Remicade) are also used to treat
rheumatoid arthritis, which
is a health condition already
subject to the Enhanced Special
Authorization process.
Beginning July 1, 2018,
semi-private and private
hospital room coverage was
raised to mirror increases to
charges implemented by Alberta
Health, eff ective July 1, 2018.
The ARTA Retiree Benefi ts
Plan now covers semi-private
hospital room charges at one
hundred per cent up to $150 per
day and private hospital room
charges at one hundred per cent
up to $187 per day. Coverage for
long-term hospital rooms was
also increased as of July 1, 2018.
Usual and customary charges
have been updated to refl ect
the claims for medical aids,
devices, and services submitted
over the past year. When usual
and customary fees for the most
common medical aids, devices,
and services were originally
implemented on November 1,
2017, the ARTA Health Benefi ts
Committee made a commitment
to review these charges on an
annual basis to ensure they
continue to be relevant based
on the marketplace. In addition,
the list of usual and customary
fees has been expanded for
paramedical practitioners based
on the type of claim submitted;
for example, the plan now has
separate allowable maximums
for acupuncture assessments
and for acupuncture
treatments, whereas the
plan originally had only one
allowable maximum, no matter
the type of claim submitted.
Along with ensuring that most
of the claims will be covered,
the list of usual and customary
fees guarantees that claims
that are signifi cantly higher
than marketplace standards do
not introduce excess costs into
the plan.
Finally, for those members
covered under the Dental
Care benefi t, fl uoride varnish
application has been added as
a separate covered procedure
code in order to comply with the
changes to Canada’s Uniform
System of Coding and List
of Services, which separated
fl uoride varnish treatment from
fl uoride foam, gel, or rinse.
ARTA is proud to be able to
introduce the plan enhancements
with no rate change, eff ective
November 1, 2018. ARTA will
continue to review potential
plan enhancements on an
ongoing basis, while keeping
the plan aff ordable for our
covered members. ●
news&views WINTER 2018 | 11