CBC Investigates

'I feel like a little bird': Quebec mom overjoyed after family gets health coverage back

Nearly three weeks after a Blainville family's medicare cards were abruptly cancelled by Quebec's health insurance board, RAMQ now says they were actually eligible.

Sandra Tomb got call from RAMQ this morning, apologizing for cancelling family's health insurance

While Tomb's family waited for RAMQ to review the file, all their medical appointments were in limbo, including prenatal exams for Tomb, who is pregnant with their third child. (CBC News)

Nearly three weeks after a Blainville family's medicare cards were abruptly cancelled by Quebec's health insurance board (RAMQ), the government has reinstated the family's coverage.

The health insurance board has also apologized to the family, saying it would work "better" on its approach.

When Sandra Tomb got the call from RAMQ today, her relief was immediate.

"I feel like a little bird, I can fly," said Tomb.

Pregnant with her third child, Tomb says all her medical appointments were on hold while she and her family waited for the results of an appeal they filed with RAMQ.

Typically, once a RAMQ decision is appealed, the board has up to 90 days to respond.

Sandra Tomb says she never had any problems with her medicare card until she sent in her renewal form last November.

Card renewal triggered problems

Tomb's problems with RAMQ started when she sent in a renewal form for her medicare card, which was set to expire last November.

At the end of January, Tomb received four letters from RAMQ, saying it did not have the necessary information it needed to maintain her coverage, along with the rest of her family.

Her husband, Mark Hoyek, as well as her two young sons — Alexander, 3, and Christopher, 2 — also lost their coverage, effective immediately.

RAMQ did not believe the family lived in Quebec. The boys were both born in Quebec, in the West Island.

Worse, RAMQ said the family would have to pay back any medical care or prescriptions they received, dating back to 2013.

RAMQ said if there are questions about a person's eligibility, they are contacted by phone or by mail, or an investigation is launched.

Tomb said she never received such a call.

RAMQ also cancelled the medicare cards of Sandra Tomb's two young sons. The decision is retroactive to their dates of birth, even though both boys were born on the West Island. (CBC News)

Proof of residence sent

Bewildered, Tomb appealed the decision.

She and her husband faxed hundreds of pages of personal and financial documents to prove they do indeed live in the province.

Reached by phone, RAMQ told them their file was considered a priority. But two and half weeks later, they still hadn't heard anything.

Finally, this morning, RAMQ told her everything was in order.

"We did an evaluation and realized you are actually eligible for the card," Tomb said the agent told her.

Tomb's children and husband's cards still hadn't expired, so the cards were reactivated.

As for Tomb, RAMQ faxed her a temporary card until her new card arrives in the mail.

"Do you know the amount of stress this has given me?" Tomb says she told the RAMQ agent, who couldn't give her an explanation about why the cards were cancelled in the first place.

She said the man apologized for the delay and the situation.

No longer in limbo

Tomb says she no longer feels her life and those of her family are on hold.

"I felt like a rock was removed from my stomach," said Tomb. 

While their medical coverage was in limbo, even a simple outing to go skating or skiing seemed too risky. 

As for RAMQ, Tomb says reviews of people's eligibility have to be done faster.

"Don't take that long," said Tomb. "Not only did you make a mistake, but it took you two and a half weeks to correct it."

"If I am a priority and it takes that long, how long does it take for someone that's not a priority?"


Share your story with CBC Montreal's investigative team. Leave a message on our confidential tip line (514-597-5155), send us an email or contact us on Facebook or Twitter

Comments

To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.

By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.