Asthma worsened for a woman after discontinuation of medication coverage

Disappointed couple from Ottawa can't get answers from Canada Life

It's like breathing through a straw.

That's how Janice Namesnevski describes her daily struggle for breath since she developed asthma at the age of 30.

Now 63 years old, Namesnevski, a retiree living in the Orleans area of Ottawa with her husband Conrad, manages her condition with a series of corticosteroid inhalers, but her lung capacity, initially measured at 30 percent, has only worsened.

"Over time, it just got worse and worse, and all the doctors could do up to this point is just throw another inhaler at me," Namesnevski said.

Their daughter nearly drowned. Now they're going into debt to pay for her care. Change in medical insurance plan ends payouts for late soldier's daughters She was hospitalized after her life-sustaining drug coverage was cut. Then, last year, an allergist suggested she try Xolair, an injectable medication used to treat moderate to severe asthma in patients for whom inhalers simply don't work.

The drug is expensive — $2,264.70 for a course with injections every two weeks. It's covered by OHIP, Ontario's provincial health insurance program, but only for residents aged 65 and over.

This week, CBC Ottawa will share new stories of public servants affected by the transition to Canada Life. If you want to share your story, send us an email. SEE | She couldn't afford asthma treatment after Canada Life coverage change:

She couldn't afford asthma treatment after Canada Life coverage change. 1 hour ago Duration3:47 Janice Namesnevski felt hopeful when she started treating her asthma with Xolair, an injectable medication costing $2,264.70 per course. But she can't afford it if it's not partially covered by her insurance plan, and her insurance was abruptly terminated when Canada Life took over the public health plan in July. A "Hallelujah" Moment Fortunately, Conrad Namesnevski, who retired in 2019 as a colonel after a 42-year military career during which the couple traveled the world, is covered by the Public Service Health Care Plan (PSHCP).

They'll still have to pay 20 percent out of pocket — $452.95 for the treatment or about $900 a month — but the couple, who recently finished paying off their mortgage, decided they could afford to give Xolair a chance.

Janice began treatment in January, and by March, her lung capacity had increased to 46 percent.

"I started noticing significant improvements," she said. "So it was like a 'hallelujah' moment!"

Conrad also noticed an improvement in his wife's health.

"I noticed a significant difference in her energy, her ability to speak without wheezing, her ability to go up the stairs without stopping," he said.

The Namesnevski family is among the 1.7 million federal workers, retirees, and their families eligible for benefits under PSHCP. Canada Life took over management of the plan on July 1, and along with it came changes in what's covered, claim limits, the claims process, and how members can communicate with agents.

The Treasury Board of Canada Secretariat, which oversees labor relations between the federal government and the public sector, said changes to the plan, including claim limits, coverage conditions, and the right to participate, were approved last fall, independently of the transition to Canada Life.

These changes took effect after Canada Life won the contract to administer PSHCP.

A couple walks along a wet suburban street. Conrad and Janice Namesnevski take a walk in their Ottawa east-end neighbourhood. Janice can even get breathless from walking. (Francis Ferland/CBC) Lack of Communication In July, the Namesnevskis learned that their Xolair coverage had suddenly stopped without explanation. Two weeks later, they tried again, but their claim was rejected before the prescription was filled.

Unable to afford the full cost of the medication, Janice hasn't had Xolair treatment since June 28 and has noticed her health deteriorating again since.

"I'm losing it," she told CBC. "We're going backward, and it's very upsetting."

To the couple's disappointment, there has also been a complete lack of communication with Canada Life. Despite countless hours of waiting and numerous emails sent, they have been unable to find out why their coverage was terminated.

"I haven't heard anything about any of these attempts," Conrad said. "It's helplessness and hopelessness because if you can't talk to somebody, if you can't get an answer by email, if you can't reach them by chat... you're left in a suspended state, and we're at a loss."

Numerous Canada Life clients covered under the Public Service Health Care Plan have described a similar frustrating experience.

In August, the couple asked their doctor to resubmit a pre-authorization form to Canada Life for Xolair, but they received no instructions on how to obtain it.

"There just wasn't any communication, so we have no idea what's happening," Janice said.