Lymphedema: 5 points about reimbursement

Living with lymphedema affects people with the condition to varying degrees. Recommended treatments include bandaging and compression garments. While there is still a long way to go to support people with lymphedema, we can be pleased that the program associated with lymphedema treatment supplies has been enhanced.

 

How do you recognize lymphedema?

Lymphedema is a disorder of the lymphatic system that often manifests itself as a feeling of swelling or heaviness, less flexibility in movement, sudden or gradual swelling. You may notice hard, tight skin that marks easily under pressure and is accompanied by severe pain. You may also have difficulty putting your limbs into your clothes. Lymphedema can be primary in nature, which is present at birth, or secondary, which appears in adulthood, either naturally or as a result of trauma such as breast cancer. When in doubt, it is important to consult a physician.

 

The RAMQ coverage program

1. Greater accessibility

Anyone diagnosed with lymphedema by a physician and covered by the Quebec public health insurance plan (RAMQ) is now eligible.

2. Adults: up to 75 % reimbursement

The new version of this program allows for a 75% reimbursement of the purchase cost for people 18 years of age and older, up to the maximum amount established. Therefore, the maximum number allowed for 18 years and older for 12 months has increased to:

• 1 set of multi-layer bandages
• 3 daytime elastic compression garments
• 1 non-elastic compression garment
• 1 night-time compression garment
• 1 compression garment accessory

3. Children: 100 % reimbursement!

For those under 18 years of age – and for those receiving the JobLink program or last-resort financial assistance – reimbursement is now up to 100 % of the purchase cost, up to the established maximum amount. In addition, the number of supplies allocated for children each year continues to be doubled and they will no longer have to wait 6 months between purchases.

To see all the details of the enhanced program, click here or here.

4. How do I apply?

For each member with lymphedema, you must obtain a medical prescription that clearly states

• The diagnosis of lymphedema
• The side(s) affected (right or left)
• The affected body part(s)

5. Pay only the difference

With your prescription in hand, go to your compression garment provider. For providers who have signed an agreement with the RAMQ, such as CEO Médic, the RAMQ will reimburse the portion covered by the program.