Veterans Health Care Regulations

3 (1) The following clients are eligible to receive treatment benefits in Canada or elsewhere in respect of a pensioned condition:

• (a) veteran pensioners;

• (b) civilian pensioners;

• (c) [Repealed, SOR/2001-326, s. 2]

• (d) Red Cross pensioners; and

• (e) flying accident pensioners.

• (f) [Repealed, SOR/2001-326, s. 2]

(2) Newfoundland Special Award pensioners are eligible to receive treatment benefits in Canada or elsewhere in respect of the disability for which they receive the award.

(2.1) Clients referred to in subsections (1) and (2) who are seriously disabled are eligible to receive treatment benefits in Canada for any health condition, to the extent that the treatment benefits are not available to them as members or former members of the Canadian Forces or as insured services under a provincial health care system.

(2.11) Veteran pensioners and civilian pensioners, who are entitled to a pension at a rate set out in any of classes 6 to 11 of Schedule I to the Pension Act, are eligible to receive treatment benefits in Canada for any health condition, to the extent that the treatment benefits are not available to them as members or former members of the Canadian Forces or as insured services under a provincial health care system.

(2.2) Special duty service pensioners are eligible to receive treatment benefits

• (a) in Canada or elsewhere in respect of a pensioned condition to the extent that the treatment benefits are not available to them as members or former members of the Canadian Forces; and

• (b) in Canada to the extent that the treatment benefits are not available to them as members or former members of the Canadian Forces or as insured services under a provincial health care system, if they are eligible to receive any of the veterans independence program services referred to in paragraphs 19(a), (b) and (e).

(2.3) Military service pensioners who are no longer members of the Canadian Forces, or who are members of the Canadian Forces as members of the reserve force, are eligible to receive treatment benefits in Canada or elsewhere in respect of a pensioned condition to the extent that the treatment benefits are not available to them as members or former members of the Canadian Forces.

(3) Where a client is hospitalized and the client asserts that hospitalization is required in respect of the client’s pensioned condition, treatment benefits in respect of that hospitalization, in Canada or elsewhere, are deemed to be required in respect of the pensioned condition, for the period during which there is uncertainty as to whether the primary condition in respect of which the treatment benefits are required is the client’s pensioned condition.

(4) Income-qualified veterans and income-qualified civilians are eligible to receive treatment benefits in Canada to the extent that the treatment benefits are not available to them as insured services under a provincial health care system.

(5) Civilian pensioners, prisoners of war entitled to basic compensation under subsection 71.2(1) of the Pension Act and Canada service veterans are also eligible to receive treatment benefits in Canada, to the extent that the treatment benefits are not available to them as insured services under a provincial health care system, if they are eligible to receive any of the veterans independence program services referred to in paragraphs 19(a), (b) and (e).

(6) Veteran pensioners, overseas service veterans, dual service veterans and overseas service civilians are eligible to receive treatment benefits in Canada, to the extent that the treatment benefits are not available to them as insured services under a provincial health care system, if they are eligible to receive any of the veterans independence program services referred to in paragraphs 19(a), (b) and (e) or are in receipt of any of those services under section 18.

(7) Clients who are in receipt of adult residential care, intermediate care or chronic care in a departmental facility or contract bed are eligible to receive treatment benefits in Canada to the extent that the treatment benefits are not available to them as insured services under a provincial health care system.

(8) Canada service veterans who are in receipt of chronic care in a community facility under subsection 22(2) are eligible to receive treatment benefits in Canada to the extent that the treatment benefits are not available to them as insured services under a provincial health care system.

(9) Clients who are in receipt of chronic care in a community facility under section 22.1 are eligible to receive treatment benefits in Canada to the extent that the treatment benefits are not available to them as insured services under a provincial health care system.

(10) Clients who are in receipt of the cost to them of intermediate care or chronic care under section 21.1 are eligible to receive treatment benefits in Canada to the extent that the treatment benefits are not available to them as insured services under a provincial health care system.