Partially Covered Services

Health coverage in Saskatchewan covers only a part of the cost for the following services. You will be responsible to pay the amount that is not covered.

Air Ambulance Service

The province's Critical Air Ambulance Program consists of the Saskatchewan Air Ambulance (SAA) fixed-wing service and the Shock Trauma Air Rescue Service (STARS) rotary-wing program. Both SAA (also called Lifeguard) and STARS provide air medical flights for critically ill/injured patients. For both fixed-wing and rotary-wing flights, patients with valid health services cards are charged a flat fee of $465 per trip, while third party insurers and out-of-province residents are charged per flown mile. When transported by fixed-wing and rotary-wing, the patient may also receive a ground ambulance bill to/from the airport/hospital.

The patient charge is waived for beneficiaries of the Supplementary Health Program or Family Health Benefits Program, and for eligible Seniors who are transported by air as part of an inter-facility transfer within the province.

Note: The Saskatchewan Ministry of Health does not pay for the return of Saskatchewan residents who have a medical emergency outside the province or outside Canada. Residents are strongly encouraged to obtain travel or health insurance to cover unforeseen costs including emergency care and transportation when travelling outside the province or outside Canada.

Senior Citizen's Ambulance Assistance

Under the Senior Citizens' Ambulance Assistance Program (SCAAP), eligible Saskatchewan seniors aged 65+ pay a maximum of $135 per trip for ground ambulance services within the province and inter-facility transfers within the province are fully covered.

Home Care

The Saskatchewan Health Authority provides home care for free in Saskatchewan, including:

• Case management and assessment;
• Home nursing; and
• Physical and occupational therapy service.

There is a fee to cover part of the cost of the following services, based on a person's income and the amount of services they receive:

• Homemaking, including personal care, respite, and home management services;
• Meals; and
• Home maintenance.

Private home care services are not covered, such as private homemaking and private home nursing agencies.

Long-Term Care

Provincial funding to the Saskatchewan Health Authority covers a major portion of costs for long-term care in special care homes (nursing homes), health centres, and hospitals. However, each resident also pays a resident charge based on income.

Individuals admitted to a long-term care facility that are assessed as Level 1 must pay the full cost of services.

Charges for personal care homes (residential facilities that provide adults with accommodation, meals, and help with personal care) are not covered.

Dental services

In Saskatchewan, routine dental services are not covered. The Ministry of Health does cover the following:

• Limited oral surgery procedures required to treat certain conditions that may be caused by accidents, infection, or congenital problems.
• Limited orthodontic services for cleft palate when referred by a physician or dentist.
• Extractions of teeth in limited circumstances, such as when medically required before undertaking certain surgical procedures related to the heart, chronic renal disease, head or neck cancer, total joint replacement by prosthesis, stem cell transplants and within 15 years of specific cancer radiation treatment where recommendations from the radiation oncologist and dentist have been followed.
• Dental implants are covered in exceptional situations where no other method of treatment is appropriate. Coverage is limited to circumstances related to tumours and congenital defects (cleft palate and metabolic disorders). Coverage will require a specialist in oral maxillofacial surgery to submit a written request for prior-approval from the Ministry of Health. The specialist must include detailed information and rationale to support the request. Coverage is limited to the initial cost to provide dental implants and does not extend to ongoing maintenance costs. Dental implants for trauma, post-surgical temporomandibular joint disorder (TMJ) or cosmetic purposes will not be covered.

Optometric services

An annual eye exam is covered for:

• All individuals under 18 years of age;
• All individuals who have a confirmed diagnosis of type 1 or type 2 diabetes; and
  *Note: Routine follow-up exams are not covered.
• Ocular emergencies are covered e.g. injury to eyes, foreign body in eye, etc.
  *Note: Follow-up exams are covered for ocular urgencies/emergencies.

Prescription Drugs

The Drug Plan provides coverage to eligible Saskatchewan residents for listed drugs prescribed outside Saskatchewan hospitals.

You are eligible for drug coverage if you:

• Receive Supplementary Health Program benefits;
• Receive special benefits from the Saskatchewan Aids to Independent Living (SAIL) program, where coverage is limited to people registered with SAIL's Paraplegia, Cystic Fibrosis or End Stage Renal Disease programs; and
• Qualify for palliative care.

Covered drugs are listed in the Saskatchewan Formulary. Ask your physician whether the drug prescribed for you is included in the Formulary.

The Special Support Program can help reduce drug costs for residents with low incomes and for families who have high drug costs in relation to their income.

• The program is available to those whose annual covered prescription drug costs exceed 3.4 % of their annual adjusted income; and
• The Drug Plan adjusts family income by deducting $3,500 for each dependent child under 18 years of age.

Families or individuals pay a reduced portion of drug costs if they receive Guaranteed Income Supplements, Saskatchewan Income Plan, or Family Health Benefits.

Saskatchewan Aids to Independent Living (SAIL) Program

Saskatchewan residents with a long-term physical disability may be eligible to receive services, equipment and supplies from the SAIL program including:

• Free loan of mobility aids such as wheelchairs and walkers and other aids such as hospital beds and transfer assists;
• Financial assistance for home oxygen and aerosol therapy;
• Artificial limbs and braces; and
• Aids including magnifiers, talking book machines and Braille watches.