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Green Party leader says changes to fertility treatment funding unfair

The province's Fertility Treatment Program provides between $5,000 and $10,000 per year for expenses associated with in-vitro fertilization (IVF) and intrauterine insemination (IUI), based on family income.  (Sang Tan/The Associated Press - image credit)
The province's Fertility Treatment Program provides between $5,000 and $10,000 per year for expenses associated with in-vitro fertilization (IVF) and intrauterine insemination (IUI), based on family income. (Sang Tan/The Associated Press - image credit)

The leader of the P.E.I. Green Party says changes to the way the province funds fertility treatments are leaving some Islanders without support.

Peter Bevan-Baker raised the issue in the P.E.I. Legislature Wednesday.

The Fertility Treatment Program provides between $5,000 and $10,000 per year for expenses associated with in-vitro fertilization (IVF) and intrauterine insemination (IUI), based on family income.

In 2022, the province made changes to the application process for the program, which covers some of the costs associated with fertility treatments.

Prior to those changes, the program would allow reimbursements for treatments to be made retroactively as long as the person was eligible for the program. But now the province will only reimburse Islanders for treatments that take place after they are approved.

Bevan-Baker said this means people have to apply and wait for approval before getting treatment to have those costs covered or pay out of pocket.

'Those that need the treatment, need it'

He said the issue was brought to his attention by one of his constituents, Amanda Burry, after she found out her fertility costs wouldn't be covered because she got treatment before being approved by the province.

"I was in the midst of fertility treatment when I found out," Burry told CBC News.

She said her doctor told her she would need IVF treatment in order to conceive and was referred to a clinic and began treatment in May. She said she had been waiting almost three years to start a family and didn't want to wait any longer.

She paid for her treatment out of pocket and saved all her receipts to submit to the province for funding, only to find out that none of it would be covered because she was not yet approved by the provincial program.

Legislative Assembly of P.E.I.
Legislative Assembly of P.E.I.

"I was quite enraged and quite upset. It's a lot of money up front, it's a lot of time, it's a lot of medication," she said.

"It's a huge process and fertility in itself is a big thing. It's something a lot of people don't talk about so it can very isolating."

She said so far she's spent close to $15,000 that won't be eligible for reimbursement because of the policy change, which has added more stress to an already challenging situation.

"I wanted to focus on my health, I wanted to focus on my stress levels, I wanted to focus on the treatment itself because I was in the middle of it," she said.

"If you can prove that you've gotten that treatment and you've paid for that treatment then I don't understand the need for that date of approval ... those that need the treatment, need it."

Minister says he'll raise issue with department

Speaking in the legislature, Bevan-Baker asked P.E.I.'s health minister why the change was made to the policy and whether he would consider revoking it.

"Undergoing fertility treatment is costly, it's stressful and a deeply emotional process and remembering to fill out an application form prior to incurring any medical costs could understandably slip somebody's mind," he said.

"Why do we no longer cover medical costs incurred prior to approval of an individual's application?"

Health Minister Mark McLane didn't say why the policy change happened, but said he would raise the issue with department staff to see if something could be done. He agreed more needed to be done to clearly communicate the criteria of support programs with Islanders.

Ken Linton/CBC
Ken Linton/CBC

"That really doesn't seem right to me to be quite honest with you so I'd recommend we have a side bar to talk about that situation and maybe see if we can get a move on that file and help that person if possible," McLane said.

In a statement from the Department of Health and Wellness, a spokesperson said a program like this is "analogous to insurance coverage. Coverage begins on the date of enrolment and any expenses incurred prior to the enrolment date are not covered."

Bevan-Baker asked if the minister would commit to removing the new policy and allowing families to be reimbursed for treatment retroactively.

"I do agree with the premise and I will work with the department. I will commit to try to make that happen," McLane said.