/0055/mental-health-e.asp

Nova Scotia:

http://www.cdha.nshealth.ca/mental-health-program/programs-services/eating-disorders-program

Prince Edward Island:

http://www.healthpei.ca/index.php3?number=1020500&lang=E

 

http://www.healthpei.ca/mentalhealth

Newfoundland & Labrador:

http://www.health.gov.nl.ca/health/mentalhealth/mhprograms.html#eating

http://www.health.gov.nl.ca/health/findhealthservices/in_your_community.html#contact

Northwest Territories:

http://www.hlthss.gov.nt.ca/pdf/brochures_and_fact_sheets/health_care_benefits_and_services/2003/english/core_hss_in_the_nwt.pdf

 

Yukon:

http://keltyeatingdisorders.ca/maps

http://ementalhealth.com/Yukon/Bulimia/index.php?m=heading&ID=36

http://keltyeatingdisorders.ca/yukon-mental-health-services

 

Nunavut:

http://www.hss.gov.nu.ca/en/About%20Us%20Facilities%20Health%20Centres.aspx


About Us

Home Page
Principles
History
Board of Directors
Professional Advisory Panel
Contact Us

Services

Learning Center
Store
Media Contact
Research Participants
Glossary
Book Reviews

News

Blog
News Feed
Newsletters
Events

Forum

Forum Rules
Forum Main Discussions
Hall of Fame

 

Reference

Terms of Use
Privacy Policy
Community Rules
Legal
YM Admin

Support Us

Donate
Memorial Gifts
Donate with Paypal
Volunteer Center
Employer Matches
Shop AmazonSmile 
 
 

F.E.A.S.T. (FAMILIES EMPOWERED AND SUPPORTING TREATMENT OF EATING DISORDERS)
info@feast-ed.org | US +1 855-50-FEAST | Canada +1 647-247-1339 | Australia +61 731886675 | UK +44 3308280031

F.E.A.S.T. is registered as a nonprofit organization under section 501(c)(3) of the United States Internal Revenue Code. Information on this site is meant to support, not replace, professional consultation. Unless otherwise noted, content is edited by F.E.A.S.T. volunteers with assistance from our Professional Advisory Panel.

  F.E.A.S.T. | P.O. Box 1281| Warrenton, VA 20188 USA