The PSW benefit plays a critical role in helping members age at home. Over the lifetime of the plan, asrTrust anticipates covering $1.5 billion in member PSW claims. Given this significant investment, we’re committed to maximizing the value and quality of care members receive.
Why SE Health?
SE Health has been a trusted Canadian healthcare leader for 115 years. SE Health shares GreenShield’s mission to provide innovative, person-centered care. Together, we are enhancing the PSW experience to better support you and your loved ones through shared commitment and collaboration.
What’s New with the Enhanced PSW Program:
The Enhanced PSW Program will offer nurse-led assessments, regular care reviews and support you in accessing additional community resources beyond PSW services – all designed to support your health and well-being. It will NOT change your current coverage but instead enhance the quality and personalization of the service.
What You Need to Know:
For New PSW Services: Members initiating new PSW services will no longer contact Bayshore Carepath. Instead, members will simply contact Greenshield who will co-ordinate an initial assessment with a SE Health nurse.
For Members Currently Using PSW Services: There is no immediate change for you at this time. Greenshield will be contacting you prior to your next renewal and to provide guidance for transitioning to SE Health for your authorization process.
The website has been updated to reflect the changes of this new partnership.
This initiative reflects our commitment in delivering exceptional care and value to you and your loved ones.
For more information see the Frequently Asked Questions below.
Frequently Asked Questions
1. What is this program?
Effective January 15, 2025, GreenShield has partnered with SE Health to enhance PSW care for AsrTrust plan members. This new enhanced program replaces the Bayshore Elder Care Carepath program to bring plan members enhanced quality care through home support services.
Traditionally, asrTrust members needed to get authorization from their primary care provider for PSW services; instead, their assessment and authorization of covered hours will be done by an SE Health nurse. The SE Health nurse will also follow up every few months to make sure the approved hours still reflect their care need. If members need additional support, the SE health nurse can also provide care navigation support (for example, walking them through the process to find and apply for long-term care).
2. What has changed?
With this new program, asrTrust members will not need to get authorization from their primary care provider for PSW services; instead, their assessment and authorization of covered hours will be done by an SE Health nurse. This program replaces the Bayshore ElderCare program that only provided upfront care navigation support.
There is no other change to PSW coverage for plan members.
3. Why has asrTrust implemented this program?
asrTrust recognizes the challenge some members face in trying to access their primary care provider in a timely fashion to get the required approval for their PSW claims. In some cases, this creates a delay in accessing the care they need. This process of obtaining approval for PSW services will be greatly improved through SE Health. When members contact SE Health, a nurse will complete a virtual or in-person visit to assess member needs and authorize PSW care. SE Health’s regular care reviews also ensure that members are receiving the amount of care that reflects their health needs.
4. How is this different from the Bayshore CarePath program?
The Bayshore program is an optional service for asrTrust members looking for care navigation support only. This new SE Health care management program replaces the elder care component of the Bayshore program, adding much more than just navigation to help asrTrust members receive PSW services. This allows for additional client and family support in navigating the complexities of the health care system and increases client awareness of additional services they could access. asrTrust members still have access to CarePath for chronic disease and cancer care support – for more information, contact Bayshore directly.
5. What if I am working with CarePath right now?
If you have an open case with Care Path for Elder Care, they will continue to support you until your case is closed. Care Path will not open new cases for asrTrust members after January 1, 2025. Please contact GreenShield’s call center, and they will seamlessly transfer you to a SE Health partner who can support your needs.
6. I am actively using a PSW now, paid for under the asrTrust plan. What do I do?
All members who are currently using a PSW will be included in the new program. You will be contacted directly within the first 6 months of 2025. SE Health will schedule an in home or virtual visit with a SE Health nurse to ensure that your care plan is effective, and you are receiving quality care. After this visit, you will no longer be required to provide authorization from your family physician every 3 months to continue care. This assessment and authorization will be provided by the SE Health nurse.
7. Do I have to use an SE Health PSW?
No. As described in the benefits booklet, plan members may claim PSW services based on the hours they are authorize for, by any provider who:
- Holds a certificate from an accredited program
- Is employed by a provincially recognized, bonded health care provider
- Is not a relative
For convenience, all SE Health PSWs hold valid PSW certificates and are insured. If SE Health is your chosen PSW provider, SE Health can submit the claims on your behalf, and you do not need to provide additional documentation (e.g. PSW certificate). This also allows for a more seamless plan member experience. Other PSW providers may be able to submit claims on your behalf; to confirm, please check provider eligibility.
8. Has my PSW coverage changed?
No, your PSW service coverage and limits have not changed. Your initial assessment with the SE Health nurse will determine the hours you are authorized for, to a maximum of $100,000 annually. Your nurse will assess your needs and update your authorized hours as required based on any change to your care needs.
9. Who do I contact if I have questions or concerns about my PSW?
If you are using an SE Health PSW, you can contact SE Health directly for any questions or concerns regarding your care. If you have a non-urgent inquiry, your nurse can review with you at your care management or care review appointment.
If you are using a PSW from an organization other than SE Health, please contact that organization directly. While your SE Health nurse may be able to provide feedback about your care plan, they will not be able to liaise with a non-SE Health PSW on your behalf.
10. Who do I contact if I have questions about the care management Enhanced PSW Program or my coverage?
For questions regarding the program or your coverage, please contact GreenShield directly.
