However, the situation recently changed in April when the Ontario Ministry of Long Term Health introduced new regulations – not to improve the situation for patients but to make it worse. Now, if the treatment is available for sale in Ontario, it will not be reimbursed even if the patient seeks that treatment outside the country. These new regulations re-define what is considered to be ‘performed in Ontario’ to include ‘services that are for sale anywhere in Ontario to a person in the same medical circumstances as the insured person’.
Now, in order to qualify for out-of-country reimbursement in Ontario, the treatment must neither be offered publically or privately in Ontario. If the treatment exists in Ontario, but you can’t afford it, you just might be out of luck.
It certainly appears that the Ministry of Health, having lost its argument at the Appeal Board consistently decided to simply change the regulation in its own favour and to the disadvantage of patients needing urgent medical services that they cannot afford.
We hope that this is a regulatory change that will remain isolated to Ontario. Please let us know if you are facing similar issues in your province. CARP will be calling on the Ontario government to re-evaluate this change in light of the impact it could have on a number of Canadians.