Newfoundland & Labrador

PROVINCIAL/ TERRITORIAL HEALTH PROGRAMS

Medical Insurance

The Newfoundland and Labrador Medical Care Plan (MCP)

Hospital Insurance

Newfoundland Hospital Insurance Plan

Prescription Drug Insurance

The Newfoundland and Labrador Prescription Drug Program comprises three programs:

• The Income Support Program
• The Senior Citizens Drug Subsidy Program
• The Special Needs Program

HEALTH PREMIUMS/TAXES

Health Insurance Premiums/Employer Tax

The Health and Post-secondary Education Tax is 4% of payroll between $600,000 and $700,000 or 2% over $500,000 if payroll exceeds $700,000.

Additional Premiums

Not applicable

WHEN COVERAGE BEGINS

If move is from within Canada

Coverage on the first day of the third month after arrival in Newfoundland & Labrador

If move is from outside Canada

Coverage on the date of arrival in Newfoundland & Labrador

HOW LONG COVERAGE CONTINUES

Moving within Canada

Balance of the month in which you leave the province plus two consecutive months

Moving Outside Canada

Date of departure

Short Absences

Coverage is maintained during an absence of up to 4 months in any 12 month period if Newfoundland remains the permanent and principal home

OUT OF PROVINCE / COUNTRY COVERAGE

Out-of-province

Insured medical services obtained in other provinces and territories paid at the standard rates of the province/territory where services were obtained

Cost of emergency in-patient / out-patient hospital while outside of Canada

Insured hospital services paid at rates established by the provincial plan.
Services must be provided by a recognized facility (licensed or approved by the appropriate authority within the state or country in which the facility is located) outside Canada.
Newfoundland Hospital Insurance Plan pays the following Insured Inpatient Hospital Rates:

• A maximum of $350 per day in a community or regional hospital
• A maximum of $465 per day in a tertiary or specialized hospital
• Out-patient Hospital Rates maximum of $62 per day

With certain exceptions, claims for insured out-patient medical services obtained outside Canada are paid at MCP rates, which are the rates paid to Newfoundland and Labrador physicians.
Patient responsible for additional costs.

WHAT IS COVERED

Physician Services

Medically required services associated with physician and diagnostic services and hospital in-and-out patient care, such as:

• Surgical, diagnostic and therapeutic procedures
• Anaesthesia
• Pre- and post-operative care
• Complete maternity care
• Radiology interpretive services

Eye Examinations

Not covered

Dental

Certain medically necessary surgical-dental procedures which are performed in hospital by a dentist or oral surgeon

Hospital

Standard ward hospitalization in an approved hospital and in-patient services such as:

• Private and semi-private room charges covered if provided for medical reasons or if standard accommodation is not available
• Nursing services
• Laboratory, x-ray and other diagnostic procedures, e.g., EKG, Nuclear Medicine, Respiratory Therapy
• Drugs; Medical and surgical supplies
• Operating Room, Labour & Delivery
• Use of radiotherapy facilities and radioactive isotopes where available
• Rehabilitative Services, e.g. Physiotherapy, Occupational Therapy, Audiology, Speech Language Pathology

PARAMEDICAL SERVICES

Physiotherapy Services

Physiotherapy services provided at a hospital, on an inpatient or outpatient basis within Canada

Chiropractic Care

Not covered

Osteopath

Not covered

Chiropodist/podiatrist

Not covered

Drug

The Newfoundland and Labrador Prescription Drug Program comprises three programs:
General

• The Income Support Program
• Provides prescription drug coverage, for identified benefit agents, for residents of the province who qualify for full benefit coverage under the Department of Humans Resources and Employment
• Provides for prescription drug coverage, for identified benefit agents, for residents who, due to the high cost of their medications, may qualify for drug card only benefits
• Provides 100% coverage of the ingredient cost, up to a 10% markup where ingredient cost exceeds $30.00, and a maximum dispensing fee of $6.50

Seniors

• The Seniors Drug Subsidy Program
• Provides prescription drug coverage, for identified benefit agents, for residents who are 65 years of age or over, who are in receipt of the GIS and who are registered for the OAS benefits
• Provides coverage of defined ingredient cost only for identified benefits. The remaining cost paid by the senior as co-payment. Amount is not regulated by government

Special Needs

• Special Needs Program
• Provides universal coverage for patients with Cystic Fibrosis and Growth Hormone
• Universal coverage provided for Food Bank clients but must apply for coverage under the Dept of Human Resources and Employment once they reach 18 years of age, at which time access to the program is based on financial need
• Provides 100% coverage for identified benefits - disease-related prescription drugs, enzymes, foods, medical supplies, and equipment
• Supplied through the Health Sciences Central Supply and Pharmacy

Ambulance

Not covered