'These products are essential:' Group pushes for ostomy supplies coverage

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A group representing New Brunswick ostomy patients is asking the province to expand its financial coverage of medical supplies to provide relief amid rising living costs.

Sharon Mercer, president of the Moncton chapter of the Ostomy Canada Society, said her group, with support from the national organization and nurses working with ostomy patients, submitted a proposal to the Department of Health dated March 11 with a series of recommendations on changes they would like to see for ostomy coverage.

An ostomy is a surgical opening that can be created from the intestine or urinary tract to the surface of the abdomen. This opening is created to remove feces or urine from the body, and requires a medical device called a pouching system to contain the drainage.

The pouching system needs to be emptied throughout the day and changed regularly to protect the surrounding skin.

Mercer, who has had an ostomy for 23 years, said people of all ages have ostomies for Crohn’s disease, colitis and other bowel illnesses. She added more younger people are needing surgery to get an ostomy, and in some cases it can be a matter of life or death.

 “These products are essential,” she said.  “We can’t function in our community unless we have these products on our body.”

It’s estimated that more than 5,000 people in New Brunswick living with an ostomy, but Mercer said the number is under reported because of a lack of standardized reporting.

Currently, the Department of Social Development offers the Health Services Ostomy/Incontinence Program to Social Development clients and their dependents who hold a valid white health card, and covers the cost of supplies.

In order to qualify for full benefits, clients must not have any other medical coverage.

“Eligible services are paid monthly,” the program’s website states. “Quantities and frequencies are monitored and may be restricted.”

There is also a program for New Brunswick seniors over the age of 65 through Blue Cross with 80 per cent coverage for ostomy products, but there is a one-year penalty on ostomy supplies if the person does not apply for the program within 60 days after their 65^th birthday.

Those who do not qualify for the Social Development program or the seniors’ Blue Cross program have to pay out of pocket, or pay for private insurance if it is not provided through their employment. Ostomy supply coverage from private insurance ranges from 70-100 per cent.

Louise Levesque-Burley, a Moncton resident, has been living with an ostomy since 2021 because of Crohn’s disease.

She has full coverage for her supplies, but is advocating for those who cannot afford the steep costs.

“If I wasn’t covered I don’t know how I would pay for them,” she said. “If someone is making minimum wage I don’t know how they can afford pouches.” 

Mercer said the amount of ostomy products needed varies depending on their medical condition, but the minimal cost is roughly $3,000 a year. 

“That really bites at your budget,” she said, noting the cost of gas, groceries, and utilities has increased, and ostomy patients are left cutting costs on medication, rent, and fuel. 

According to the proposal, the group is asking for the province would cover the remaining costs not covered by private insurance or the seniors Blue Cross program, including co-pay and amounts exceeding the cap.

It is also asking the province to cover the full cost of “essential” ostomy supplies for uninsured New Brunswickers who do not qualify for Social Development, as well as removing the one-year penalty from the Blue Cross program.

Mercer said coverage for ostomy products differs from province to province. For example, Manitoba offers 100 per cent coverage for basic ostomy supplies.

“New Brunswick doesn’t have that. It’s time they pull up their socks,” she said. 

Members of the group have met with Health Minister Bruce Fitch last month where they presented the proposal. Since then, they have not received word on if their recommendations were being considered.

“Everything is at a standstill,” said Levesque-Burley.