Treatment and Service Costs
Illness-related costs can include costs associated with treatments not covered by RAMQ and costs for support services such as childcare or cleaning.
In this section, we look at some of these costs so that you can be prepared if you are diagnosed with a serious illness.
Because each person’s situation is different, it is impossible to predict costs due to treatment or after for a serious illness. Some of these costs may be covered, in whole or in part, by a private insurance policy.
Which of the following do you believe are not covered by RAMQ?
Insulin ports for people with diabetes
Mobility aids such as wheelchairs, walkers or scooters
Wigs and headgear
Actually, none of the above items are fully covered by government health insurance (in Quebec, the Régie de l’assurance maladie du Québec or RAMQ).
For example, the medical technology required for patients to self-administer medications is not always covered by Medicare.
While many prescription drugs are covered by the RAMQ drug program, many others are not, even if a doctor prescribes them.
Breast prostheses, in case of mastectomy, are not covered. For a prefabricated silicone prosthesis, the average cost is about $400. For a custom-made prosthesis, the cost can be as high as $5,000. A mastectomy bra with pockets to hold the prosthesis comes at an additional cost.
Mobility aids such as wheelchairs can cost between $200 and $1,500 and over $3,000 when motorized. Walkers can cost anywhere from $50 to $900 depending on size, quality and functionality, while scooters cost several thousand dollars.
Finally, although wigs and head coverings can be crucial to the psychological well-being of those suffering from hair loss due to their treatments, they are not considered medically necessary and are not covered.
Other illness-related expenses
Wound care and postoperative supplies
Dressings, ointments, antibiotic creams, etc., must be paid for by the patient or family.
Physiotherapy/occupational therapy (outside a hospital or CLSC)
If you need physiotherapy or occupational therapy services and are on a waiting list for these services in the public system, you may decide to pay for private services.
Coping with a serious chronic illness, accepting functional limitations or grieving a loss can take a toll on your morale. You may need mental health support, but the public sector does not usually cover these services unless you find a therapist at a hospital or CLSC.
Although some illnesses or accidents may require extensive dental work, it is not covered unless it is done in a hospital.
The basic cost of ambulance transportation is $125 for pick-up, plus $1.75 per kilometer to the hospital. There is no charge for the person accompanying the person being transported, but there is a $35 charge for any additional person.
Personal transportation and parking
The cost of transportation to the hospital for treatment, such as by car or cab, can be very high. In addition, parking fees for a hospital, CLSC or CHSLD range from $7 to $10 per day. In some cases, users can benefit from special rates.
Assistance with personal care and household tasks may be provided by the CLSC, but often must be supplemented by private help.
Aids and devices
Lymphedema devices, compression garments, insulin pumps, ports and blood test strips are not covered by the public health system.
Over-the-counter treatments and supplies
Some treatments such as radiation therapy or medications can cause significant skin problems that need to be treated with creams that are not covered by the public drug plan.
Many patients use complementary or alternative therapies, such as acupuncture, naturopathy, herbal medicine, or massage, to reduce the side effects of the disease or its treatment.
Unfortunately, none of these therapies are covered by the public health system when obtained outside of the hospital.
Nausea or lack of appetite may require you to purchase nutritional supplements to supplement your diet. Your condition may also require you to follow a special diet and you will be responsible for the cost.
When you have a serious illness or even when you are recovering from an illness, you may need help preparing nutritious meals.
If the ill person is a parent, he or she may need babysitting services that were not previously required.
Miriam, a 39-year-old single mother of two children, ages 7 and 9, was diagnosed with multiple sclerosis two years ago. One of the main symptoms of this disease is chronic fatigue. Miriam continues to work as a lab technician and take care of her home and children, but is finding it increasingly difficult to do everything. So she is thinking about using the following services:
- Hiring a housekeeper ($100/day)
- Buy prepared meals ($18/meal x 3 x 3 = $108/week)
- Hire a person to pick up children from after-school activities ($15/hr x 2 hrs x 5 days = $150/week)
All of these choices have significant financial consequences. Yet they could mean the difference between Miriam being able to keep her job or having to reduce her work time, which would also have financial consequences.
As you can see, a serious illness can have financial implications beyond the inability to work.
A financial support system with several components, including an emergency fund and long-term disability insurance, can provide important support in dealing with the various financial challenges created by a serious illness or accident.