Tariff for insured visual aids and related services aides visuelles/2016/liste_at_aides...SCHEDULE 1...

SCHEDULE I

(s. 1)

TARIFF FOR INSURED VISUAL AIDS

AND RELATED SERVICES

Document produced by the Régie de l’assurance maladie du Québec and published on its website

Legal deposit – Library and Archives Canada, 2011

ISSN 1925-4709

Québec, December 12, 2016

PART I: CATEGORIES AND TYPES OF AIDS INSURED FOR ALL PERSONS WITH A VISUAL

DEFICIENCY .............................................................................................................................................................. 1

DIVISION I: READING AIDS ................................................................................................................................. 1

DIVISION II: WRITING AIDS ................................................................................................................................. 6

DIVISION III: MOBILITY AIDS ............................................................................................................................. 7

DIVISION IV: COMPUTER AIDS ........................................................................................................................... 9

SUBDIVISION 1: AIDS FOR THE “PRINT MAGNIFICATION” METHOD OF COMMUNICATION . 9

SUBDIVISION 2: AIDS FOR THE “SOUND” METHOD OF COMMUNICATION ................................ 10

SUBDIVISION 3: AIDS FOR THE “BRAILLE” METHOD OF COMMUNICATION ............................ 11

DIVISION V: AIDS FOR DAILY AND DOMESTIC LIFE ................................................................................... 12

SUBDIVISION 1: RENEWABLE AIDS .......................................................................................................... 12

SUBDIVISION 2: ONE-TIME AIDS ............................................................................................................... 14

SUBDIVISION 3: RENEWABLE HEALTH AIDS ........................................................................................ 15

PART II: CATEGORIES AND TYPES OF AIDS INSURED FOR PERSONS WITH A VISUAL

DEFICIENCY REFFERED TO IN SECTION 26 OF THE REGULATION RESPECTING INSURED

VISUAL AIDS AND RELATED SERVICES ......................................................................................................... 16

DIVISION I: COMPUTER AIDS............................................................................................................................ 16

SUBDIVISION 1: AIDS FOR THE “PRINT MAGNIFICATION” METHOD OF COMMUNICATION

.............................................................................................................................................................................. 16

SUBDIVISION 2: AIDS FOR THE “SOUND” METHOD OF COMMUNICATION ................................ 17

SUBDIVISION 3: AIDS FOR THE “BRAILLE” METHOD OF COMMUNICATION ............................ 18

DIVISION II: READING, WRITING AND MOBILITY AIDS ............................................................................. 19

SUBDIVISION 1: READING AIDS ................................................................................................................. 19

SUBDIVISION 2: WRITING AIDS.................................................................................................................. 21

SUBDIVISION 3: MOBILITY AIDS ............................................................................................................... 22

PART III: UNINSURED VISUAL AIDS WHOSE COST HAS ALREADY BEEN REIMBURSED BY THE

RÉGIE, BY A PROGRAM UNDER THE RESPONSIBILITY OF THE MINISTER OF HEALTH AND

SOCIAL SERVICES OR BY THE INSURED PERSON FOR REPAIR PURPOSES ....................................... 23

PART IV: QUARTER-HOURLY RATE FOR THE REPAIR OF INSURED VISUAL AIDS .......................... 26

SCHEDULE 1 Tariff for insured visual aids and related services

(authentic version)

Updated: December 12, 2016 1

PART I: CATEGORIES AND TYPES OF AIDS INSURED FOR ALL PERSONS WITH A

VISUAL DEFICIENCY

DIVISION I: READING AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

1. Hearing aid

182 a. Single-function digital reader 430.00

183 b. Digital reader with advanced functions 418.00

185 c. Hand-held single-function digital reader with a

recording mode

360.00

184 d. Digital reader software 150.00

Component:

186 Memory card for hand-held digital reader 30.00

Supplements:

187 Earphones 30.00

188 Carrying case 30.00

189 Microphone 30.00

2. Vocal note taking device

190 a. Hand-held vocal note taking device 70.00

360 3. Split-lens with additions greater than four (4)

diopters

350.00

Component:

361 Frame 120.00

4. Adapted electronic calculator

401 a. Sound model, French, single-function 110.00

403 b. Sound model, English, single-function 110.00

431 c. Large-print model, single-function 60.00

257 5. Yellow filter sheet 3.00

342 6. Contact lens (left or right) 225.00

340 7. Contact lens with artificial pupil (left or right) 200.00


(authentic version)

2 Updated: December 12, 2016

460 8. Fresnel lens 250.00

Components:

461 Carrier lenses (left and right) 250.00

462 Frame 120.00

390 9. Microscopic lens 300,00

Component:

391 Frame 120.00

10. Filtering lens

393 a. Non-prescription tinted filtering lenses, with frame 150.00

394 b. Prescription tinted filtering lenses 250.00

395 c. Non-prescription photochromic filtering lenses 200.00

396 d. Prescription photochromic filtering lenses 300.00

Component:

258 Frame (for prescription tinted model and for

prescription and non-prescription photochromic

models)

120.00

11. Magnifier

433 a. Pocket model 80.00

437 b. Hand-held model 120.00

438 c. Fixed-focus model 150.00

435 d. Adjustable-arm illuminated model 400.00

Component:

436 Appropriate support for fixed-focus magnifier 145.00

Supplement:

352 Auxiliary lens for adjustable-arm illuminated

model

100.00

350 e. Magnifier 80.00

Supplement:

351 Appropriate support 110.00

434 f. Hand-held model 180.00

255 12. Obturator 5.00

254 13. Occluder 10.00


(authentic version)


14. Fresnel prism

470 Fresnel prism, basic model 50.00

464 Sectional Fresnel prisms 300.00

Components:

471 Lenses 250.00

472 Frame 120.00

15. Reading stand

256 a. Table-top model 105.00

259 b. Adjustable-arm model 75.00

16. Microscopic optical system

320 a. Monocular model 500.00

330 b. Binocular model 500.00

Components:


304 Frame 120.00

Supplement:

302 Contact lens (left or right) 225.00

17. Telescopic optical system

310 a. Binocular 550.00

353 b. Monocular 3x 400.00

354 c. Monocular 4x 400.00

355 d. Monocular 5x 445.00

356 e. Monocular 6x 520.00

357 f. Monocular 7x 400.00

358 g. Monocular 8x 500.00

363 h. Monocular 6 x 16 160.00

364 i. Monocular 7 x 25 170.00

365 j. Monocular 10 x 20 165.00

366 k. Monocular 10 x 30 165.00

367 l. Monocular 8 x 20 205.00

368 m. Monocular 4 x 10 165.00

369 n. Monocular 4 x 12 165.00

362 o. Monocular with prescription 1,000.00

371 p. Binocular with prescription 1,800.00

359 q. Monocular, other 430.00

Components:


304 Frame 120.00


(authentic version)


Supplement:


18. Video magnifier

840 a. Self-contained power supplied model, small screen 600.00

850 b. Portable self-contained power supplied model, large

screen

1,100.00

280 c. Mini-camera model, no screen 1,265.00

841 d. Standard-screen model 1,850.00

842 e. Large-screen model 2,450.00

Reassignable video magnifiers

281 e. Camera model, free-standing 1,265.00

282 f. 14 in. to 17 in. monochrome model 2,600.00

283 g. 14 in. to 17 in. monochrome model with reading

functions

2,650.00

284 h. 14 in. to 17 in. two-colour model with reading

functions

2,960.00

285 i. Large-screen monochrome model with reading

functions

2,200.00

286 j. 19 in. large-screen, two-colour model with reading

functions

3,000.00

287 k. 14 in. colour model with reading functions 3,900.00

288 l. Large-screen colour model with reading functions 3,500.00

289 m. Portable monochrome model 3,000.00

671 n. Colour model, thin screen 4,500.00

674 o. Portable colour model, with or without SVGA 3,900.00

859 p. Video magnifiers assignable pursuant to section 15 of

the Regulation respecting insured visual aids and

related services

N/A

Supplements:

202 Height-adjustment device 145.00

206 Support 15.00

Reassignable valorized video magnifiers

279 q. Monochrome model (voyageur 14 in.) 675.00

Optional component:

177 Cathode ray screen 100.00

680 r. Voyageur XL model (camera and original 19 in.

monitor)

675.00

681 s. Voyageur XL model (camera and original 15 in.

monitor)

675.00

682 t. Vantage model 675.00

Optional component:


(authentic version)


175 Original 15 in. monitor 125.00

683 u. Lumina model 1,275.00

253 19. Pinhole disk 11.00

251 20. Typoscope 10.00

252 21. Visor 30.00

199 22. Other reading aids S.C.


(authentic version)


DIVISION II: WRITING AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

23. Brailler

591 a. Bimanual mechanical model 1,200.00

592 b. Jumbo mechanical model 1,300.00

Component:

511 Extension keys 65.00

Supplement:


299 24. Other writing aids S.C.


(authentic version)


DIVISION III: MOBILITY AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

25. Cane

601 a. Long sensing cane, folding 45.00

602 b. Long sensing cane, rigid 45.00

Supplements:

603 Rubber tip 8.00

604 Roller 15.00

26. Door detector

860 a. Sound model 350.00

27. Electronic obstacle detector

820 a. Hand-held tactile model 800.00

830 b. Neck-mounted tactile model 1,250.00

701 28. Acquisition costs for a guide dog 210.00

702 29. Annual maintenance costs for a guide dog 1,028.00

605 30. Mobility lamp 130.00

606 31. Night vision goggle 4,500.00

32. Telescopic optical system

310 a. Binocular 550.00

353 b. Monocular 3x 400.00

354 c. Monocular 4x 400.00

355 d. Monocular 5x 445.00

356 e. Monocular 6x 520.00

357 f. Monocular 7x 400.00

358 g. Monocular 8x 500.00

363 h. Monocular 6 x 16 160.00

364 i. Monocular 7 x 25 170.00

365 j. Monocular 10 x 20 165.00

366 k. Monocular 10 x 30 165.00

367 l. Monocular 8 x 20 205.00

368 m. Monocular 4 x 10 165.00

369 n. Monocular 4 x 12 165.00


(authentic version)


362 o. Monocular with prescription 1,000.00

371 p. Binocular with prescription 1,800.00

359 q. Monocular, other 430.00

399 33. Other mobility aids S.C.


(authentic version)


DIVISION IV: COMPUTER AIDS

SUBDIVISION 1: AIDS FOR THE “PRINT MAGNIFICATION” METHOD OF

COMMUNICATION

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

34. Print magnification software

501 a. Model without speech synthesis 550.00

502 b. Model with speech synthesis 750.00

264 c. Under Windows, French 800.00

268 d. Under Windows, English 952.00

35. Monitor

503 a. Large-screen model 350.00

504 b. Extra-large-screen model 500.00

246 c. 19 in. model 415.00

262 d. 21 in. model 1,100.00

36. Adjustable-arm support

505 a. Adjustable-arm support 300.00

274 b. For 17 in. and 19 in. monitors 250.00

653 c. For other monitors 300.00

398 37. Other aids for the “Print Magnification”

method of communication

S.C.


(authentic version)


SUBDIVISION 2: AIDS FOR THE “SOUND” METHOD OF COMMUNICATION

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

38. Screen reader software

507 a. French version 1,600.00

508 b. English version 1,400.00

638 c. Under Windows, French 1,345.00

639 d. Under Windows, English 1,400.00

39. Print recognition unit

607 a. Software, French version 1,450.00

613 b. Software, English version 1,250.00

509 c. Off-line model 1,850.00

Component:

624 Digitizer (software, French and English

versions)

210.00

620 d. French model 500.00

621 e. English model 500.00

622 f. Bilingual model 500.00

498 40. Other aids for the “Sound” method of

communication

S.C.


(authentic version)


SUBDIVISION 3: AIDS FOR THE “BRAILLE” METHOD OF COMMUNICATION

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

41. Braille display

278 a. Outdated model N/A

529 b. Model that can be assigned pursuant to section 22 of

the Regulation respecting insured visual aids and

related services

N/A

42. Screen reader software

507 a. French version 1,600.00

508 b. English version 1,400.00

638 c. Under Windows, French 1,345.00

639 d. Under Windows, English 1,400.00

43. Print recognition unit

607 a. Software, French version 1,450.00

613 b. Software, English version 1,250.00

509 c. Off-line model 1,850.00

Component:

624 Digitizer (software, French and English

versions)

210.00

620 d. French model 500.00

621 e. English model 500.00

622 f. Bilingual model 500.00

598 44. Other aids for the “Braille” method of

communication

S.C.


(authentic version)


DIVISION V: AIDS FOR DAILY AND DOMESTIC LIFE

SUBDIVISION 1: RENEWABLE AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

710 45. Arithmetic frame 55.00

Component:

711 Cubarithm 45.00

712 46. Adapted geometry kit 240.00

47. Adapted labeller

713 a. Braille model 70.00

714 b. Sound model 200.00

715 48. Magnifying mirror 80.00

49. Adapted watch

716 a. Braille model 250.00

717 50. Sound level 60.00

718 51. Inclined reading stand 120.00

52. Adapted protractor

719 a. Large-print model 25.00

720 b. Braille model 70.00

721 53. Pocket Braille frame 85.00

54. Adapted tape measure



724 c. Tactile model 60.00

725 55. Tape holder for brailler 75.00

56. Braille slate (letter size)

726 a. Letter-size model 135.00


(authentic version)


698 57. Other renewable aids S.C.


(authentic version)


SUBDIVISION 2: ONE-TIME AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

740 58. Adapted plate 35.00

741 59. Adapted knife with guide 40.00

742 60. Liquid level sound detector 30.00

743 61. Check guide 25.00

744 62. Dedicated accent reading lamp, without

magnifier

130.00

63 Adapted food scale




748 64. Adapted pedometer 55.00

749 65. Adapted wallet 35.00

66. Adapted alarm clock




753 67. Syringe stand 30.00

754 68. Adapted meat thermometer 60.00

798 69. Other one-time aids S.C.


(authentic version)


SUBDIVISION 3: RENEWABLE HEALTH AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

770 70. Talking blood glucose monitor 600.00

71. Adapted bathroom scale



773 72. Talking blood pressure clamp 400.00

774 73. Talking personal thermometer 60.00

898 74. Other renewable health aids S.C.


(authentic version)


PART II: CATEGORIES AND TYPES OF AIDS INSURED FOR PERSONS WITH A VISUAL

DEFICIENCY REFFERED TO IN SECTION 26 OF THE REGULATION RESPECTING

INSURED VISUAL AIDS AND RELATED SERVICES

DIVISION I: COMPUTER AIDS

SUBDIVISION 1: AIDS FOR THE “PRINT MAGNIFICATION” METHOD OF

COMMUNICATION

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

1. Computer

512 a. Desktop model with system software 1,600.00

513 b. Portable model with system software 2,200.00

Components:

514 Standard printer 210.00

515 Office software, regular price 300.00

516 Office software, student price 200.00

Supplement:

518 Carrying case for portable model 100.00

397 2. Other aids for the “Print Magnification”

method of communication

S.C.


(authentic version)


SUBDIVISION 2: AIDS FOR THE “SOUND” METHOD OF COMMUNICATION

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

3. Computer



Components:




517 Monitor for desktop model 200.00

Supplement:


235 4. Screen reader control keyboard 80.00

649 5. Speech synthesis software 850.00

497 6. Other aids for the “Sound” method of

communication

S.C.


(authentic version)


SUBDIVISION 3: AIDS FOR THE “BRAILLE” METHOD OF COMMUNICATION

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

7. Computer



Components:




517 Monitor for desktop model 200.00

Supplement:


235 8. Screen reader control keyboard 80.00

9. Braille display

422 a. 24-cell or less model 4,000.00

522 b. 25 to 59-cell or less model, with cable 3,200.00

233 c. 25 to 59-cell or less model, without cable 4,000.00

523 d. 60-cell or more model 8,000.00

345 e. Personal assistant display 6,500.00

524 10. Dedicated Braille communication computer

system

9,000.00

275 11. Braille printer 4,000.00

12. Braille shortening software

525 a. Braille shortening software 850.00

644 b. Under Windows 800.00

645 c. Under Macintosh 1,020.00

649 13. Speech synthesis software 850.00

597 14. Other aids for the “Braille” method of

communication

S.C.


(authentic version)


DIVISION II: READING, WRITING AND MOBILITY AIDS

SUBDIVISION 1: READING AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

15. Hearing aid

181 a. Multiple-function digital reader with a recording

mode

1,100.00

Component:

186 Memory card for hand-held digital reader 30.00

Supplements:

187 Earphones 30.00



16. Adapted scientific calculator

402 a. Sound model, French 550.00

404 b. Sound model, English 550.00

432 c. Large-print model 550.00

17. Reading stand

269 a. Free-standing model 125.00

18. Telemicroscopic optical system

370 a. Monocular model 1,400.00

380 b. Binocular model 2,400.00

Components:

303 Carrier lens (left and right) 300.00

304 Frame 120.00

Supplement:



(authentic version)


19. Video magnifier

851 a. Computer-compatible model 2,900.00

290 b. SVGA model, other 4,500.00

697 20. Other reading aids S.C.


(authentic version)


SUBDIVISION 2: WRITING AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

21. Electric brailler

595 a. Single-function model 1,400.00

596 b. Multiple-function model 1,600.00

Component:

511 Extension keys 65.00

Supplement:


797 22. Other writing aids S.C.


(authentic version)


SUBDIVISION 3: MOBILITY AIDS

Maximum

purchase or

replacement

price

Maximum price

used to establish

repair costs for

reassigned aids

only

23. Electronic obstacle detector

810 a. Sound model 1,500.00

24. Adapted satellite geopositioning system

805 a. Single-function model 950.00

897 25. Other mobility aids S.C.


(authentic version)


PART III: UNINSURED VISUAL AIDS WHOSE COST HAS ALREADY BEEN REIMBURSED

BY THE RÉGIE, BY A PROGRAM UNDER THE RESPONSIBILITY OF THE MINISTER OF

HEALTH AND SOCIAL SERVICES OR BY THE INSURED PERSON FOR REPAIR

PURPOSES

Maximum cost

that may have

been reimbursed

upon purchase or

replacement

1. Recording and listening device

110 a. Variable-speed tape recorder, portable 418.00

120 b. Variable-speed tape recorder, compact 315.00

130 c. Tape recorder with electronic capacity control 350.00

170 d. Conventional tape recorder, portable 45.00

180 e. Conventional tape recorder, compact 130.00

Supplements:

131 Earphone(s) 28.00


136 Foot control 13.00

137 Patch cord 20.00

138 Compatible case and strap 25.00

2. Adapted calculator

420 a. Braille model with tactile reader 1,035.00

3. Computer

236 a. Desktop model N/A

241 b. Desktop model 1,000.00

242 c. Portable model 1,400.00

296 d. Portable model N/A

306 e. Portable model and Windows XP 2,900.00

347 f. Desktop model and Windows XP 2,000.00

4. Monitor

243 a. Monitor 395.00

239 a. 17 in. standard monitor 265.00

244 5. Standard printer 210.00

375 6. Standard printer N/A


(authentic version)


7. Voice synthesizer

265 a. French model 2,025.00

266 b. English model 1,700.00

267 c. Bilingual model 1,900.00

8. Dedicated Braille writing computer system

611 a. Model with Braille keyboard 5,500.00

612 b. Sound model 3,500.00

9. Word processing software

376 a. French version N/A

633 b. Under Windows, French, regular price 400.00

634 c. Under Windows, French, student price 185.00

635 d. Under Windows, English, regular price 350.00

636 e. Under Windows, English, student price 185.00

642 f. Under Windows Office XP, French, student price 260.00

643 g. Under Windows Office XP, English, student price 260.00

646 h. Under Windows, French or English, regular price, Word 660.00

647 i. Under Windows, French or English, student price, Office 353.00

648 j. Under Windows XP 400.00

100 10. Print converter, tactile model 5,500.00

Supplements:

102 Typewriter lens 1,445.00

104 Compatible guide control 295.00

105 Fixed-focus lens 400.00

106 Cathode ray screen lens 540.00

103 11. Lens with adjustable focus 60.00

12. Video magnifiers

220 a. Video magnifier, complete system adaptable to a typewriter including

an electronic line marker

2,300.00

297 b. Valorized video magnifier, private sector 675.00

Supplements:

201 Additional work table 45.00

204 Screen separator 150.00

205 Mirror 50.00

207 Video camera 1 650,00

208 Microfiche reader 750.00

209 Zoom lens 1,000.00

291 Automated viewing table 2,000.00

590 13. Brailler, unimanual model 420,00


(authentic version)


450 14. Brailler, with tactile reader 300.00

247 15. Articulated-arm support for 14 in. monitor 40.00

499 16. Other reading, writing and mobility aids S.C.

599 17. Other writing or reading computer systems S.C.

699 18. Other print reading computer systems S.C.

195 19. Aids, components or supplements whose cost has already been

reimbursed by a visual aid program under the responsability

of the Minister of Health and Social Services before June 2,

2011

N/A

196 20. Aids, components or supplements whose cost was assumed by

the insured person and whose repair is eligible pursuant to

section 10 of the Regulation respecting insured visual aids and

related services

N/A


(authentic version)


PART IV: QUARTER-HOURLY RATE FOR THE REPAIR OF INSURED VISUAL AIDS

QUARTER-HOURLY RATE: $12.04

Tariff for insured visual aids and related services aides visuelles/2016/liste_at_aides...SCHEDULE 1...

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Transcript of Tariff for insured visual aids and related services aides visuelles/2016/liste_at_aides...SCHEDULE 1...