Each year the ARTA Health Benefits Committee reviews potential changes to the ARTA Benefit Plans. These potential changes often arise when covered members submit change requests to the Health Benefits Committee for consideration. Each of these requests is reviewed to determine if a group benefit plan such as ARTA is allowed to cover the service or device and to make certain a significant number of members would benefit from the coverage change. Additional changes are then considered to ensure the plan continues to provide the best benefits available to ARTA members.
The following changes became effective November 1, 2022, for all members covered by the ARTA Extended Health Care plan:
- Transport wheelchairs are now covered under the current manual wheelchair benefit. A transport wheelchair differs from a regular wheelchair in that standard wheelchairs are designed with large wheels so that people can propel themselves, while transport wheelchairs have small wheels and are meant to be pushed from behind by a second person.
- Occupational therapists were added to the list of eligible paramedical practitioners. The Health Benefits Committee received several requests over the past year to consider adding coverage for these practitioners as they expand the services they offer, which have historically been available primarily through each province’s public health care plans.
- Supplies for insulin pumps (including sensors and transmitters) have been re-allocated from the four-year insulin pump supplies benefit to the annual diabetic supplies benefit. Often if a member needed to purchase an insulin pump, they did not have any coverage remaining for supplies for the next four years. This change allows members who have purchased an insulin pump through the plan to take advantage of the annual diabetic supplies maximum to cover their sensor costs.
- The annual maximum for support stockings has been increased from $200 to $250.
- Coverage for Xenical, a weight-loss medication, which was only covered under the Health Wise Plus and Ultimate Health plans, is no longer covered given the prevalence of more effective weight-loss medications in the marketplace. Members who are currently using Xenical will have their coverage grandfathered.
- Usual and customary charges for a few devices and services were updated to reflect actual charges in the marketplace.
Earlier this year — April 1, 2022 — the following change became effective in ARTA Dental Care plans:
- The basis of payment was updated to be the current Alberta Dental Association & College Fee Guide.
Considering the past year’s claims experience for each plan and the inflationary pressures being experienced in the marketplace, renewal rates saw an extended health care premium increase for the first time in five years.
Detailed information on these coverage changes is included in the benefit booklets, available online here.
ARTA continues to review potential plan enhancements, while keeping the plan affordable for our covered members. Please continue to submit plan change suggestions that you think may be suitable for the Health Benefits Committee’s consideration. Suggestions may be mailed to the ARTA office or via email to [email protected].