During recent negotiations with BCPSEA to improve our provincial Extended Health Benefits (EHB) Plan, the BCTF requested clarification on the coverage for CPAP machines required by members who experience sleep apnea. The BCPSEA benefits consultant assured us that our provincial EHB plan provides more than one CPAP machine per lifetime if the member has moderate to severe sleep apnea. See attached FAQ that lists the change in eligibility as of October 2018.
Depending on their claim’s history, members are required to have their CPAP provider submit a pre-determination to Pacific Blue Cross (PBC) prior to replacing their device. This form is attached for ease of reference.
If a member is denied coverage, please advise them to contact PBC and submit an appeal for review. Once that process is initiated, they can also reach out to the BCTF by emailing me directly at email@example.com.
We also requested that PBC update the information listed on members’ online CaresNet accounts to accurately reflect the coverage of CPAP machines.
Other Benefit Changes Effective July 1, 2023
- HPV vaccines are now covered.
- Vision care limit increased from $550 to $600 per year.
- Naturopath limit increased from $900 to $1,000 per year.