COVERAGE FOR TREATMENT AND SUPPLIES

Coverage for Lymphedema treatment and supplies varies greatly across the Canadian provinces. 

Funding for compression eligible prescriptions and supplies in BC is through Pharmacare. 

Funding for MLD treatment comes under the Medical Services Plan (MSP) but only for patients on income assistance.

One of BC Lymphedema Association's (BCLA) main goals is expanding coverage for people with Lymphedema and your membership and donations help our advocacy efforts greatly.

LYMPHEDEMA COVERAGE IN BRITISH COLUMBIA 

For compression reimbursement coverage, you need a prescription from a physician or nurse practitioner dated within the past 12 months. Prescription detail must include:

• Diagnosis
• Compression Class
• Which body part covered (Left or Right or Both)
• Quantity
• Duration required
  
  

PHARMACARE

Coverage for breast cancer related lymphedema and income based.

            Plan 1 – Fair Pharmacare

            Plan C – Income Assistance

            Plan W – First Nations Health Authority

To check which Pharmacare Plan you are under: Call 1-800-661-7100

Click here for suppliers that can submit pharmacare applications.

MINISTRY OF SOCIAL DEVELOPMENT AND POVERTY REDUCTION

(MoSD&PR) covers any body part with lymphedema – the fitter prepares a quote for items and sends along with the prescription/medical note to the MoSD&PR.  This can be a 4-8 week process.

FIRST NATIONS HEALTH AUTHORITY & HEALTH CANADA'S NON-INSURED HEALTH BENEFITS PROGRAM

(NIHB)(Federal) – Medical Supplies & Equipment (MS&E) in partnership with Pacific Blue Cross will cover medically necessary “surgical stockings and pressure garments”.   Call 1-855-550-5454.    

NIHB/Pacific Blue Cross coverage varies Over The Counter (OTC, ready made) versus Made to Measure (MTM, custom) products, and may also cover some bandaging costs.  Prescription required.

MSP

Patients on income assistance may be eligible for $23 reimbursement from MSP per session to a maximum of 10 sessions a year for Manual Lymph Drainage coverage from a registered therapist.  Please note the treatments reimbursed per year include all massage therapy, physiotherapy and chiropractic appointments combined to a total of 10 sessions.

Complete form (HLTH 1916) patient and therapist and submit along with prescription to MSP within 90 days of treatment date.  Prescription required for massage or physiotherapy.  

PRIVATE INSURANCE COVERAGE

Varies from plan to plan. Prescription required.

INCOME TAX
If you do not have any (or much) extended health and do not fall into any of the previous coverage categories keep all your medical expenses and claim on your income tax.  Prescription required.