What financial supports N.W.T.ers might be entitled to for medical travel

Medical travel will look different for each patient depending on their financial status, eligibility for Non-Insurable Health Benefits and Metis Health Benefits. Eligibility can't singularly be changed for families who are affected by the reduction of delivery services at Stanton Territorial, the health minister says.

Changing medical travel would set a 'precedent' for all who access it in the N.W.T., says health minister

Royal Alexandra Hospital in Edmonton, Alberta, during July 2019. (Codie McLachlan/CBC)

With birthing services on pause at Yellowknife's Stanton Territorial Hospital, many people are left wondering what options they have for medical travel — and what financial support is available for that.

In the N.W.T., medical assistance will differ for all patients, health authority spokesperson David Maguire told CBC in an email.

The territorial government has a guide to help people understand medical travel, a program that is widely used — 15,141 patients and 6,443 medical escorts have used medical travel in 2019-2020.

Support available to N.W.T. residents differs based on your income level, if you have dependents and your eligibility for programs such as federal Non-Insurable Health benefits, or territorial Métis Health Benefits, Maguire wrote.

While the N.W.T.'s medical policy states the cost of medical travel should not be a barrier to accessing insurable health services, some people, depending on their benefits, may be left with some costs.

In the Legislative Assembly, MLA Caitlin Cleveland asked if the N.W.T. government would waive costs such as a $400 co-payment fee for airfareand to increase the hotel reimbursement from $50 up to $100, regardless of whether a person travels with an escort. 

But Julie Green, health minister, said the benefits will remain the same, matching what all medical travel patients are able to access.

Health Minister Julie Green in the N.W.T. Legislative Assembly on Nov. 23. (Travis Burke/CBC)

She said medical travel is not a "dollar for dollar" cost replacement for going South, and paying more into costs such as families' child care and lost income, will set a "precedent."

CBC News put together an overview of what some people can expect in terms of support for medical travel depending on their benefits.

If you don't have private insurance

You are eligible for two tiers of assistance based on household income and access to health benefits such as federal Non-Insured Health Benefits if you have a valid treaty or status card (details here), territorial Métis Health Benefits or Extended Health Benefits

To get extended health benefits, you have to be enrolled in the seniors program, specified disease conditions program or Métis Health Benefits program. 

If you are covered under Non-Insured, Métis, or Extended Health benefits, you and your escort will have your airfare coordinated and covered, alongside meal, accommodation and ground transport in Edmonton. 

You can also travel on your own and seek reimbursement by submitting expense claims. 

The threshold for low-income is set at $75,000 for individuals, $85,000 for a couple or $100,000 for a couple or individual with dependents. 

Residents who need quick facts on medical travel can look through this guide published by the N.W.T. government. Health Minister Julie Green said staff are connecting with expectant parents to learn more about their needs as roughly 120 families are flown to Edmonton between December and February. (GNWT)

If you don't have health benefits

If you don't have employer, third-party, low-income or supplementary health benefits, you are eligible for patient airfare with a $400 co-payment for round-trip and authorized non-medical escort airfare.

Costs you incur for local transportation in Edmonton to and from the airport, accommodations, hospital and pharmacy will be reimbursed. 

You and your escort will be reimbursed up to $18 per day each, as well as a nightly accommodation rate of $50 each, both excluding the days the patient is admitted to hospital.

If you're unionized

At least a dozen active agreements are posted to the Union of Northern Workers website, where you can search for language in the agreement related to medical travel, such as leave entitlements.

The territorial government encourages people with private insurance through their employer to ask for information about medical travel entitlements.

If you work for the N.W.T. government

You require a medical document certifying the necessity of out-of-community treatment. You will be reimbursed for: 

  • Taxi fare, though airport shuttles should be used if possible.

  • The most economic airfare or mileage reimbursement.

  • Up to 25 days of hotel accommodation and meal/incidental costs.

  • A maximum of $50 daily for accommodation, meals, local transport if you must stay longer than 25 days. This reimbursement is cut off at 40 days, and does not include days you are in hospital or treatment. 

If you are under the collective agreement and are escorting the person giving birth, you are entitled to special leave that cannot be unreasonably denied.

As an escort, you apply for travel assistance under a group surgical or medical plan, and share the premium with your employer. If you choose to drive rather than fly, travel time cannot be deducted from your sick leave, unless it exceeds the length of time it would take to fly.

If you don't have an N.W.T. health card

The N.W.T. government recommends you consider getting private health insurance.