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Canada Free Healthcare: Health Benefits for Manitoba Public Health Insurance

on 9 Jun, 2019

Are you a resident of Manitoba or about to move to Manitoba?

Like all Canadian permanent residents and citizens, you have access to Canada’s free healthcare program. In Manitoba, the Health, Seniors and Active Living department run the Insured Benefits Branch, which deals with health care coverage.

Manitoba’s healthcare coverage differs from the coverage you get elsewhere in Canada. Like all provinces and territories, Manitoba pays for all essential care from physicians and hospitals. However, the way it deals with ophthalmology, chiropractic care, and prescription drugs is unique.

Ready to learn more about what kind of coverage you receive in Manitoba? We break down Manitoba’s free healthcare program here.

Who Qualifies for Manitoba Public Health Insurance?

Do you want to sign on to the public health insurance plan in Manitoba?

All Canadian citizens, permanent residents (and applicants), and refugees receive healthcare under the Canada Health Act.

To enroll in Manitoba’s program, you need to live in Manitoba. If you are new to the province, your coverage begins “on the first day of the third month” after you arrive.

For example, if you arrive on May 29, then May counts as your first month of residency. From there, you’ll wait through June and July. The first day you are eligible for Manitoba Public Health insurance is August 1.

How to Apply for Insurance in Manitoba

When you meet the residency requirements, you are free to apply.

To do so, you’ll need three documents:

You can fill out the Manitoba Health Card registration form online via the link provided above.

What Does Manitoba Public Health Insurance Cover?

Manitoba’s public insurance comes from the Benefits Branch of the Manitoba Health, Seniors, and Active Living department.

Like other provinces and territories, Manitoba must cover a minimum amount of services as provided in the Canada Health Act.

You receive coverage for:

  • GP and hospital services
  • Ophthalmology
  • Chiropractors
  • Dental surgeons

Here’s what the program covers and what it expects you to pay.

GP and Hospital Services

You’ll never get a bill when you visit a covered physician, and if you receive an insured service from a physician outside the plan, you can ask for reimbursement.

If you need hospital testing services, then you are covered for diagnostic, laboratory, and x-ray imaging procedures carried out within the hospital.

Manitoba also covers your accommodations and meals as well as necessary nursing services. The hospital won’t bill you for operating room procedures and related costs like routine surgical supplies.

When you leave the hospital, you also have access to insured occupational therapy, physiotherapy, and speech therapy. The province also provides dietetic counseling.

Ophthalmology

If you are 19 and under or 65 or over, then you receive a routine complete eye exam as part of your Manitoba health coverage. You can get one review in a two-year benefit period.

For other residents, eye exams only count for coverage when deemed medically necessary. Your eye care provider makes this designation based on the exam itself.

Outside of these conditions, Manitoba residents must pay for their ophthalmology coverage.

Manitoba also covers the following tests when required:

  • Dilated fundus exam
  • Full threshold visual fields test
  • Tonometry test

The province does not pay for prescription eyewear or any other routine eye care unless it falls under the realm of a medical condition, such as diabetes.

Chiropractors

Manitoba residents receive seven covered visits to the chiropractor each year.

Not all chiropractic services receive funding. Only chiropractic adjustments count. If your chiropractor also offers massage or acupuncture, then you must pay for those services yourself.

Dental Surgeons

As in other provinces, major dental surgeries that require hospitalization fall under the coverage umbrella.

Any dental issues taken care of outside the hospital setting are not covered.

Does Manitoba Cover Prescription Drugs?

Each province creates a unique prescription drug program. In Manitoba, the program is “Pharmacare.”

The provincial Pharmacare drug benefit program covers all eligible Manitobans without discriminating against age. Your contribution to the cost of your prescription drugs depends on your family income and the price of the drug.

Everyone must pay a portion of the cost of their drugs each year via the annual Pharmacare deductible. The province calculates your deductible according to your family income, which it adjusts according to your marital status and number of dependents.

Not all drugs benefit from coverage. You can find a list of the drugs covered through the Manitoba Drug Benefits and Interchangeability Formulary, which outlines the high-quality, therapeutically effective drugs eligible for the program.

If you don’t yet use the program and you want to know how much your current prescriptions will cost, we recommend using the following tools:

These programs will show whether the provinces pay for your drugs, what you might expect to pay, and how to make the deductible more affordable.

Keep in mind that the price of prescription drugs does not include the dispensing fee. The dispensing fee varies from city-to-city and pharmacy-to-pharmacy. The fee covers the administrative cost of storing and dispensing the medication to the client.

At present, pharmacies have the liberty to charge up to $30 per prescription regardless of the value of the drug.

Manitoba covers the fees on drugs covered by Pharmacare as well as the Home Cancer Drug Program and Palliative Care Drug Access Program.

It is important to note that Manitoba does cover the cost of prescription drugs for cancer when the patient is eligible for CancerCare Manitoba. This differs from provinces like Ontario, where patients must apply for coverage for oral cancer and other supportive drugs.

Does Manitoba Cover Long-Term Home Care?

In Manitoba, long-term care homes, like nursing homes, are known as “personal care homes.” Manitoba offers coverage for long-term and skilled care, but the system faces significant demand. It continues to meet that demand by benefiting from the highest rate of beds per 1,000 people over 75 in all of Canada.

However, as retirees know, offering enough beds is only a small part of the broader answer. Costs are also a massive part of access to care.

If you can no longer remain at home as a result of health care needs or a disability, then Manitoba pays for part of your personal care. The services include:

  • Activities of daily living (ADL) assistance
  • Nursing care
  • Routine medical supplies
  • Meals (including special diets)
  • Laundry and linen services
  • Physiotherapy

However, the funding you receive depends on your residency and your income.

Personal Care Residency Qualifications

To qualify for personal care home funding, you need to live in Manitoba for 24 consecutive months before you are eligible. If you were a former resident of the province and you lived there for 30 years or more, then there is no waiting period.

Additionally, if you were a resident of another province for the previous five years and can provide your health care card, then you can access the services right away.

New residents who require personal home care will pay an extra fee if they need the service right away.

How Much Do Personal Care Homes Cost?

For those who qualify, Manitoba Health, Seniors, and Active Living split the cost of personal care home services with those who require the services. If you need these services, you’ll receive funding from the department via your regional health authority.

What will you pay for personal home care? It depends on your residency and your income. All personal home care recipients pay a daily income-based charge. The charges may increase year-on-year as the cost of care grows, even when there’s no change to the patient’s income.

As of 2018, the minimum rate for care is $37.90 per day. Clients pay a maximum of $88.50 per day.

Manitoba provides a full breakdown of the residential charges in increments of $0.10.

To qualify for the lowest daily rate, you must make between $0.00 and $18,069.99 per year after tax if you are single or widowed. Married or common-law partnerships have a combined net income of $0.00 to $56.301.99 after tax.

If you are single/widowed/divorced and you make $36,502.50 or more after tax, then you will qualify for the maximum daily contribution of $88.50. The number jumps to $74,734.50 and over for residents with a spouse or partner.

Canada’s Free Healthcare: Paying for Care in Manitoba

Manitoba upholds Canada’s free healthcare with its own program. It covers all essential and emergency care free of charge for all residents of the province. However, there are gaps in the coverage.

Ophthalmology services are only partially covered, and dental services aren’t covered at all, except for major surgeries performed in hospitals. Although these services are often annual affairs, they can become costly if your eye or oral health changes.

Then, there is the cost of long-term care, which will continue to grow as the Manitoba health service experiences more pressure.

Private insurance, like health, dental, and life insurance, can help cover those unexpected costs. Click here to see our guide to insurance products to see how insurance can add certainty to your life.

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