When a family is dealt a blow as severe as the diagnosis of cancer of a loved one, it is extremely important that the family have time to digest and come to terms with the diagnosis and planned treatment.
Often however, the reality of life is such that the patients have mortgages to pay, food they need to buy and children that need to be taken care of. The costs of medications, accommodations, childcare and travel for many patients can cost thousands of dollars.
The vast majority of our patients and their families find the financial burden of a hematological illness and its treatment difficult. However, they have no choice but to continue with the treatment plan.
We hope the resources in this section will assist you in the practical side of coping. Please feel free to contact your BMT social worker if you have any questions or concerns.
Cost Information on Medications
During your treatment with the Leukemia/BMT Program, you may be prescribed many medications. While you are an inpatient, you do not have to pay for these medications. However, when you are discharged and are treated as an outpatient, you will be responsible for the costs of your prescriptions, which can be considerable. This includes all medications that are not given via an IV.
Some patients have private insurance, which may cover some of these costs. Others rely solely on government programs, such as BC Fair PharmaCare, and subsidies. If you are not enrolled in BC Fair PharmaCare, please sign up ASAP. Feel free to speak to your BMT social worker if you have any questions.
Click on the links below to learn more.
BC Fair PharmaCare Program
British Columbia’s Fair PharmaCare Program started May 1, 2003. PharmaCare subsidizes eligible prescription drugs and designated medical supplies.
The Fair PharmaCare Program covers the cost of most medications, based on family income. Individuals still have to pay for a part of their medications. This is called a deductible. The deductible is calculated based on net family income. Unfortunately, for many patients and families this can add up to a significant amount of money.
If you are not signed up for the BC Fair PharmaCare program, please sign up ASAP. If you do not know how to do this, speak with your BMT social worker. For more information, visit the BC Fair PharmaCare web site.
Individuals and families must all sign up for the PharmaCare program to receive coverage. Coverage for the current year is calculated based on net family income from two years ago. For example, for the 2009 calendar year, individuals pay a deductible based on their income for the year 2007.
For more information on how to do this, you can speak with your BMT social worker, call Fair PharmaCare directly at 1-800-387-4977 or visit the BC Fair PharmaCare web site.
Medications Excluded from BC Fair PharmaCare
There are some medications your physician may prescribe which are not covered by the Fair PharmaCare program. Some examples include G-CSF, Voriconazole, Valtrex, Rabeprazole and all other Proton Pump Inhibitors.
If a doctor prescribes a drug that is not covered on the PharmaCare list, a “Special Authority” request form MUST be completed by the attending physician and then submitted to the PharmaCare program.
The medication must be approved by PharmaCare PRIOR to the prescription being filled. This process may take several days. If the medication is authorized, then it is considered a PharmaCare drug for that individual. The length of the PharmaCare coverage is different for every “Special Authority” medication. Another “Special Authority” form will have to be submitted if the drug is required after the first coverage expires.
A pharmacist will likely assist you with this process, please ask them any questions you may about Pharmacare and “Special Authority” drugs that have prior to discharge.
Note that the BC Fair PharmaCare Program will not pay retroactively for prescriptions filled prior to “Special Authority” being approved.
All chemotherapy drugs are provided free of charge from the BC Cancer Agency. Individuals purchasing these drugs must have a registration number. If you are a patient of the Leukemia/Bone Marrow Transplant Program, you should automatically have a registration number.
Cyclosporine and Tacrolimus are provided free of charge for transplant patients from Lancaster Pharmacy at 601 West Broadway (Tel. 604-873-8585). Patients must pay the dispensing fee.
For Fluconazole, there is a group “Special Authority” in place for all BMT patients at all pharmacies. However, the prescription must be signed by a BMT physician. Patients must pay the dispensing fees.
If Prednisone is prescribed as a part of your chemotherapy treatment, it will be provided free a charge from the BC Cancer Agency. It is not covered if it is prescribed for the treatment of GVHD.
Please note that you may also be eligible for assistance with drug coverage under the BC Cancer Agency Compassionate Access Program (CAP).
You may be eligible for a number of financial assistance programs. Click on the links below to learn more. Feel free to speak to the BMT social workers for further information.
Below is a list of Federal programs. If you need assistance or have questions, please speak to the BMT social workers.
Employment Insurance Sick Benefits
You may be eligible for EI Sick Benefits. Eligible recipients may collect EI Sick Benefit for a maximum of 15 weeks. You need a minimum of 650 hours to be eligible. To apply for EI Sick Benefits you will need an EI Medical Report and your Record(s) of Employment.
Your BMT social worker can assist you with the application process. For further information, please call 1-800-206-7218 with SIN or visit Service Canada EI.
Employment Insurance Compassionate Care Benefits
Your spouse and/or your family members may be eligible for Compassionate Care Benefits if you become terminally ill. Your family members can share EI Compassionate Care Benefits up to 6 weeks between all. To apply for EI Sick Benefits you will need a special EI Medical Report and your Record(s) of Employment.
Your BMT social worker can assist you with the application process. For further information, please call 1-800-206-7218 with SIN or visit Service Canada EI.
Canada Pension Plan (CPP) Disability Benefits
You may be eligible for CPP Disability Benefits. A written application and a medical report from your primary hematologist are required. See your BMT social worker for application forms. For further information, please call 1-800-277-9914 with SIN or visit the CPP.
Revenue Canada Disability Tax Credit/Medical Expense Deductions
You may be eligible for tax credits and deductions for medical expenses. You will need medical documentation by your primary hematologist. For further information, you may talk to your BMT social worker or visit the CRA.
Below is a list of BC Provincial programs. If you need assistance or have questions, please speak to the BMT social workers.
Ministry of Social Development & Poverty Reduction
This is a provincial income assistance program based on financial need. Programs within MSD include: Income Assistance (IA), Persons with Disabilities (PWD), and Life Threatening Health Needs (LTHN).
Provides monthly income of up to $760/month per person, if eligible. Asset criteria for regular assistance include cash assets of less than $5,000 (including: savings/RRSP/Investments/etc.). One personal vehicle and owned primary residence are excluded. Applications process includes eligibility interview with MSD worker as you will need to provide details about your current living situation, income, and assets.
Click on the following Link to access more information.
Persons with Disability:
Your BMT social worker can explain this program to you and assist you with the application process for both regular and PWD assistance. You can apply by telephone or in person at the nearest Ministry of Employment & Income Assistance office. See Blue Pages in the phone book for locations. Visit the MSD Disability Assistance webpage for more information.
Life Threatening Health Needs:
The ministry may provide access to medical equipment, medical supplies, medical transportation and accommodation support to persons who are experiencing a direct and life threatening health need who require specific medical treatment outside of their local health region. The application process is the same as Income Assistance, however eligibility requirements include income less than $42,000 and no access to other available resources (savings, RRSPs, income, etc.)
Please click on the Link for more information.
Ministry of Children & Family Development Childcare Subsidy
You may be eligible for financial assistance with childcare. Your BMT social worker can assist you with this application or you can apply by telephone or in person at the nearest Ministry of Children & Family Development office. See Blue Pages in the phone book for locations. Visit the Ministry of Children and Family Development for more information.
Short Term Disability/Long Term
You may be eligible for short term and/or long term disability benefits through your employer. Some employer-sponsored long term disability programs also require you to apply for Canadian Pension Plan (CPP) Disability as well as Long Term Disability. Please check with your Human Resources/Benefits Department to clarify coverage, timelines and application requirements. Your BMT social worker can help you with the application process and assist with acquiring the required medical documentation.
Extended Health Benefits
You may also be eligible for drug coverage under your extended health benefits through your employer. Check with your Human Resources/Benefits department to clarify coverage. You may also require medical documentation for coverage for some drugs.
Provincial Travel Assistance Program (TAP)
All patients are eligible for the Travel Assistant Program (TAP).
TAP helps alleviate some of the transportation costs for eligible B.C. residents who must travel within the province for non-emergency medical specialist services not available in their own community. TAP is a corporate partnership between the BC Ministry of Health and private transportation carriers. The Ministry of Health Services coordinates the program and the transportation partners agree to waive or discount their regular fees. TAP does not provide direct financial assistance to patients for travel costs.
To apply for TAP and to view a list of transportation partners, see your BMT social worker or visit the TAP web site.
Please note that if you use BC Ferries, you and a caregiver travel for free under the TAP Program. You can also get a Medically Assured Loading Letter from your BMT social worker. This letter guarantees you get on the ferry without a reservation, as long as you arrive at the loading dock a minimum of 30 minutes prior to sailing.
Canadian Cancer Society Emergency Aid Programs
The Canadian Cancer Society provides assistance towards cancer-related transportation, accommodation and medication expenses for up to one year (which can be extended). Assistance is granted based on financial need and is means tested. If you live outside of the Greater Vancouver area, you can get assistance with accommodation and travel expenses.
All BC residents with a cancer diagnosis may also be eligible for the BC Cancer Agency and Canadian Cancer Society Financial Support Drug Program. This drug program only covers drugs directly related to the treatment of cancer.
Apply online. Applicants are interviewed for eligibility by an authorized volunteer who conducts a confidential needs assessment.
The Emergency Aid Programs are made possible through the generosity of donors and partnership with the BC Cancer Agency.
Auto Loans; Personal Loans; Personal Lines of Credit
You may be eligible for illness/disability provision if your loan or line of credit is insured for illness/disability. Review this option with your loans officer or bank manager.
CAUTION: If you choose the illness/disability provision, it is unlikely you can continue to access any funds under the line of credit for the duration.
You may be eligible for illness/disability provision (usually monthly minimum payment made for duration) if your credit card is insured for illness/disability. Review this option with your credit card company.
CAUTION: If you choose the illness/disability provision, it is unlikely you can continue to use the credit card for the duration.
You may be eligible for disability provision if your mortgage is insured for illness/disability. Review this option with your mortgage officer.
Putting one’s legal affairs in order does not necessarily mean an anticipated negative outcome. Dealing with these issues early on in your treatment will allow you more opportunities to focus on getting better.
Some legal documents and resources you may wish to consider are:
DISCLAIMER: The information on this web site is not legal advice.
Creating an advance care plan lets your family, friends, and health care professionals know the health decisions you would make for yourself if a health emergency arises and you are incapable of making decisions. No one knows what tomorrow may bring, but having an advance care plan can alleviate some of the stress for family or close friends who may deal with difficult health care decisions. Visit BC Family and Social Services for more information.
Nidus Personal Planning Resource Centre & Registry
This resource center offers comprehensive information on representation agreements and enduring powers of attorney as well as a registry service. Call 604-408-7414 or email at email@example.com or www.nidus.ca.
Dial-a-Law is a library of pre-recorded tapes with information about the law in BC. They have a tape on making a will as well as making a representation agreement. Call 604-687-4680 or toll-free at 1-800-565-5297. Or visit their website at www.dialalaw.peopleslawschool.ca
The People’s Law School
The People’s Law School is “an independent, non-profit, non-political society whose purpose is to provide British Columbians – especially those with particular legal needs – with reliable and impartial information about the law”. They can be reached by phone at 604-331-5400. Or visit their website at www.publiclegaled.bc.ca.
Click Law BC
This website provides access to general legal information. Visit their site at www.clicklaw.bc.ca.
Society of Notaries Public
Phone or visit the website to obtain the name and telephone number of a Notary Public near you. They can be reached at 604-681-4516 or toll-free at 1-800-663-0343. Or visit their website at www.notaries.bc.ca/bcdirectory.
Lawyer Referral Service
Lawyer referral service can be found through Access Pro Bono and provides help to all British Columbians find a suitable lawyer to help resolve legal problems. They can be reached at 604-687-3221 or toll-free at 1-800-663-1919. Please click on the link for more information about this service.
It is never comfortable to contemplate your own mortality, especially at a time when you or a family member is diagnosed with a life-threatening illness. Deciding whether or not to make a will when you are undergoing treatment is a personal decision. While we hope for the best possible outcome from your treatment, we also encourage you to be prepared for all possible outcomes.
It is important to know that a living will on its own has no legal effect. A living will must fit within a Representation Agreement for it to have legal authority. It is another piece of information that will enable your Representative to carry out your wishes. You may consider it important to put in writing the limits of treatment you wish to receive should your condition deteriorate. Putting your wishes in writing may make it easier on your next of kin, as they will clearly know how you feel, and what you want for yourself.
Please note that if you do want to put limits on the treatment you will be receiving, or do not want specific types of medical intervention, please discuss this with your hematologist. Owing to their many years of experience, they are often able to add a perspective that you possibly had not considered, and it is best to have the most accurate information when making your decision.
The purpose of writing a will is to pass on your possessions to the people you care about, and provide care for any minor children involved according to your wishes with as few problems as possible.
By having a will, you can make sure that the things you own go to the people you want to have them. A will can be useful for people who outlive you. They can then feel sure that they are carrying out your wishes.
If you should die without a will, it is usually a lot more complicated, time-intensive, and expensive to settle your estate. What this essentially means is that your loved ones will receive less.
Wills can either be done by an attorney or a notary, or on your own with a will kit, provided you do not have a complex estate. If you would like a copy of a will kit, please ask the BMT social workers.
- Assets: Money, property, possessions, a business – everything you own
- Estate: Everything you own at your death
- Beneficiary: A person or organization you leave something to in your will
- Codicil: A document made after the will that changes some things in your will
- Executor: The person you appoint to carry out the instructions in your will
- Probate: The procedure that says financial institutions and other organizations may rely on the will as being the last will you made.
Who can witness my will?
A will needs two witnesses, both of whom need to be over the age of 19. A witness cannot be a beneficiary. The witnesses do not need to read the will, but rather witness you sign it, and then sign the will themselves in front of you. The witness also cannot be a member of your healthcare team, such as a nurse or doctor involved in your care.
How detailed does my will have to be?
You need to be clear about exactly who your beneficiaries are. You cannot say, for example, that you wish to leave your money to hungry children in Africa.
But you don’t have to write down everything. You only need to be specific about articles of great value, either financial or sentimental. For example, you might want to say who should get your grandfather’s gold watch. You may not want to say what should happen to your alarm clock.
What does not go in a will?
A will often isn’t read until after the funeral. So you need to tell someone what kind of ceremony you want when you die, and whether you wish to be buried or cremated.
Joint assets do not form part of the estate, so if you and your spouse own a house together, it automatically goes to the spouse. Information about beneficiaries of RRSPs, RRIFs and life insurance policies don’t usually need to be included because when you purchase these you are often required to select a beneficiary right away.
What about executors?
Your executor is the person you name in your will to carry out your wishes and instructions. Your executor may need a document called a ‘Grant of Letters Probate’ from the Supreme Court to settle your estate.
An executor needs to be a reliable adult, who is not likely to predecease you. You can appoint more than one executor, but keep in mind that these people will need to be able to work together to settle your estate. Most people ask a family member or a close friend to be their executor. You can also appoint a lawyer, a private trust company or the Public Guardian and Trustee as executor.
Being an executor is a lot of work, so choose someone who has some knowledge of financial matters, and is comfortable dealing with government officials.
Your executor can be one of your beneficiaries.
Can I change my will after I have made it?
You can make a new will at any time, or change the will you have in place by signing a separate document called a codicil. The codicil has the same legal requirements as a will. The codicil must be in writing and be signed by you and two witnesses who are not beneficiaries. You don’t have to use the same two witnesses you used for your will.
Do I have to leave my estate to my family?
You are free to leave your estate to whomever you choose. Only a spouse (including common-law spouse) or your children can dispute the arrangements you make in your will.
Does it cost a lot of money to make a will?
A simple will does not cost much money and you may find that a lawyer or a notary public is the safest way to avoid mistakes. Ask a lawyer or Notary how much it will cost before you decide to give the job to him or her.
Do I have to register my will?
The law does not require that you register your will. However, it is a good idea to register your will because it shows where you have put your current will. You can register your will with the provincial government’s Wills Registry service. Please visit the Wills Registry information page on the BC governments’ website.
It may happen that at some point in your treatment, you become unable to handle your financial or health care decisions on your own. In such instances, family members are usually consulted. However, if there is a particular person you want to make decisions on your behalf when you become unable to do so, you must make that clear in a legal document. This legal document is called a Representation Agreement.
The reason to write a Representation Agreement is to appoint someone as your legal representative to handle your financial, legal, personal care and health care decisions, if you are unable to make them on your own.
In British Columbia, if you do not have a Representation Agreement in place during your treatment, the responsibility for health care decisions automatically falls to your next of kin. This may not be the person you would choose. Or, you may prefer a friend.
In addition, unless designated by a Representation Agreement (or an Enduring Power of Attorney), your next of kin will not have the authority to manage your financial affairs.
- Your wishes are at the center of decisions affecting you.
- You get help from those you choose, trust and who know you.
- Those you choose will have the legal authority to help you.
- You avoid extra costs, delay and conflicts that can result if there is no plan. It also eases the burden on others.
- You avoid government involvement in your personal and private affairs.
Who should I choose to represent me?
There are many factors to consider when choosing the people you want to help you, for example knowledge, skills, health. Trust is an important factor as well as respect for your wishes.
It is a good idea to name more than one person in your Agreement so you will have a “back up” in case one of them becomes ill, dies or resigns. The people you choose can live in another city, province or country.
Do I also need an Enduring Power of Attorney?
You may be able to cover all areas with the Representation Agreement. However, if you own real estate property and you would like to include this in your legal plan, you should use Enduring Power of Attorney. You should consult your notary public or lawyer if you are not certain.
Do I have to go to a lawyer or notary public?
It is recommended that you see a notary public or a lawyer when making a Representation Agreement. They can help you understand the wide range of issues surrounding this legal document and to avoid mistakes.
What happens when I die?
A Representation Agreement ends when you die. Then your Will takes over.
Many patients requiring treatment do not live in the Lower Mainland or may have friends and relatives from out of town who wish to stay in Vancouver to support them. If needed, the social workers can assist in finding accommodation in the area.
When making reservations, be sure to ask for “Medical Rates”.
Helpful information about places to stay near VGH can be found on the CIBC Centre for Patients and Families website.
Please note that rates in the Accommodations Guide are not guaranteed and subject to change. The facilities cited are only suggestions. No endorsements or comments are in any way implied with regard to quality, safety, or other aspects of operations. Visitors should contact the individual residences for further details such as check in/out times, cancellation policies, etc. Any concerns with the accommodation should be discussed and resolved with the proprietor.