A-29, r. 4 - Regulation respecting devices which compensate for a physical deficiency and are insured under the Health Insurance Act

Section 51 Disposition versions

2012-09-01

51. Notwithstanding section 38, a manual wheel chair, a lightweight manual wheel chair or any of their components or supplements appearing on a list in the Tariff are insured only if they are furnished in the following cases:

(1)  to a hemiplegic insured person with a posture or balance disorder;

(2)  to a paraplegic insured person;

(3)  to a quadriplegic insured person whose injury is located at a level other than levels C3-C4, C4-C5 or C5-C6;

(4)  to an insured person who has sustained a bilateral femoral or bilateral coxofemoral amputation or a bilateral hemipelvectomy;

(5)  to an insured person with a permanent loss of function of the lower limbs, in cases of spastic disorders, ataxy and athetosis; or

(6)  to an insured person with functional disorders that permanently prevent the use of the lower limbs;

(7)  to an insured person with a degenerative deficiency of the musculoskeletal system, who already has a device allocated under section 53 and who requires a manual wheel chair or a lightweight manual wheel chair to maintain his residual abilities, which allow him nonetheless to use such a wheel chair independently.

For an insured person referred to in subparagraph 7 of the first paragraph, and notwithstanding section 38 and the first paragraph, only a manual wheel chair or a lightweight manual wheel chair having been returned to an institution in accordance with the second paragraph of section 57 is insured.

Notwithstanding section 38 and the first paragraph, where such insured person already owns a manual wheel chair or a lightweight manual wheel chair for which the Board has already assumed the purchase or replacement cost, that wheel chair is insured without having been returned to an institution.

Only fitting and repair services for such wheel chairs and their components or supplements furnished in the same cases are insured.

In addition, where an insured person referred to in subparagraph 7 of the first paragraph agrees to have the Board assume responsibility for a manual wheel chair or a lightweight manual wheel chair belonging to him on 12 November 1998 but for which the Board has not assumed the purchase or replacement cost, fitting and repair services for such wheel chair and its components or supplements are insured.

The Board shall assume responsibility only for a wheel chair that is similar to a wheel chair appearing on a list in Subdivision I or II of Division I of Part I of the Tariff, that complies with the requirements of section 41 and that meets the requirements of the first paragraph of section 45.

O.C. 612-94, s. 51; O.C. 1334-98, s. 24; Decision 001-2009, s. 24.