Change healthcare coverage for Canadian military veterans

39

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The Issue

 My husband Mark, between the Army and Air Force, served 27 years. He was deployed to the middle east, and has been on many training deployments. He has taught new members in his trade, influenced and guided a newer generation of service members. He has sacrificed time with his children, family and friends  for the love and safety of our great nation. However, witnessing firsthand the struggles with inadequate healthcare provisions, including medical, vision, and prescription coverage, that our veterans and their families endure is disheartening and unacceptable. This is not only a personal concern but a national one that affects all Canadian military veterans and their families, past, present, and future.

Canada has always prided itself on supporting its veterans, yet the reality remains that the healthcare coverage currently extended to military veterans is neither sufficient nor respectful of the sacrifices they have made. According to Veterans Affairs Canada, as of 2021, there were 629,300 veterans across the country, many of whom face significant health challenges that the present system does not adequately address. Approximately 47% of veterans report a disability, often requiring specialized and ongoing medical attention.

Vision care, which is essential for early detection of diseases that can affect the veterans' livelihoods and quality of life, is inadequately covered. Many veterans face prohibitively high costs for necessary eyewear, which can exceed $1,000 every few years, unaffordable to those living on fixed incomes. Prescription drugs, another critical component of healthcare, often remain only partially covered, forcing veterans to choose between medications and other basic needs. This lack of comprehensive coverage severely affects their ability to live healthy, dignified lives post-service.

 

Active duty Service members pay nothing out of pocket for themselves.

They need medicine? They go to the MIR and get it.

They need glasses?  

The Canadian Armed Forces (CAF) covers up to $600.00 every 24 months for prescription eyeglasses, frames, and lenses through Medavie Blue Cross under Program of Choice (POC) 14 – Vision Services. 

They need Physio, Chiropractic, orthopedic help? 

 

 PHYSIO

Members can often access physiotherapy directly on-base through military health centers, sick parade, or walk-in/appointment services without needing a complex external referral. 

out-patient physiotherapist visits are covered up to 20 appointments per condition when authorized by a physician, with options for clinical review if extended care is needed. 

 

CHIROPRACTIC

not a direct-access service and must be officially prescribed by a military medical officer or attending physician. 

Chiropractic treatment is typically delivered off-base through civilian providers outside the direct military health system.

10 appointments per condition, after which a physician must review the case to determine if further treatment is clinically necessary. 

 

ORTHOPEDIC

Orthopedic care involves specialized surgical or advanced medical interventions for structural bone and joint issues.

The Gatekeeper Process: Accessing an orthopedic specialist strictly requires a referral from a base Care Delivery Unit (CDU) medical practitioner. 


Civilian vs. Military Facilities: Depending on the location, you may see a uniformed military orthopedic specialist or be referred out to a local civilian hospital. For example, members stationed in Ottawa often utilize dedicated military operating room blocks via partnerships with civilian facilities like the Montfort Hospital. 


Cost: All medical imaging (MRIs, X-rays), specialist consultations, and surgical costs approved through this pipeline are 100% covered by National Defence. 

 

Active duty service member families however through Canada Life's PSHCP

PRESCRIPTIONS

Reimbursement Rate: 80% of reasonable and customary charges, leaving a 20% member co-pay. 


Catastrophic Drug Coverage: Once your out-of-pocket eligible drug expenses reach $3,500 in a calendar year, additional eligible prescription drug costs are reimbursed at 100%. 


Mandatory Generic Substitution: Prescriptions are reimbursed at 80% of the cost of the lowest-priced alternative generic drug. Brand-name drugs are only covered at 80% if a physician provides a medical necessity exception. 


Biosimilars Transition: Originator biologic drugs transition to lower-cost biosimilars (reimbursed at 80% of the lowest-cost biosimilar) unless a medical exception is approved. 


Dispensing Fee Cap: Pharmacy dispensing fees are capped at a maximum of $8 (reimbursed at 80%), and maintenance drug dispensing fees are limited to a maximum of 5 times per calendar year. [1, 2]
Day Supply Limit: Standard prescriptions are limited to a 100-day supply (or up to a 200-day supply for extended travel). 


Special Limits: Erectile dysfunction drugs: Maximum of $500 per calendar year.


Smoking cessation aids: Lifetime maximum of $2,000 (reimbursed at 80%).


Prior Authorization: Certain specialty or high-cost drugs require pre-approval through Canada Life PSHCP Member Services before filling

 

VISION

Vision Care Benefit Details
Eye Examinations: Covered at 80%, limited to one exam every two calendar years (starting January 1 of each odd calendar year, such as 2025, 2027). 


Eyeglasses and Contact Lenses: Reimbursed at 80%, with a maximum eligible expense of $400 every two calendar years (commencing odd years). (This covers the purchase and repairs of prescription glasses or contacts). 


Elective Laser Eye Surgery: Reimbursed at 80%, with a lifetime maximum eligible expense of $2,000. (Procedures where the laser does not reshape the cornea to correct common vision problems are excluded). 


Post-Surgery or Accident: If glasses, contact lenses, or intraocular lenses are required as a direct result of a surgery or accident and purchased within six months, there is no maximum dollar limit (reimbursed at 80%). 


Special Expenses: Artificial eyes have specific age-based replacement limits (subject to 60-month or 12-month limits). 

 

PHYSIO, CHIROPRACTIC, ORTHOPEDIC

Under the Canadian Public Service Health Care Plan (PSHCP), eligible expenses for these treatments are reimbursed at 80% of Reasonable and Customary (R&C) charges, up to specific yearly limits per person. A physician's prescription is not required for physiotherapy or chiropractic care, but may be required for orthopedic items. 


The exact coverage limits for each category include:

🩺 PSHCP Coverage Overview


Category
Annual Maximum Limit (per person)
Maximum Out-of-Pocket Reimbursement (at 80%)
Prescription Required?

Physiotherapy
$1,500 per calendar year
$1,200
Prescription Required? No

Chiropractic
$500 per calendar year
$400
Prescription Required? No

Orthotics (Custom)
$550 per pair (Max 1 pair/year)
$440
Prescription Required? Yes (Valid for 3 years)

Orthopedic Shoes
$250 per calendar year
$200
Prescription Required? Yes (Valid for 1 year)

 


 


📋 Important Rules & Context

Physiotherapy: There is a hard cap of $1,500 per year. The "member-paid corridor" (which used to require members to pay 100% of costs between certain amounts) has been permanently eliminated.


Orthotics & Orthopedic Shoes: Custom orthotics must be prescribed by a physician, nurse practitioner, podiatrist, or chiropodist. They must be dispensed by an approved specialist (such as a podiatrist, chiropodist, pedorthist, orthotist, or chiropractor). Orthopedic shoes must be an integral part of a brace or specially constructed/modified to qualify. 


Reasonable and Customary (R&C) Charges: The 80% reimbursement is based on the average going rate for that service in your specific province. If a clinic charges significantly above the regional R&C cap, your reimbursement will only cover 80% of the capped allowance. 


If your spouse or common-law partner has an independent health insurance plan, you can coordinate benefits to cover the remaining 20% co-payment. 

NOW FOR THE DIFFERENCE IN COVERAGE (active duty PSHCP and veteran)

The Public Service Health Care Plan (PSHCP) differs significantly between active Canadian Armed Forces (CAF) members and veterans in terms of who is covered, how it is paid for, and how it interacts with primary medical care. 

Active Duty Service Members vs. Veterans Under the PSHCP


Who Is Covered:

Active Duty: Active-duty military members themselves receive their primary medical and dental care directly through the Canadian Forces Health Services (managed via Medavie Blue Cross). Active members do not use the PSHCP for themselves; instead, the PSHCP is accessed purely to cover their eligible dependents (spouses and children).


Veterans: Veterans can access the PSHCP either as federal/public service pensioners (if they retire with a public service pension) or through specific Veterans Affairs Canada (VAC) pathways (such as those approved for Long Term Disability (LTD) post-April 1, 2006, or service-related rehabilitation). In this case, the plan covers the veteran and their eligible family members directly.


Cost and Contributions:

Active Duty: The employer (Government of Canada) covers the cost for the dependent-focused extended health and hospital provisions associated with the active member's registration.


Veterans / Pensioners: Participation as a pensioner or VAC client is voluntary (for certain groups) and requires monthly participant premiums/contributions deducted from pensions or paid out-of-pocket (typically shared 50/50 with the employer for supplementary coverage, unless qualifying for low-income relief provisions). 


Role and Scope of Coverage:

Active Duty Dependents: Acts as an extended health care plan (reimbursing 80% for vision, prescription drugs, and practitioners like physiotherapy) and hospital provisions (semi-private/private rooms) alongside provincial Medicare.


Veterans: Acts as a supplementary (in Canada) or comprehensive (outside Canada) health plan that picks up 80% of eligible extended health costs not covered by provincial/territorial health insurance (such as prescription drugs, medical equipment, and practitioner fees). Routine dental care is not included under the VAC PSHCP (only dental treatment resulting from an accidental injury is covered), whereas active families or separate military/veteran dental plans have different structures. 

Here is the MAIN DIFFERENCE that is not talked about in any of these facts and statistics.

PAY DIFFERENCES

 

Active duty military members in Canada receive a regular, periodic salary and active allowances for ongoing service, while veterans (or released members) transition to pensions, disability benefits, and income replacement programs managed by Veterans Affairs Canada (VAC). 

 

Active Duty Member Pay (Canadian Armed Forces)

Salary Structure: Full-time Regular Force and Reserve Class C members earn a monthly/annual basic salary determined by rank, occupation, and pay increments (ranging from about $4,337/month for a Private to over $29,000/month for senior officers).


Military Factor Compensation: Active pay includes a built-in "Military Factor" percentage (e.g., 8% to 20%+) to compensate for 24/7 availability, personal liabilities, and operational separations.
Allowances & Benefits: Active personnel receive active-duty specific perks like the Mobility Allowance for postings, environmental/field allowances, and comprehensive military health and dental care.


Pensions: Active members accrue service time toward an ongoing Canadian Armed Forces Pension Plan. 

 

 


Veterans Pay & Benefits (Veterans Affairs Canada) All subject to approval by VAC

It must be pointed out here that not all veterans are approved and therefore entitled to these compensations.

Income Replacement Benefit (IRB): Replaces active salary if a veteran has a service-related illness or injury impacting their ability to earn a living, providing 90% of their gross pre-release military salary.


Pain and Suffering Compensation: Monthly or lump-sum payments ranging from $70.99 to $1,419.82 monthly (or up to $461,956.71 lump-sum) depending on the assessed percentage of a service-related disability.


Additional Pain and Suffering Compensation: Tax-free monthly stipends between $617.31 and $1,851.93 for severe and permanent disabilities that create barriers to career progression or re-establishment.


Education and Training Benefit: Veterans can access up to $50,569.97 (6 years of service) or $101,139.94 (12 years of service) for post-secondary education or retraining. Which has to be completed within the first 2 years after release.


Canadian Forces Income Support (CFIS): A monthly income top-up for low-income veterans or survivors (e.g., up to $2,131.63 monthly for an individual veteran). 

 

 


Key Comparison Summary


Feature
Active Duty Member Pay
Veterans Pay (VAC)

Source
Department of National Defense
Veterans Affairs Canada

Nature of Income
Regular salary based on rank and trade
Compensation, pension, or injury-related income replacement

Work Requirement
Active full-time service, readiness, and duty
Post-service life, medical rehabilitation, or retirement

Health Support
Full military-provided medical/dental coverage
VAC-managed health programs, rehab, and disability awards

DIFFERENCE IN COST FOR THE Public Service Healthcare Plan (Canada Life coverage)

 

Active Duty Service Members

Extended Health Care & Hospital Level I: The Government of Canada pays 100% of the cost for active duty Canadian Armed Forces members. 


Hospital Level II or III: Members only pay out-of-pocket if they voluntarily upgrade their daily hospital room allowance. Monthly member contributions for regular force upgrades range from $1.63 to $4.01 monthly (depending on single or family and level). 


Senior Officers / Executives: Designated senior ranks or executives may receive higher hospital levels (such as Family Level III) 100% employer-paid. 

 

Veterans / Pensioners

Extended Health Care (Supplementary): Retired members and veterans with supplementary coverage share the cost 50/50 with the employer. Monthly pensioner contribution rates range from $76.32 to $99.54 monthly for single coverage and $169.12 to $198.49 monthly for family coverage (effective April 2026). 


Hospital Level I: The employer continues to pay 100% of the Hospital Level I portion for retired members. 


Hospital Level II or III: Retired members choosing higher hospital coverage levels are responsible for 100% of the additional hospital upgrade expense. 


Relief Provision: Low-income pensioners or those receiving the Guaranteed Income Supplement (GIS) qualify for a reduced 25:75 cost-sharing split on the extended health portion (ranging from $38.16–$61.38 single or $84.56–$113.93 family). 


Side-by-Side Comparison


Feature / Coverage Component
Active Duty Service Member
Veteran / Pensioner (Supplementary)

Extended Health Provision (EHP)
$0.00 (Employer pays 100%)
50% shared with employer ($76.32–$198.49/mo)

Hospital Level I ($90/day)
$0.00 (Employer pays 100%)
$0.00 (Employer pays 100%)

Hospital Level II ($170/day) or III ($250/day)
Member pays small monthly upgrade ($1.63–$4.01/mo)
Member pays 100% of the hospital upgrade cost

Low-Income / Relief Option
N/A
25:75 cost-sharing available if eligible for GIS

So to sum all of this up..............

An active duty service member

 makes 100% of their pay

pays out zero for themselves and next to nothing for their family

A veteran 

No longer makes 100% of their pay

pays out a SIGNIFICANTLY larger amount of money for their own benefits, and that of their family members.

HOW DOES THIS MAKE SENSE?

Within the framework of Canadian values, our veterans deserve a healthcare system that genuinely meets their needs. By reforming the medical, vision, and prescription coverage offered, we can honor their service with due respect. Specific steps include:

1. Implementing a comprehensive healthcare package specifically for veterans and their family, covering all essential medical services without out-of-pocket expenses or a monetarily significantly decreased amount.


2. Extending full vision care coverage to include annual exams and necessary eyewear without financial burden.


3. Ensuring all necessary prescription medications are fully covered, acknowledging the particular health requirements veterans face.

 

By addressing these issues, we not only improve the quality of life for veterans but also uphold the integrity and gratitude we hold for their service. It's time to demand action from our policymakers to commit to these changes.

Join me in urging the Government of Canada and Veterans Affairs to reform the healthcare coverage for our military veterans. They gave their all; now it's time for us to give them the healthcare they deserve. Please sign this petition to make a difference in the lives of those who have served our nation.

The Decision Makers

General Jennie Carignan
Chief of the Defence Staff
Mark Carney
Prime Minister of Canada
David J. McGuinty
Minister of National Defence
Jill McKnight
Minister of Veterans Affairs, Canada

Petition Updates