No more waiver worry

Authority Interior Health Authority

Linda’s mother lived in a supportive housing facility and over time had come to need more and more help with daily tasks. Staff from the Interior Health Authority (IHA) told Linda they thought her mother should have help with taking her medications but Linda had been concerned about how much this would cost. IHA staff told her that her mother could apply for a waiver, which if approved, would mean that IHA would cover these costs. Staff assured Linda that her mother would be eligible for this coverage. Linda prepared the waiver application and meanwhile, IHA staff began helping her mother take her medications.

Linda started to worry when she received invoices for the medication services, but IHA staff assured her she just needed to wait for the application to go through. The invoices kept coming and the amount due continued to grow. When she didn’t hear anything, Linda submitted the paperwork a second and third time. IHA would not confirm the waiver was approved and by the time she called us, Linda was getting collection calls. The bill had grown to more than $5,000 – much more than Linda’s mother could afford on her limited income.

When Linda called us about her mother’s situation we began an investigation. We contacted a manager at IHA. He confirmed that IHA staff had assured Linda that the application would be approved, but when the paperwork was processed it turned out that her mother’s expenses were not considered large enough to justify the waiver. The manager said that he wanted to remedy the problem and asked for some time to figure out how to do this.

The manager found a solution. He explained that IHA had recently reviewed and revised its interpretation of a ministry guideline on how to deal with expenses when determining eligibility for a waiver. IHA applied this new interpretation method to Linda’s mother’s situation retroactively, which resulted in the cancellation of almost the entire debt. It decided to write off the small amount of debt that remained. The manager said that the new way of calculating eligibility meant that medication services for Linda’s mother would also be covered in the future. The new method would also make it easier for others to qualify for a waiver. Linda was happy with how things had worked out. By the time the issue was resolved the bill had reached approximately $6,500, which was reduced to zero and she no longer had to worry whether her mother’s medications were administered safely. She thanked us for our help.

Category Health, Seniors
Type Case Summary
Fiscal Year 2010
Location The Interior