news&views Winter 2022 | Page 10

Health Benefits

Gary Sawatzky | Chief Operating Officer , ARTA

Changes to the ARTA Benefit Plans Effective November 1 , 2022

Each year the ARTA Health Benefits Committee reviews potential changes to the ARTA Benefit Plans . These potential changes often arise when covered members submit change requests to the Health Benefits Committee for consideration . Each of these requests is reviewed to determine if a group benefit plan such as ARTA is allowed to cover the service or device and to make certain a significant number of members would benefit from the coverage change . Additional changes are then considered to ensure the plan continues to provide the best benefits available to ARTA members .
The following changes became effective November 1 , 2022 , for all members covered by the ARTA Extended Health Care plan : 1 . Transport wheelchairs are now covered under the current manual wheelchair benefit . A transport wheelchair differs from a regular wheelchair in that standard wheelchairs are designed with large wheels so that people can propel themselves , while transport wheelchairs have small wheels and are meant to be pushed from behind by a second person .
2 . Occupational therapists were added to the list of eligible paramedical practitioners . The Health Benefits Committee received several requests over the past year to consider adding coverage for these practitioners as they expand the services they offer , which have historically been available primarily through each province ’ s public health care plans .
3 . Supplies for insulin pumps ( including sensors and transmitters ) have been re-allocated from the four-year insulin pump supplies benefit to the annual diabetic supplies benefit . Often if a member needed to purchase an insulin pump , they did not have any coverage remaining for supplies for the next four years . This change allows members who have purchased an insulin pump through the plan to take advantage of the annual diabetic supplies maximum to cover their sensor costs .
4 . The annual maximum for support stockings has been increased from $ 200 to $ 250 .
5 . Coverage for Xenical , a weight-loss medication , which was only covered under the Health Wise Plus and Ultimate Health plans , is no longer covered given the prevalence of more effective weight-loss medications in the marketplace . Members who are currently using Xenical will have their coverage grandfathered .
6 . Usual and customary charges for a few devices and services were updated to reflect actual charges in the marketplace .
Earlier this year — April 1 , 2022 — the following change became effective in ARTA Dental Care plans :
● The basis of payment was updated to be the current Alberta Dental Association & College Fee Guide .
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