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Who Pays for HEALTHCARE?

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Who Pays for HEALTHCARE? Who pays for HEALTHCARE? MANITOBA We gathered the information in this guide as of April 7, 2014. We’ve made a considerable effort to confirm that the information is accurate, but it may be incomplete or incorrect. It’s important that you consult your own legal and tax advisors to review your personal situation. We also recommend you check your employer and personal insurance plans for details on your specific coverage. DISABILITY HOME LONG TERM PALLIATIVE PRESCRIPTION TRAVEL EMERGENCY MANITOBA PROTECTION CARE CARE CARE DRUGS HEALTH INTRODUCTION Brought to you by Health always matters most cancers and dementia. In this context of change, we recommend you consider your own needs, Canadians strongly identify with their medicare preferences and personal resources. Planning for system and most see it as a national icon. We have health expenses is as important as buying a house enjoyed universal, first-dollar coverage for hospitals or saving for retirement; indeed, health and wealth and physicians for decades, but other health planning are natural companions. services can be surprisingly expensive. Our needs have changed over time, often radically. Introducing Sun Life’s While the principles of the Canada Health Act healthcare funding guides (1984) remain sound, in the last 30 years there has These guides outline some of the coverage options, been a six-fold increase in health costs.1 Private personal costs and other key considerations for health spending by individuals and insurers was six common health events and services: disability, estimated at $63 billion in 2013. Some of those costs home care, long term (nursing home) care, palliative likely came from your pocket…or may soon. (end-of-life) care, prescription drugs and travel emergency medical. Planning and paying: A shared responsibility The guides are organized by province, just as our healthcare system is operated and you’ll find many Government and employer health plans provide embedded web links to other authoritative websites complementary coverage for many health-related for more detail and the latest updates. They are expenses. But there are common, medically meant to be a quick reference that you will find necessary health services that are not fully covered. practical, informative and easily accessible. Planning Each province makes their own decisions and those ahead can provide important protection and peace entitlements may change over time, especially as of mind and help you get what you need, when governments struggle with high debts and deficits, you need it. demographic changes and higher rates of many common chronic diseases such as diabetes, certain Research provided by H3 Consulting. 1 Canadian Institute for Health Information, 2013. National Health Expenditure Trends 1975 to 2013 (Link: https://secure.cihi.ca/free_products/NHEXTrendsReport_EN.pdf). www.sunlife.ca/whopaysforhealthcare/MB 2 DISABILITY HOME LONG TERM PALLIATIVE PRESCRIPTION TRAVEL EMERGENCY MANITOBA PROTECTION CARE CARE CARE DRUGS HEALTH DISABILITY PROTECTION Brought to you by Overview Disability can affect your income, lifespan and quality of life and your chances of becoming disabled are greater than you may think. Statistics Canada has reported that nearly 4.5 million Canadians (14.3%) had a disability in 2006. That percentage has increased since 2001 and also increases steadily with age. Among younger people of working age (25-44), 8% reported a disability. For those ages 45-64, 18% reported a disability. For all adults, the most frequent disabilities are related to pain, mobility and agility and of those reporting a disability, 82% reported more than one and 40% reported their disability was severe or very severe. • Employment Insurance (EI) pays a sickness benefit COVERAGE Federal government for up to 15 weeks for those unable to work due to 4.5 million sickness, injury or quarantine. Your earnings must (14.3%) of • The Canada Pension Plan (CPP) provides a disability have dropped at least 40% due to your condition Canadians had benefit to those under age 65 who have contributed and you must have at least 600 hours of insurable a disability 14.3% to the plan and who have a severe and prolonged earnings during (generally) the last 52 weeks. There in 2006 disability that 1) prevents a claimant from being able is a two-week waiting period once approved. Based to work at any job on a regular basis or 2) will result on 55% of your insurable earnings, the maximum in death. Applications take about four months to Reported disabilities more weekly benefit was $514 in 2014, but there is a than double after age 45 be processed, although those considering terminal supplement for qualifying low income families. conditions will be reviewed in two days. As of 8% 25-44 years March 2014, the average monthly benefit is $896.87 • The Child Disability Benefit (CDB) is a tax-free and the maximum benefit for 2014 is $1,236.35. The benefit for families with a child under age 18 who 18% 45-64 years basic amount ($457.60 - 2014) is fixed for all eligible has a severe and prolonged impairment in mental or claimants, with additional benefits based on the physical function. The CDB provides up to $218.83 claimant’s CPP contributions. If the claimant qualifies, per month for each eligible child (July 2013 - June 2014) but is reduced according to the number of Most frequent disabilities there is also an additional benefit for dependent children and family net income. are related to children payable up to age 25. The current (2014) PAIN, agility benefit is a flat monthly rate of $230.72. and mobility www.sunlife.ca/whopaysforhealthcare/MB 3 DISABILITY HOME LONG TERM PALLIATIVE PRESCRIPTION TRAVEL EMERGENCY MANITOBA PROTECTION CARE CARE CARE DRUGS HEALTH DISABILITY PROTECTION Brought to you by • Veterans and active military personnel may aids, medical equipment, mobility equipment, ◊ Places of training and employment qualify for a disability award or a disability etc. There is an extensive list of other benefits may qualify for a partial offset of costs pension if their disability is related to their too. Financial benefits depend on the age and required to accommodate a disabled military service. Current and former members number of children and whether there are one worker. The disabled person’s home is of the RCMP and certain civilians may also or two adults in the family. Provincial benefits not eligible unless it is also the place of qualify for the disability pension. are paid monthly, are not taxable and currently employment. See: Section 166.2 Building (effective July 1, 2013) range from $801 for one Modification of the marketAbilities • For severe and prolonged disability in physical single disabled adult to $1,658 for two adults Program Operating Manual. or mental functions, there are other federal tax (one qualifying for EIA) with three children: benefits for which you may qualify, including ◊ There is funding (up to 75%) for vehicle see page 6 of the following link. the Disability Tax Credit (DTC). For those who modifications needed for a program qualify for the DTC, contributions can be made • For those in financial need, the Income participant to be transported or for to a Registered Disability Savings Plan (RDSP). Assistance for Persons with Disabilities independent transportation to the Those with a RDSP are eligible for federal program provides financial and employment training or employment site. See: grants and bonds. assistance for adults with a disability living Section 166.4, Vehicle Modification in the community. This includes an automatic of the marketAbilities Program payment of $105 each month. Those who are Operating Manual. COVERAGE Provincial government working can keep some of their monthly pay • Community Living disABILITY Services helps and may also receive money for work clothing, adults who are vulnerable (as defined under • The Employment and Income Assistance work transportation and child care.2 The Vulnerable Persons Living with a Mental Program (EIA) provides financial help to those • The marketAbilities Program helps those ages Disability Act) and living with a significant with no other way to support themselves or 16 and older with a physical, mental, psychiatric mental disability to meet basic needs in their families. EIA will also provide support for or learning disability to find and keep work. personal care or management of his or her people who are unable to work. Both income It includes vocational assessments, training property. The program offers residential, and assets are assessed for eligibility. A wide and counselling as well as support and direct day and support services as well as help variety of health benefits are available through employment services such as resume writing with independent decision making. Additional this program including Pharmacare (deductible and training. This program is jointly funded information about this program is available waived), dental, chiropractic, podiatry, hearing with the federal government. in the Family Services brochure. 2 The earnings exemption allows qualified people to keep the first $200 of net monthly earnings, and 30% of any amount earned over $200, before employment and income assistance benefits are reduced. www.sunlife.ca/whopaysforhealthcare/MB 4 DISABILITY HOME LONG TERM PALLIATIVE PRESCRIPTION TRAVEL EMERGENCY MANITOBA PROTECTION CARE CARE CARE DRUGS HEALTH DISABILITY PROTECTION Brought to you by • The Children’s disABILITY Services Program provides information, services and supports COVERAGE ProvincialEmployer plansgovernment COVERAGE Personal insurance for families caring for a disabled child, 17 years of age or younger. These include • Many larger employers and some smaller ones, • Individual disability insurance plans are behavioural services, child development, provide compensation when you cannot work available directly through insurers, or through supplies and equipment, home and vehicle due to disability. These include partial or full pay membership in various associations including modifications, respite care and other under casual absence or sick leave programs, or post-secondary alumni associations.
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