Children's H ealth C are

1. Children's Health Care By: Aidos, Ashley & Jackson

2. What is This Presentation About • This presentation will discuss the various differences between the access of different forms of health care in Canada, Ontario & Oakville, for the average person or child, with or without health care insurance.

3. General Health Care in Canada In Canada we have a national health insurance program, most commonly known as “Medicare”. This national program is made up of 13 interconnecting provincial and territorial health insurance plans. All share common features and basic standards of coverage, that are enforced by the CHA or Canada Health Act. Simplified this means that if you live in Canada, many of the health care services you require are publically funded. This means that the government pays all or part of the cost for you.

4. How is Medicare paid for in Ontario? • To pay for Medicare/healthcare services, Ontario has the OHIP or the Ontario Health Insurance Plan. When Ontario Citizens pay their taxes part of that money goes into this plan to help pay for their health care services when they become necessary. • If you do not qualify for OHIP however, you must pay for your own health costs or buy private health insurance. With private insurance though you must pay a monthly fee. You may still however purchase private health care even if you are qualified for OHIP to help pay for some services that OHIP does not cover.

5. Medicare Covered Services • Services that you are entitled with, with Medicare include: • Visits to your family doctor • Most basic & emergency health care services, • including surgery and hospital stays • Physicians • Other health care providers such as physiotherapists will be partially covered by OHIP you must however pay yourself any additional costs • Dental services when done in hospital (only surgeries are covered, otherwise you must pay the cost of regular dental services in a dentists office) • Eye care or once a year visits to the optometrist for those who are under 20 or 65 and over. • OHIP WILL NOT pay for services that are not medically necessary such as cosmetic surgery.

6. Physical Health Care in Canada • Canada’s provinces and territories provide • coverage to certain groups of people • (e.g., seniors, children and social • assistance recipients) for health services • that are not generally covered under the • publicly funded healthcare system. Some • of the things that the supplementary • health benefits often include prescription • drugs, dental care, vision care, medical • equipment and appliances (prostheses, • wheelchairs, etc.), independent living and • the services of allied health professionals, • such as podiatrists and chiropractors.

7. Dental Care in Canada • In Canada Dental care is not free and is only covered by yourself or insurance. • For those who in no way afford OHIP or Private insurance, you can ask your • dentist about a payment plan. If you cannot afford a payment plan • then your best option is to contact their the nearest: • Social services agency to see if you qualify for government-funded • dental care. Or… • Dental school where senior dental students provide treatment at • reduced cost. • It is also important when going to any form of dentistry or even service • that you know exactly what you should be paying on average before • going to see anyone. CBC’s Market Place found after going under cover • with a woman known as Theresa who needed some type of treatment • for nearly all her teeth. They went to over 20 dentists to ask their • opinion on what she needed done and how much it would cost, Market • place said that “By the end, the dentists had recommended • treatments covering 19 different teeth, ranging from nighttime mouth • guards to veneers promising a ‘complete smile makeover,’ with cost • estimates ranging from $144 to $11 931.” (CBC News 1) This shows • how depending where you go the price that they may charge you could • be blown way out of proportion to the realist cost that you should have to pay.

8. NIHB • The Non-Insured Health Benefits Program (NIHB) however do have a • policy on Dental Crowns. In short, if you meet their criteria they will • fix your teeth (only by either giving you artificial teeth replacements, • or crowns) but they will not cover a general check-up visit to the • dentist. They will only consider coverage for a crown when this • criteria have been met: • -All crowns require a predetermination. • -There is a frequency limitation of one (1) crown in any three (3) • year period per client. • -Only single unit metal or porcelain-fused to metal crowns are • eligible under the NIHB Program. • -Porcelain/ceramic crowns, including fortified/reinforced • porcelain/ceramic crowns, are not a covered benefit under the • NIHB Program (exclusions). • -All basic treatment addressing any existing active biological disease • (caries and periodontal), must be completed before submitting • requests for crowns.

9. Dental Care Program Eligibility To be eligible for NIHB Program benefits, a person must be a Canadian resident and have the following status: -a registered Indian according to the Indian Act; or -an Inuk recognized by one of the following Inuit Land Claim organizations - Nunavut Tunngavik Incorporated, Inuvialuit Regional Corporation, Makivik Corporation. For an Inuk residing outside of their land claim settlement area, a letter of recognition from one of the Inuit land claim organizations and a birth certificate are required; or -an infant, less than one year of age (1), whose parent is an eligible client; & -is currently registered or eligible for registration, under a provincial or territorial health insurance plan; and -is not otherwise covered under a separate agreement (e.g. a self government agreement) with federal, provincial or territorial governments. The following are excluded from the NIHB Program: -First Nations and Inuit clients incarcerated in a federal provincial/territorial or municipal corrections facility;   -First Nations children who are in the care of a provincial/territorial social service agency; and -Those individuals who are in a provincially/territorially funded institutional setting, such as nursing homes.

10. Ontario Health Care • Many of Ontario’s Health • Care coverage and policies • (OHIP) are the same as • Medicare. There may be • slight differences between • provinces. In Ontario all pre- • Stated information about • Medicare coverage applies.

11. Conditions of OHIP Coverage in Ontario • The General Policies of the government of Ontario require that a resident of Ontario must have a health card to show that he or she is entitled to health care services paid for by OHIP. The Ministry of Health and Long-Term Care will pay for a wide range of health services for eligible residents, however, they will not pay for services that are not medically necessary, such as cosmetic surgery. • To be eligible for Ontario health coverage you must :-be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act; and-be physically present in Ontario for 153 days in any 12-month period; and-be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and make your primary place of residence in Ontario. • - For children if you are born in Ontario and you have OHIP eligible parents then you get OHIP health insurance.

12. Mental Health Care in Ontario In Ontario there is CMHO which stands for Children’s Mental Health Ontario. CMHO represents and supports the providers of child and youth mental health treatment services throughout Ontario. Their core membership consists of over 85 accredited community-based children’s mental health centresthat serve some 150,000 children and their families annually. Services are provided at no cost to clients.

13. Health Care in Oakville • All information about • health care in Ontario • applies to Oakville. The • following section will mainly • talk about some of the • good choices for local • health care help centres • that are available, and • what kind of services/ • programs they offer.

14. Mental Health Care in Oakville One of the best places in Oakville for people to access mental health care is The ROCK children's mental health centre. It offers free mental health care provided by the government for infants, children, youth & their families. People are accepted from birth to 18 and up to people of 21. This Centre is licenced annually by the ministry of community and social workers.

15. Health Care Services in Oakville This is a list of some of the many of places where you can access health care services in Oakville: Your closest Walk-in/After Hours Clinic (in non-emergency situations) Emergency Room (for emergency/life-threatening situations) Public Health Unit (provides health promotion information and disease prevention programs) Family Health Care Provider (provides ongoing health care and familiarity with patient history) Urgent Care Centre (for the treatment of serious but not life threatening illnesses and injuries) Community Health Centre (provides non-emergency health care and health promotion programs for individuals, families and those who are not covered by OHIP)