A-29, r. 3 - Regulation respecting insured visual aids and related services

À jour au 1^er septembre 2012

Ce document a valeur officielle.

chapter A-29, r. 3

Regulation respecting insured visual aids and related services

Health Insurance Act

(chapter A-29, ss. 3 and 69).

O.C. 1403-96; O.C. 470-2011, s. 1.

CHAPTER I GENERAL

O.C. 470-2011, s. 2.

0.1. In this Regulation, the word “tariff” refers to the Tariff for insured visual aids and related services (chapter A-29, r. 8.1), made by the Régie de l’assurance maladie du Québec under section 72.1 of the Health Insurance Act (chapter A-29).

O.C. 470-2011, s. 2.

1. A service or a visual aid referred to in this Regulation and supplied to a person with a visual deficiency by a recognized institution in the cases, on the conditions and in the circumstances described herein is considered insured for the purposes of the sixth paragraph of section 3 of the Health Insurance Act (chapter A-29).

The Régie de l’assurance maladie du Québec, established under the Act respecting the Régie de l’assurance maladie du Québec (chapter R-5), shall reimburse the recognized institution for the cost of such a service and for the purchase or replacement cost of such a visual aid supplied in the form of a loan by that institution.

O.C. 1403-96, s. 1; O.C. 470-2011, s. 25.

2. A person who is insured within the meaning of the Health Insurance Act (chapter A-29) and who has a visual deficiency such as to render the person permanently incapable of reading, writing, moving about in an unfamiliar environment, or carrying on activities related to the person’s lifestyle or social roles, is a person having a visual deficiency.

For the purposes of the first paragraph, visual deficiency is characterized, for each eye, after correction by means of ophthalmic lenses, excluding special optic systems and additions greater than 4 diopters, by one of the following conditions:

(1)  a visual acuity of less than 6/21;

(2)  a visual acuity equal to or less than 6/18 for persons who suffer from a degenerative visual problem, a motor, hearing or speech physical deficiency, or an intellectual deficiency;

(3)  a continuous visual field of less than 60 °, including the central fixation point measured horizontally or vertically;

(4)  complete hemianopia.

O.C. 1403-96, s. 2; O.C. 470-2011, s. 3.

2.1. A person who has a visual deficiency that, after correction by means of ophthalmic lenses, excluding special optic systems and additions greater than 4 diopters, leaves each eye with a visual acuity equal to or less than 6/120 or with a continuous visual field of less than 10 °, including the central fixation point, measured horizontally or vertically, and that, in either cases, renders the person incapable of making functional use of the visual aids of the print magnification method of communication, is functionally blind.

Despite the foregoing, a person who has fluctuating vision, a defective field of vision or sensitivity to contrast, or a degenerative eye pathology is deemed to be functionally blind if that vision, defect or pathology renders the person incapable of making functional use of the visual aids of the print magnification method of communication.

O.C. 470-2011, s. 3.

2.2. A functionally blind person who uses braille and who, by reason of a hearing deficiency, cannot resort to any sound aid to carry on daily activities is a person who suffers from deafblindness.

O.C. 470-2011, s. 3.

3. An institution recognized within the meaning of this Regulation is an institution recognized by the Minister for the purposes of the sixth paragraph of section 3 of the Health Insurance Act (chapter A-29) for the services provided and the visual aids lent in accordance with this Regulation.

O.C. 1403-96, s. 3; O.C. 1091-2011, s. 1.

CHAPTER II INSURED VISUAL AIDS AND INSURED SERVICE

O.C. 1403-96, c. I; O.C. 470-2011, s. 4.

4. For the purposes of this Regulation, a visual aid is a visual aid that is intended for a person with a visual deficiency and that is designed to compensate for the disabilities resulting from that deficiency.

A visual aid may have components, which are its constituent parts, as well as supplements, each of which consists in an accessory that is both necessary to improve the operation of the visual aid and required for permanent use.

O.C. 1403-96, s. 4; O.C. 470-2011, s. 25.

5. Subject to the conditions set out in this Regulation and provided they are subject to a tariff, visual aids falling in any of the groups or sub-groups of aids listed respectively by category and by type in Schedule I, as well as their components and supplements, are insured.

A visual aid whose maximum purchase or replacement price indicated in the Tariff is marked “SC” (special consideration) may constitute an insured visual aid in respect of a person with a visual deficiency if it is demonstrated, through a clinical and functional evaluation by a team of rehabilitation specialists from a recognized institution, that, because of a particular disability resulting from a physical or intellectual deficiency, he or she is unable to use any of the insured visual aids appearing in the list in the same division or subdivision, as the case may be, of the Tariff. A physical deficiency includes a motor, hearing or speech deficiency.

Notwithstanding the foregoing, a visual aid is an insured visual aid only if it is similar, with respect to its operation and price, to a visual aid appearing in the list in the Tariff in that same division or subdivision, as the case may be, and if, in reference to that similar visual aid, it meets the requirements of the first paragraph.

O.C. 1403-96, s. 5; O.C. 470-2011, ss. 5 and 25.

6. (Revoked).

O.C. 1403-96, s. 6; O.C. 470-2011, s. 6.

6.1. A visual aid is insured only if the following conditions are met:

(1)  the visual aid is loaned to the person with a visual deficiency to meet actual functional needs, taking into account the person’s lifestyle and social roles, insofar as no other means can meet those needs;

(2)  after training, the person is capable of using the visual aid in a functional and efficient manner.

The person’s functional needs and the visual aid’s functional and efficient use are evaluated by a team specializing in rehabilitation in a recognized institution.

For the time of the training, the visual aid used for the purposes of the training referred to in subparagraph 2 of the first paragraph is also insured, if the training may be provided only in the environment of the person with a visual deficiency.

O.C. 470-2011, s. 7.

6.2. From among the visual aids that may meet a same need, only the more affordable aid is insured.

O.C. 470-2011, s. 7.

6.3. Where a loaned visual aid accessorily meets a need other than the need for which the aid is mainly intended, only that aid is insured to meet that other need.

O.C. 470-2011, s. 7.

6.4. A new visual aid is insured only if no similar recovered visual aid is available when the visual aid is loaned.

O.C. 470-2011, s. 7.

6.5. A visual aid must be recovered by the recognized loaning institution if its use is no longer required by reason of changes in the functional needs of the person to whom the visual aid was loaned, or because the person is no longer using it or is deceased. In that respect, the recognized institution must ensure each year that the loaned visual aid is used by the person to whom it was loaned and that the loan remains justified and in compliance with this Regulation. The institution must also repair, or cause to be repaired, the visual aid as soon as it is recovered so that it is available for another loan.

A visual aid thus recovered may be loaned again as an insured visual aid, and the person to whom the aid is loaned may not choose instead a new visual aid.

O.C. 470-2011, s. 7.

6.6. The visual aids listed in Part II of Schedule I are insured only if no aid in Part I makes it possible to effectively make up for the disability of a person with a visual deficiency.

O.C. 470-2011, s. 7.

6.7. Only one visual aid of any one type is insured in respect of any one person with a visual deficiency.

O.C. 470-2011, s. 7.

7. The replacement of an insured visual aid or of a visual aid whose cost has already been reimbursed by the Board is insured, where the clinical and functional evaluation by a team of rehabilitation specialists from a recognized institution establishes the need for such a replacement

(1)  by attesting that the visual condition of the person with a visual deficiency has sufficiently changed to render ineffective the visual aid he is using;

(2)  by attesting that the person with a visual deficiency’s general condition has changed sufficiently to render him incapable of operating or handling the visual aid he is using;

(3)  by attesting that the device no longer meets the needs generated by the pursuit of activities related essentially to recognized studies or to paid work; or

(4)  by attesting that any of the circumstances described in subparagraphs 1 to 3 apply, that the visual aid to be replaced was initially loaned to enable the person with a visual deficiency to begin a process of obtaining or returning to work or to gain advancement at work and that replacement of the visual aid is necessary in order for the person with a visual deficiency to keep such work.

A visual aid that is no longer insured but whose cost has already been reimbursed by the Board shall be replaced only by an insured visual aid in accordance with the provisions of this Regulation.

O.C. 1403-96, s. 7; O.C. 375-99, s. 1; O.C. 470-2011, s. 25.

8. The replacement of a visual aid whose cost has not already been reimbursed by the Board is insured under either of the following conditions:

(1)  the visual aid no longer meets the person with a visual deficiency’s functional needs, as determined by a team of rehabilitation specialists from the recognized institution; or

(2)  the visual aid to be loaned is of a different type than the visual aid he is already using.

A visual aid whose cost has not been reimbursed by the Board shall be replaced only by an insured visual aid in accordance with the provisions of this Regulation.

O.C. 1403-96, s. 8; O.C. 470-2011, s. 25.

9. For a 2-year period from the event or irreparable breakage, the replacement of a visual aid is not insured if the only reason for the replacement is that the visual aid was used negligently or was lost, stolen or destroyed.

The period provided for in the first paragraph ceases to run from the time when the person with a visual deficiency replaces, at his own expense, the visual aid that was the object of the event or breakage with an insured visual aid that is similar with regard to its operation and price, and agrees to the institution’s becoming the lender of the new visual aid.

Similarly, subject to section 42, the replacement of a visual aid is not insured if the principal reason for the replacement is a delay caused by the fact that the visual aid is awaiting repair or is being repaired, except in an extreme emergency.

The replacement of a visual aid is not insured where such replacement can be justified only by the fact that the aid has lost one or more of its accessory functions that are not essential to its use by the person with a visual deficiency.

O.C. 1403-96, s. 9; O.C. 470-2011, s. 25.

10. The repair of an insured visual aid or of an insured component or supplement is insured, as is the repair of an uninsured visual aid or of an uninsured component or supplement whose cost has already been reimbursed by the Board or by a visual aid program under the responsibility of the Minister of Health and Social Services before 2 June 2011 and that appears in the list in the Tariff.

The repair of an uninsured visual aid at the disposal of a person with a visual deficiency is also insured, if the aid is similar in function and price to an aid appearing in the Tariff, provided that the person is entitled to such aid at the time of repair.

The levelling of a computer aid listed in Part II of Schedule I is deemed to be a repair, provided that the aid meets a need arising out of the visual deficiency of the insured person.

Despite the foregoing, where the cost for repairing a visual aid, a component or a supplement, added to the cost of previous repairs, exceeds 70% of the cost of replacing the aid, component or supplement by a new one, only the replacement of the aid, component or supplement is insured, unless the visual aid needing repair is the only one that can meet the needs of the person with a visual deficiency.

Notwithstanding the foregoing, the repair of a visual aid used negligently or used for purposes for which it was not designed or for which it was not loaned is not insured.

O.C. 1403-96, s. 10; O.C. 375-99, s. 2; O.C. 470-2011, s. 8.

11. (Revoked).

O.C. 1403-96, s. 11; O.C. 375-99, s. 3; O.C. 470-2011, s. 9.

CHAPTER III SPECIAL CONDITIONS APPLICABLE TO CERTAIN VISUAL AIDS

O.C. 1403-96, c. II; O.C. 470-2011, s. 10.

12. A hearing device with a record mode and a vocal note taking device may not be simultaneously insured in respect of any one person.

O.C. 1403-96, s. 12; O.C. 375-99, s. 4; O.C. 470-2011, s. 10.

13. A contact lens listed in Part I of Schedule I is insured in respect of a person with a visual deficiency who is 6 years of age or over only if that person has one of the following deficiencies:

(1)  an antimetropia or anisometropia with a difference of at least 2 diopters between the 2 eyes;

(2)  a myopia of at least 5 diopters;

(3)  a hypermetropia of at least 5 diopters;

(4)  a regular astigmatism with a difference of at least 3 diopters between the major meridians;

(5)  an ocular pathology that has been medically diagnosed and that requires the wearing of therapeutic contact lenses upon prescription from a physician.

O.C. 1403-96, s. 13; O.C. 375-99, s. 5; O.C. 470-2011, s. 10.

13.1. (Replaced).

O.C. 375-99, s. 6; O.C. 470-2011, s. 10.

13.2. (Replaced).

O.C. 375-99, s. 6; O.C. 470-2011, s. 10.

14. The tinted filtering lens referred to in the Tariff made pursuant to Part I of Schedule I is insured only if it provides a light transmission not exceeding 50%, and the photochromic filtering lens referred to in that Tariff is insured only if it provides a light transmission not exceeding 70%.

However, the photochromic filtering lens is insured only in respect of a person whose need cannot be compensated for by the tinted filtering lens.

Likewise, the prescription filtering lens, either tinted or photochromic, is insured only if the non-prescription filtering lens, used in combination with the person’s basic glasses, cannot meet that person’s needs.

O.C. 1403-96, s. 14; O.C. 375-99, s. 7; O.C. 470-2011, s. 10.

15. The closed-circuit television system referred to in Schedule I is insured in respect of a person whose inability to read cannot be compensated by another reading aid listed in Part I of Schedule I and who

(1)  has a visual acuity equal to or less than 6/60 in the best eye, after correction by means of ophthalmic lenses, excluding special optic systems and additions greater than 4 diopters;

(2)  has an associated physical deficiency, fluctuating vision, a defective field of vision or sensitivity to contrast;

(3)  does not benefit from the permanent presence of a person 18 years of age or over; or

(4)  is referred to in section 26.

In addition, the model of closed-circuit television system subject to a tariff pursuant to Part II of Schedule I and that is no longer operative because of its poor performance and the needs it is aimed at meeting to fulfil the academic or work requirements of persons referred to in section 26 is deemed to be subject to a tariff pursuant to Part I of Schedule I.

O.C. 1403-96, s. 15; O.C. 375-99, s. 8; O.C. 470-2011, s. 10.

16. Despite section 6.7, the following are insured in respect of any one person:

(1)  a maximum of 2 canes;

(2)  a maximum of 3 suction grips per year.

O.C. 1403-96, s. 16; O.C. 375-99, s. 9; O.C. 470-2011, s. 10.

17. The hand-held tactile electronic obstacle detector referred to in the Tariff made pursuant to Part I of Schedule I is insured only in respect of a person who

(1)  has a hearing deficiency of at least 55 dB; or

(2)  is referred to in section 26 and has a disability affecting orientation and mobility, despite having received training to overcome it and that disability is such that the person has been unable to achieve the degree of autonomy necessary for attending school or obtaining work.

The audiometric measurement that must be used to determine a hearing deficiency is that provided for in the Regulation respecting hearing devices and insured services (chapter A-29, r. 2).

O.C. 1403-96, s. 17; O.C. 375-99, s. 10; O.C. 470-2011, s. 10.

18. The neck-mounted tactile electronic obstacle detector referred to in the Tariff made pursuant to Part I of Schedule I is insured only in respect of a person who uses a wheelchair on a daily and permanent basis in order to move about and who is unable to use a cane.

O.C. 1403-96, s. 18; O.C. 375-99, s. 11; O.C. 470-2011, s. 10.

19. The mobility lamp referred to in Part I of Schedule I is insured only in respect of a person who has a night vision problem and needs to move about at night in poorly lit places.

O.C. 1403-96, s. 19; O.C. 375-99, s. 12; O.C. 470-2011, s. 10.

20. The night vision goggle referred to in Part I of Schedule I is insured only in respect of a person who has an ocular pathology causing night blindness, which hampers, on a daily basis, the movements needed to carry on daily activities. When moving about, that person must also use a cane or a guide dog.

O.C. 1403-96, s. 20; O.C. 470-2011, s. 10.

21. The visual aids referred to in Division IV of Part I of Schedule I are insured only in respect of a person with a visual deficiency who has a compatible computer.

An aid referred to in subdivision 1 of Division IV of Part I of Schedule I, an aid referred to in subdivision 2 and an aid referred to in subdivision 3 of that Division may not be insured simultaneously in respect of any one person.

O.C. 1403-96, s. 21; O.C. 470-2011, s. 10.

22. The following aids are insured only in respect of a functionally blind person:

(1)  visual aids referred to in subdivisions 2 and 3 of Division IV of Part I of Schedule I;

(2)  the braille display referred to in Part II of Schedule I that is recovered because it is no longer operative due to its poor performance and the needs it is aimed at meeting to fulfil the requirements related to the activities of persons referred to in section 26.

Despite the foregoing, for the purposes of subparagraph 1 of the first paragraph, the print recognition unit and the closed-circuit television system may not be insured simultaneously in respect of any one person.

O.C. 1403-96, s. 22; O.C. 375-99, s. 13; O.C. 470-2011, s. 10.

23. The print magnification software referred to in subdivision 1 of Division IV of Part I of Schedule I and the monitor or the adjustable-arm support referred to in the same subdivision may not be insured simultaneously in respect of any one person, except in the case of a person referred to in section 26.

O.C. 1403-96, s. 23; O.C. 375-99, s. 14; O.C. 470-2011, s. 10.

24. The visual aids referred to in subdivision 2 of Division V of Part I of Schedule I are insured only once for any one person.

The following is not insured:

(1)  the replacement or repair of those aids;

(2)  the adapted alarm clock in respect of a person who benefited from the same type of aid under the Regulation respecting hearing devices and insured services (chapter A-29, r. 2).

O.C. 1403-96, s. 24; O.C. 375-99, s. 15; O.C. 470-2011, s. 10.

25. The aids referred to in subdivision 3 of Division V of Part I of Schedule I are insured only if the person with a visual deficiency meets the following conditions:

(1)  except for the talking personal thermometer, the person holds a medical prescription that justifies the need for the aid for daily use at home;

(2)  the person must be capable of using the aid independently;

(3)  no other visual aid enables the person to compensate for the incapacity of using non-adapted current equipment.

O.C. 1403-96, s. 25; O.C. 375-99, s. 16; O.C. 470-2011, s. 10.

26. The visual aids referred to in Part II of Schedule I are insured only in respect of a person who

(1)  is a full-time student or is deemed to be a full-time student pursuing recognized studies according to the norms whose application comes under the responsibility of the Minister of Education, Recreation and Sports;

(2)  receives training to have access to a professional order;

(3)  is learning to read or write French or English under a program under the responsibility of the Minister of Immigration and Cultural Communities;

(4)  receives training under a program of Emploi-Québec with a view to holding paid employment;

(5)  begins a process of obtaining or returning to paid employment;

(6)  needs such aid to keep paid employment or gain advancement at work; or

(7)  suffers form deafblindness and uses braille as a constant method of reading and writing.

For the purposes of subparagraph 1 of the first paragraph, recognized studies are studies pursued by a student admitted to a program leading to a diploma, a certificate or another attestation of studies awarded pursuant to a basic school regulation established under the Education Act (chapter I-13.3) or the College Education Regulations established under the General and Vocational Colleges Act (chapter C-29), or studies pursued by a student admitted to a university program leading to a degree, a diploma, a certificate or another attestation of university studies.

O.C. 1403-96, s. 26; O.C. 375-99, s. 17; O.C. 470-2011, s. 10.

27. The aids referred to in Division I of Part II of Schedule I are insured in respect of a student at the preschool or elementary level only if the student is functionally blind or has an associated physical or intellectual deficiency. Likewise, those aids are insured in respect of a paid worker only if the worker is functionally blind or is entitled to a computer under section 28.

O.C. 1403-96, s. 27; O.C. 375-99, s. 18; O.C. 470-2011, s. 10.

28. The computer referred to in Division I of Part II of Schedule I is not insured in respect of

(1)  a student at the college or university level, or a student receiving training to have access to a professional order;

(2)  a person referred to in subparagraphs 3 to 6 of the first paragraph of section 26 who, had the person not been a person with a visual deficiency, would have needed to use a computer in the course of academic or work activities.

O.C. 1403-96, s. 28; O.C. 375-99, s. 19; O.C. 470-2011, s. 10.

29. A braille display, a 60-cell model or more, referred to in the Tariff made pursuant to Part II of Schedule I is insured only in respect of

(1)  a student at the college or university level or a paid worker, provided that he or she is called upon to use braille on a regular basis to read graphs, tables, mathematic formulas or specialized data banks;

(2)  a person suffering from deafblindness.

O.C. 1403-96, s. 29; O.C. 375-99, s. 20; O.C. 470-2011, s. 10.

30. The braille printer referred to in Part II of Schedule I is insured only in respect of students at the college or university level or paid workers, provided that they need to read braille on paper in the course of their studies or work and have no braille printer meeting their needs in their school or work environment.

O.C. 1403-96, s. 30; O.C. 375-99, s. 21; O.C. 470-2011, s. 10.

31. The dedicated braille communication computer system referred to in Part II of Schedule I is insured only in respect of a person suffering from deafblindness who does not use a computer and its braille adaptations.

O.C. 1403-96, s. 31; O.C. 375-99, s. 22; O.C. 470-2011, s. 10.

31.1. The hearing aid with a recording mode referred to in Part II of Schedule I is insured only in respect of a student at the college or university level or a paid worker whose needs in terms of note taking may not be met by the computer at his or her disposal.

O.C. 470-2011, s. 10.

31.2. The free-standing reading stand referred to in the Tariff made pursuant to Part II of Schedule I is insured only in respect of a person who does not already have 2 reading stands and for whom the other models do not compensate for his or her incapacities.

O.C. 470-2011, s. 10.

31.3. The adapted satellite geopositioning system referred to in Part II of Schedule I is insured only in respect of a functionally blind person referred to in section 26 who needs to frequently move about alone in unfamiliar places.

O.C. 470-2011, s. 10.

31.4. Despite section 6.7, a second visual aid of one of the types below, or an additional component or supplement to such a visual aid, is insured only in respect of a person referred to in section 26:

(1)  the closed-circuit television system;

(2)  the brailler;

(3)  the reading stand, not free-standing.

However, for the purposes of subparagraph 1 of the first paragraph, the print recognition unit may, despite section 22, take the place of a second closed-circuit television system.

O.C. 470-2011, s. 10.

31.5. Among the computer aids referred to in Schedule I, only the types of aid for a single method of communication are insured at the same time in respect of any one person.

For the purposes of the first paragraph, the aids referred to in subdivision 1 of Division IV of Part I and Division I of Part II of Schedule I are deemed to be print magnification aids. The aids referred to in subdivision 2 of Division IV of Part I and Division I of Part II of Schedule I are deemed to be sound aids. The aids referred to in subdivision 3 of Division IV of Part I and Division I of Part II of Schedule I are deemed to be braille aids.

O.C. 470-2011, s. 10.

31.6. Despite section 31.5, the types of aid for a second method of communication are also insured

(1)  in respect of a person who, following the evaluation in section 6.1, is found to suffer from a condition that leads the person to gradually switch to braille; the initial method of communication and braille may co-exist while the person is learning to use braille;

(2)  where the insured aid comes with an accessory method of communication without additional charges.

O.C. 470-2011, s. 10.

CHAPTER IV COSTS REIMBURSED BY THE BOARD

O.C. 1403-96, c. III; O.C. 470-2011, s. 11.

32. The purchase or replacement cost of a visual aid or of its component or supplement, where applicable, that is reimbursed by the Board to a recognized institution is the established price appearing in the Tariff for each visual aid, component or supplement in the list of visual aids appearing in that Tariff.

That price shall be established following a call for tenders pursuant to section 3.1 of the Health Insurance Act (chapter A-29).

If the purchase or replacement cost of a visual aid that is reimbursed by the Board to a recognized institution is not an established price, the cost reimbursed by the Board shall not exceed the maximum price appearing in the Tariff then established for the visual aid, its component or its supplement in the list of visual aids appearing in that Tariff.

In all cases, the Board shall reimburse to a recognized institution the purchase or replacement cost only of insured visual aids and only if such a visual aid is loaned to a person with a visual deficiency in accordance with the provisions of this Regulation by such recognized institution that establishes the need for such a loan. Similarly, the Board shall reimburse to a recognized institution the cost only of the insured repair or insured replacement of a visual aid.

O.C. 1403-96, s. 32; O.C. 470-2011, ss. 12 and 25.

33. Notwithstanding section 32, upon the purchase or replacement of a visual aid, its component or its supplement, the established price of that visual aid, component or supplement shall include

(1)  the price of its basic components and of its basic supplements, where applicable;

(2)  the cost of repairs covered during the warranty period; and

(3)  the adjustments and technical tune-ups required during the training period necessary for the effective and functional use of the visual aid, where applicable.

O.C. 1403-96, s. 33.

34. Upon the purchase or replacement of a visual aid, its component or its supplement, the maximum price for that visual aid, component or supplement shall include

(1)  the cost of repairs covered by the warranty during the warranty period; and

(2)  the adjustments and technical tune-ups that are required during the training period and that are necessary for the effective and functional use of the visual aid, where applicable.

O.C. 1403-96, s. 34.

35. No customs fees, customs clearance fees, currency exchange rate or taxes may be added to the price set in the Tariff for a visual aid, component or supplement reimbursed by the Board, nor costs for transporting the aid from the supplier to the loaning institution.

O.C. 1403-96, s. 35; O.C. 470-2011, s. 13.

36. Upon the purchase or replacement of a visual aid, its component or its supplement by a recognized institution, the taxes and the cost of shipping from the supplier to the loaning institution or to the address of the insured person, according to the loaning institution’s instructions, may be added to the purchase or replacement cost on the condition that the total sum reimbursed by the Board does not exceed the maximum price fixed for the visual aid or for its component or supplement, where applicable.

O.C. 1403-96, s. 36; O.C. 470-2011, s. 14.

37. Upon purchase or replacement, by a recognized institution, of a visual aid, its component or its supplement, from a foreign supplier, customs fees, customs clearance fees and the currency exchange rate applicable at the time of the purchase or replacement may be added to the purchase or replacement cost on the condition that the total sum reimbursed by the Board does not exceed the maximum price fixed for the visual aid or for its component or supplement, where applicable.

O.C. 1403-96, s. 37.

38. (Revoked).

O.C. 1403-96, s. 38; O.C. 375-99, s. 23; O.C. 470-2011, s. 15.

39. Notwithstanding section 32, the Board shall reimburse the purchase or replacement cost of a visual aid loaned by a recognized institution to a person with a visual deficiency only if no other recognized institution has already loaned him a visual aid of the same type.

O.C. 1403-96, s. 39; O.C. 470-2011, s. 25.

40. (Revoked).

O.C. 1403-96, s. 40; O.C. 375-99, s. 24; O.C. 470-2011, s. 16.

41. The Board shall reimburse to a recognized institution the purchase cost of an insured visual aid, with its listed components and supplements, where applicable, only if the person with a visual deficiency to whom that institution loaned the visual aid has neither possession nor the use of a visual aid that is similar with respect to its operation and price.

O.C. 1403-96, s. 41; O.C. 470-2011, s. 25.

42. Upon the replacement of a visual aid under the third paragraph of section 9, the Board shall not reimburse its replacement cost to a recognized institution.

O.C. 1403-96, s. 42.

42.1. (Revoked).

O.C. 375-99, s. 25; O.C. 470-2011, s. 17.

43. The purchase or replacement cost of a visual aid referred to in the second paragraph of section 5 or of any of its basic components or supplements shall be determined as follows:

(1)  the cost price of the visual aid, including that of its basic components and, where applicable, that of its basic supplements;

(2)  the taxes, where applicable, and the cost of shipping the visual aid between the supplier’s establishment where the visual aid is available and which is closest to the institution loaning the visual aid and the location of that institution or the address of the insured person, according to the loaning institution’s instructions, shall be added to the cost resulting from the application of paragraph 1; and

(3)  customs fees, customs clearance fees and the currency exchange rate applicable at the time of the purchase or replacement, by a recognized institution, of the visual aid or of its component or supplement, from a foreign supplier shall be added, where applicable, to the cost resulting from the application of paragraph 2.

O.C. 1403-96, s. 43; O.C. 470-2011, s. 18.

44. The repair cost of a visual aid, its component or its supplement that is reimbursed by the Board after the warranty period shall be established by totalling the following amounts:

(1)  the cost price of the materials;

(2)  the price of labour according to the hourly rates set in the Tariff;

(3)  the cost of shipment between the institution loaning the visual aid and the institution repairing it, where the repair is made by a recognized institution other than the institution loaning the visual aid or, where the visual aid is repaired by a supplier, the cost of shipping the visual aid between the supplier’s establishment where the visual aid is available and the loaning institution or the address of the insured person, according to the loaning institution’s instructions; and

(4)  taxes, customs fees, customs clearance fees and the currency exchange rate applicable at the time of billing by a foreign supplier.

The Board shall reimburse the cost of necessary repairs if they are carried out, as soon as the recognized institution recovers the visual aid, its component or its supplement, where applicable.

O.C. 1403-96, s. 44; O.C. 470-2011, s. 19.

44.1. The Board is to reimburse to a recognized institution the purchase, replacement or repair cost of a visual aid, its components or supplements, only if the institution sends to the Board a statement of account, using a form provided by the Board, including the following information, which may vary according to the medium used, whether the visual aid is marked “SC” or a claim for payment is made:

(1)  the health insurance number, the expiration date indicated on the health insurance card and the information required by the Board to identify the insured person who benefited from the property or service;

(2)  the institution’s name, permit number, dispenser number, the reference number of an application for a visual aid marked “SC” or a claim for payment and, in the case of a transfer, the number of the transferred device and the name and permit number of the institution where the device was transferred;

(3)  an indication relating to the visual acuity and the field of vision in each eye, the qualification of visual incapacity, a description of the pursuit of activities justifying the allocation of a visual aid and, where the purchase or replacement cost of a visual aid is marked “SC”, the information referred to in this Regulation;

(4)  the code of the property or service, its nature, justification, the number of the device, the amount claimed and the date on which the property was allocated or the service rendered;

(5)  a statement by the insured person confirming that the person received the property or service described and authorizing the Board to make the payment; and

(6)  a statement by the person in charge of the institution that the information given is accurate and complete.

O.C. 1091-2011, s. 2.

CHAPTER V TERMS AND CONDITIONS FOR THE LOAN OF VISUAL AIDS

O.C. 1403-96, c. IV; O.C. 470-2011, s. 20.

45. Visual aids referred to in Part II of Schedule I, with their listed components and supplements, where applicable, that are loaned to the persons referred to in section 26 remain on loan to such a person until they are replaced, in accordance with the provisions of this Regulation.

O.C. 1403-96, s. 45; O.C. 375-99, s. 26; O.C. 470-2011, s. 21.

46. The Board shall reimburse to a recognized institution the purchase or replacement cost of an insured visual aid, component or supplement, or the cost of its insured repair, upon receipt of any relevant document concerning the person with a visual deficiency or of any document relevant to the visual aid loaned, to a visual aid that the person with a visual deficiency is already using or has in his possession, or to the service provided.

That document may be required from the recognized institution or from the person with a visual deficiency before the visual aid is loaned or at any other time.

A recognized institution shall, in addition, confirm to the Board in writing that the person is still pursuing recognized studies or still doing the paid work that warranted the loan of the visual aid where a leveling of the visual aid is required.

O.C. 1403-96, s. 46; O.C. 375-99, s. 27; O.C. 470-2011, s. 25.

CHAPTER VI TRANSITIONAL AND FINAL PROVISIONS

DIVISION I READING AIDS

O.C. 1403-96, Div. I; O.C. 375-99, s. 28.

47. A visual aid obtained by a person with a visual deficiency under the Programme des aides visuelles aux activités de la vie quotidienne et aux activités de la vie domestique and the Fonds d’aide aux travailleurs aveugles et amblyopes before 2 June 2011 is deemed to be insured under this Regulation.

O.C. 1403-96, s. 47; O.C. 375-99, s. 29; O.C. 470-2011, s. 23.

48. This Regulation replaces paragraphs n, o and p of section 1, sections 56 to 59.1 and Schedule B to the Regulation respecting the application of the Health Insurance Act (R.R.Q., 1981, c. A-29, r. 1).

O.C. 1403-96, s. 48.

49. (Omitted).

O.C. 1403-96, s. 49.

SCHEDULE I

(s. 5, 1st par.)

LIST OF VISUAL AIDS COVERED BY THE HEALTH INSURANCE PLAN

PART I: Categories and types of aids insured for all persons having a visual deficiency

DIVISION I: Reading aids

1. Hearing aid

2. Vocal note taking device

3. Bifocal with additions greater than 4 diopters

4. Adapted electronic calculator

5. Yellow filter sheet

6. Contact lens

7. Contact lens with artificial pupil

8. Fresnel lens

9. Microscopic lens

10. Filtering lenses

11. Magnifier

12. Obturator

13. Occluder

14. Fresnel prism

15. Reading stand

16. Microscopic optical system

17. Telescopic optical system

18. Closed-circuit television system

19. Stenopeic disc

20. Typoscope

21. Visor

22. Other reading aids (SC)

DIVISION II: Writing aids

23. Brailler

24. Other writing aids (SC)

DIVISION III: Mobility aids

25. Canes

26. Door detector

27. Electronic obstacle detector

28. Acquisition costs for a guide dog

29. Annual maintenance costs for a guide dog

30. Mobility lamp

31. Night vision goggle

32. Telescopic optical system

33. Other mobility aids (SC)

DIVISION IV: Computer aids

Subdivision 1: Aids for the “Print Magnification” method of communication

34. Print magnification software

35. Monitor

36. Adjustable-arm support

37. Other aids for the “Print Magnification” method of communications (SC)

Subdivision 2: Aids for the “Sound” method of communication

38. Screen reader software

39. Print recognition unit

40. Other aids for the “Sound” method of communication (SC)

Subdivision 3: Aids for the “Braille” method of communication

41. Screen reader software

42. Print recognition unit

43. Other aids for the “Braille” method of communication (SC)

DIVISION V: Aids for daily life and domestic life

Subdivision 1: Renewable aids

44. Cranmer abacus

45. Adapted geometry kit

46. Adapted marker

47. Magnifying mirror

48. Adapted watch

49. Volume level

50. Writing stand

51. Adapted protractor

52. Pocket braille frame

53. Adapted measuring tape

54. Holder for brailler

55. Braille slate

56. Other renewable aids (SC)

Subdivision 2: One-time aids

57. Adapted plate

58. Knife with guide

59. Liquid level indicator

60. Check guide

61. Specialized secondary lamp for reading without a magnifying glass

62. Talking food scale

63. Adapted pedometer

64. Adapted wallet

65. Adapted alarm clock

66. Syringe stand

67. Adapted meat thermometer

68. Other one-time aids (SC)

Subdivision 3: Renewable health aids

69. Talking blood glucose monitor

70. Adapted scale

71. Talking blood pressure clamp

72. Talking personal thermometer

73. Other renewable health aids (SC)

PART II: Categories and types of insured aids for persons with a visual deficiency referred to in section 26 of this Regulation

DIVISION I: Computer aids

Subdivision 1: Aids for the “Print Magnification” method of communication

1. Computer

2. Other aids for the “Print Magnification” method of communication (SC)

Subdivision 2: Aids for the “Sound” method of communication

3. Computer

4. Screen reader control keyboard

5. Voice synthesis software

6. Other aids for the “Sound” method of communication (SC)

Subdivision 3: Aids for the “Braille” method of communication

7. Braille display

8. Screen reader control keyboard

9. Braille printer

10. Braille shortening software

11. Computer

12. Voice synthesis software

13. Dedicated Braille communication computer system

14. Other aids for the “Braille” method of communication (SC)

DIVISION II: Reading, writing and mobility aids

Subdivision 1: Reading aids

15. Hearing aid

16. Adapted electronic calculator

17. Reading support

18. Telemicroscopic optical system

19. Close-circuit television system

20. Other reading aids (SC)

Subdivision 2: Writing aids

21. Electric brailler

22. Other writing aids (SC)

Subdivision 3: Mobility aids

23. Electronic obstacle detector

24. Adapted satellite geopositioning system

25. Other mobility aids (SC)

O.C. 470-2011, s. 24.

REFERENCES

O.C. 1403-96, 1996 G.O. 2, 4725

O.C. 375-99, 1999 G.O. 2, 741

S.Q. 1999, c. 89, s. 53

Decision 2004-05-18, 2004 G.O. 2, 1645

O.C. 470-2011, 2011 G.O. 2, 1064

O.C. 1091-2011, 2011 G.O. 2, 3100