A woman who was denied a care plan after the Ontario government raised the cost of emergency services after a deadly wildfire last summer has been offered a new plan that could cover her $1,500 out-of-pocket costs, even though the government says it will not allow her to enroll in the plan.
Melissa Buss, 38, who lives in an apartment complex in Mississauga, was denied the $5,000-a-month, six-month plan that is the only option available to those with chronic medical conditions such as arthritis or heart conditions, a Globe and Mail review has found.
The woman was unable to access the plan because of the lack of funds in her income.
The government says the plan is only available to people with income between $50,000 and $150,000.
But the woman’s insurance company told her she could only apply if she could afford to pay the higher costs of the plan and that her income would be capped at $75,000 a year.
The Globe and Mayors of Ontario is the provincial agency that administers the province’s social assistance program, the Ontario Disability Support Program.
But Buss said the government refused to provide her with a plan that meets her needs and has been demanding that she enroll in it, as the province does not allow people with severe disabilities to do so.
Buss was born with severe epilepsy, but her parents had insurance through their pension plan that was bought through the plan administrator, said her lawyer, Mike Hirsch.
They were told they had to pay $8,000 per month for the premium to keep their plan up.
Buses’ lawyer said the insurance company was asking for a rate of $1.50 a month, which would have been a substantial increase over the $1 a month that was being asked of Buss for the plan that they were offered by her insurance company.
“I don’t think she is getting any relief from the government,” said Hirsch, whose firm represents the Buss family.
Bursam is being represented by lawyer Gary McElroy.
The province said it is working to expand the availability of care in the emergency room, but has been slow to do this because of concerns about its own finances.
“It’s a very difficult time for all of us,” said Public Safety Minister Vic Toews.
“We need more help from the provinces, and we’re going to continue to work to ensure that we have the resources we need.”
In addition to Buss’s medical needs, the government is trying to ensure other people in the province, including children, are not left out of the plans because the government doesn’t want people to be unable to pay their medical bills.
The plan is available to anyone who can prove they are not eligible for provincial disability payments and can afford it, although it is not mandatory for anyone to enroll.
A spokesperson for the Ontario Human Rights Commission said the commission has received complaints about the way the government has treated Buss.
“The Commission has made inquiries to ensure the Ontario system is in compliance with the Human Rights Code,” the spokesperson said in an email.
“Our concerns are about the manner in which the Ontario plans are administered and administered in order to ensure equal access to care for all Ontarians.”
The government’s response to Bursams concerns is not the first time it has been accused of failing to do its job.
Earlier this year, the province announced that it would not allow a woman to enroll into its emergency care plans.
In June, it changed the rules that make it possible for people with chronic conditions to get health insurance through the program, saying it would require them to prove they have severe disabilities.
A federal appeals court found the change was arbitrary and violated the rights of people with disabilities to a standard of care and to access health care.
With files from The Canadian Press