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Treatment Benefits

VACTreatment and healthGenerally non-taxable

You don't need to understand every program before taking the next step.

In one sentence

Treatment Benefits provide eligible Veterans with coverage for authorized health-care products and services.

Who this is usually for

You may wish to explore this program if the following appear relevant: A disability-benefit recipient may receive coverage related to the entitled condition.

What it may help with

Medical and related health services.
Prescription medication and supplies.
Dental, hearing and vision services where eligible.

2 min read·Preparation time varies by situationScroll to explore, or reach out if you are unsure

What is this?

Treatment Benefits provide eligible Veterans with coverage for authorized health-care products and services. Coverage is organized through Programs of Choice, including aids for daily living, ambulance, hearing, dental, medical services, supplies, nursing, oxygen, prescription drugs, prosthetics and orthotics, related health services, special equipment, vision and health-related travel. Eligibility and coverage depend on how the person qualifies, the entitled condition, clinical need, benefit-grid rules and authorization requirements.

Coverage depends on VAC eligibility, recognized conditions, the applicable Program of Choice, provider requirements, treatment limits, and any required pre-authorization. A clinician’s recommendation does not automatically confirm VAC coverage.

Never confirm coverage before checking the grid and authorization.

Why someone might look at this benefit

You have been approved for a VAC disability benefit.

You need treatment, medication, equipment or travel related to an entitled condition.

A provider says authorization is required.

A claim was declined and you need to understand the reason.

You are releasing and need to understand the transition from CAF health coverage.

Who might qualify?

You may wish to explore this program if the following appear relevant: A disability-benefit recipient may receive coverage related to the entitled condition. Some people qualify through Mental Health Benefits, , War Veterans Allowance or -supported long-term care. Serving CAF or RCMP members generally receive health coverage through their serving organization. Specific products or services may require prior authorization and clinical justification. Only Veterans Affairs Canada / Medavie Blue Cross or the legally responsible decision-maker can determine eligibility.

Only the responsible organization can determine eligibility.

What this benefit may help with

Medical and related health services.

Prescription medication and supplies.

Dental, hearing and vision services where eligible.

Aids, prosthetics, orthotics and special equipment.

Nursing and related health services.

Eligible health-related travel.

Where this may fit in your transition

Stage 6 Stage 7 Stage 9

See the full Veterans Transition Roadmap

Typical process

Confirm the VAC health card and Program of Choice; get pre-authorization where required.

Confirm eligibility and the health condition or program supporting coverage.

Check the current VAC benefit grid or contact Medavie before obtaining the service.

Obtain a prescription, referral or clinical rationale where required.

Request pre-authorization when required.

Use direct billing where available or submit the approved claim.

Keep receipts, prescriptions, authorizations and explanations of benefits.

If you receive a decision

Limits, provider rules and pre-authorization can apply.

• Entitlement — whether the condition is related to service
• Assessment — the severity or percentage rating
• Effective date — when the benefit starts
• Calculation — how the amount was determined
• Approved services — what is covered and for how long
• Frequency or dollar limit — caps on treatment or services
• Reasons for denial — the specific basis for the decision

Every situation is different. Timelines vary based on the organization, the complexity of the application, and the volume of requests being processed.

What usually happens next

Application received

The organization typically sends a confirmation that your application was received.

Information requests

They may ask for additional medical, service, or financial records to support your application.

Review

A decision maker reviews your application, the evidence provided, and the applicable program rules.

Decision

You receive a written decision explaining the outcome, the reasons, and any review rights.

If approved

Benefits begin according to the program rules and the effective date stated in the decision.

If not approved

The decision letter explains why and describes your review or appeal options, including any deadlines.

Reassessment

If your condition or circumstances change, you may request a reassessment of the decision.

Reviews and appeals

Depending on the issue, you may request a departmental review or a hearing before the Veterans Review and Appeal Board.

Every situation is different. Timelines vary and are not guaranteed.

Evidence that may help

Prescription/referral

diagnosis

treatment plan

quote

prior authorization

receipts.

Not every document is required for every application. This list is for general awareness only.