Saskatchewan Health Care Plan: The Saskatchewan Health Card Coverage and Benefits Overview
Originally posted on https://www.insurdinary.ca/saskatchewan-health/
Saskatchewan Health is the official provincial health care provider of the province that is available for all permanent Saskatchewan residents.
The Saskatchewan health care coverage covers most medically necessary services (such as hospitalization and physician) provided in a publicly funded facility in Canada.
Saskatchewan Health completely covers the following health services.
- All services rendered by a physician and considered as a medical necessity.
- Screening mammography is covered through the Provincial Screening Program for Breast Cancer and it is available for women between 50 and 59.
- Physiotherapy and occupational therapy.
- The treatment of sexually transmitted infections (STIs).
- Certain immunization services.
- Treatment of gambling addiction as well as drugs and alcohols. This is covered via the Saskatchewan Health Authority or through the Metis Addictions Council of Saskatchewan Incorporated.
- HIV testing. Anonymous testing is allowed.
- Mental health services are covered by the Saskatchewan Health Authority.
- Residents recommended for social services can leverage the supplementary health services. These services include coverages such as prescription drug costs, dental services, podiatry/chiropody, medical supplies, emergency medical transportation costs.
- Major dental services may be covered if they are considered as medical necessities such as tooth extraction, dental surgery, and dental implants. Albeit, routine dental services are not covered.
- Home care services offered free of charge. These may include home nursing, case assessment, occupational therapy and physical therapy. Check below for partially covered home care services.
- Low income families can benefit from the family health benefits. This benefit is similar to the supplementary services but is mainly designed for children below 18.
The following services are covered partially.
- Air ambulance transportation cost to obtain medical services not available in Saskatchewan. The service must be ordered by a physician. However, a fee of $350 applies.
- Seniors can benefit from the ground ambulance service. It includes a maximum fee of $275.
- Unless the resident is assessed as “Level 1”, long term costs apply. The charges that apply are determined by the resident’s income level.
- Public services like homemaking, meals, and home maintenance. The charges that apply are determined by the resident’s income level and services received. Although it does not cover private home care services.
- The services of chiropodists and podiatrists.
- If you qualify for the Family Health Benefits or the Supplementary Benefits program, you may be covered for services related to hearing such as hearing aid fittings, tests, and counseling. This is effective as of July 1, 2017.
- The services of optometrists. This includes coverage for a yearly eye exam for residents below 18, suffering from diabetes or who have once suffered some eye trauma.
These services are not covered:
- Prescription drugs are not covered except the resident qualifies for the drug program.
- Ground ambulance is only covered for seniors, else it is not covered.
- Regular dental services including fillings, scalings, and cleanings are not covered.
- Lenses and eye glasses are not covered but if you are enrolled in a Family Health Benefits program, you may be eligible for a limited coverage for glasses.
- The services of paramedical professionals such as acupuncturists, naturopaths, psychologists, and registered massage therapists.
- Unless you are required to obtain treatments not available in Saskatchewan, ambulance services are not covered.
Extended Benefits Plans And Drug Plans
If you qualify, you can leverage the several drug plans provided by Saskatchewan Health. These are described below.
- Children’s Drug Plan: Provides up to $25 for prescription drugs for children below 14.
- Emergency Assistance for Prescription Drugs: If a resident cannot afford the prescription drug required for his condition, this plan provides a one-time emergency assistance.
- Senior’s Drug Plan: Residents above 64 have to pay only $25 for the prescription drugs they need.
- Exception Drug Status: This covers certain prescription drugs, especially in line with the Drug Advisory Committee of Saskatchewan.
- Family Health Benefits: Families on a low income can benefit from this plan. It is also available for families that are on Saskatchewan Employment Supplement and for those on Saskatchewan Rental Housing Supplement.
- Guaranteed Income Supplement for Seniors: Seniors receiving old age security and are on low income can take advantage of this monthly benefit.
- Palliative Care Drug Coverage: Palliative care patients in the late stage of a terminal illness can make use of this plan for prescription drug coverage. But this plan does not offer drugs for patients suffering from terminal cancer. Registered cancer patients can get free drugs coverage from the Saskatoon Cancer Center Pharmacy and the Allan Blair Cancer Center.
- Saskatchewan Aid to Independent Living (SAIL) program: This program assists residents with physical disabilities financially. The assistance can help residents to manage some serious medical conditions.
- Seniors Income Plan (SIP): This program provides financial assistance to seniors above 64. It is designed to help them in meeting their basic needs such as prescription drugs and others.
- Supplementary Health Benefits: This plan covers non-insured benefits for government wards, correctional institution inmates and those who enroll in an income support program.
- Assistance for High Drug Costs: This program offers assistance for high drug costs but this is determined by your income level.
- Saskatchewan Insulin Pump Program: Residents below 26 suffering from Type 1 diabetes and who need an insulin pump can take advantage of this program for financial assistance.
Emergency Transportation Services
Ambulance services are made available to all and sundry; you can learn more about this in the Saskatchewan ambulance services web page.
The ambulance fees depend on the type of ambulance transport involved. Here is a breakdown of the fees by transportation mode.
- Fees for Ground Ambulance:
- $245 to $325 pickup rate.
- Distance rate, per kilometer, for transporting rural residents to a medical facility.
- $50 to $100 waiting time rate for waiting to transport a patient back home.
- If you will be accompanied by a medical professional during the trip, a special escort fee applies.
- Fees for Saskatchewan Air Ambulance:
- Basic rate of $424.
- The ambulance cost incurred to and from the airport is billed on the patient.
- Shock Trauma Air Rescue Society (STARS):
- STARS is a non-profit organization that offers air medical transportation.
- It includes an air ambulance fee of $424 for each flight.
- Specialized Transportation Services:
- Saskatchewan Pediatric transportation service designed for transporting children.
- The Northern Medical Transportation: It funds medical transportation for northern Saskatchewan residents. This could be for emergency or non-emergency purposes and it could also be via ground or air.
- You can leverage the Saskatchewan Neonatal Transportation service to transport infants.