The Newfoundland and Labrador government is refusing to pay thousands of dollars in medical travel costs related to a surgical procedure that a St. John’s woman was supposed to receive in Ottawa, but that was cancelled at the last moment.
“I went through all the processes of getting ready and was rolling through the doors of the OR when my surgery got cancelled,” said Natalie Warren in an interview last week at her home.
“Afterwards, I got stuck with the bill.”
Warren was scheduled to receive a “flow-diverter” stent in her right carotid artery at the Ottawa Hospital on Dec. 3. Both her carotids had dissected, meaning the arteries’ inner linings had torn and ballooned — a condition that stemmed blood flow to her brain and put her at major risk of a serious stroke.
“The hospital was not able to get the stent,” said the 37-year-old, who has had six mini strokes since last July, when she first went to the emergency room in St. John’s and saw a neurologist.
“That was heartbreaking. I had been so unwell for several months and had fought so hard to get to Ottawa.”
Claim rejected outright
After her return to St. John’s, Warren submitted receipts worth $5,000 for travel for her and her husband, as well as letters from her local neurologist stating the surgery she had been scheduled to undergo was “required” and that “travel out of province [was] necessary.”
The Medical Transportation Assistance Program (MTAP) rejected her claim outright.
In a one-page letter dated Feb. 3 that Warren said she still struggles to understand, the former nurse was told she was ineligible for assistance because she had travelled “to obtain a second opinion.”
“I’m not getting a carotid stent for fun,” said Warren, who is unable to work due to her condition and relies on government assistance to pay her bills. “It’s not a cosmetic procedure, it’s not an elective procedure, it’s something that I absolutely needed to live.”
Sinking into debt due to medical travel
Warren said the day after the MTAP rejection, she met virtually with another surgeon, this time at St. Michael’s Hospital in Toronto, who advised her to fly to Ontario as soon as possible given her risk of stroke.
Unable to pay off her initial trip to Ottawa without the MTAP reimbursement, Warren said she at first hesitated to rebook the surgery, then used credit cards to pay for another week’s travel to Toronto.
“I was forced to choose between my financial security and my health,” said Warren. “I’m incredibly in debt from this medical travel.”
A stent was successfully placed in her right carotid artery on March 3, with a second procedure for her left carotid booked for Tuesday.
Decision partially overturned
Warren appealed MTAP’s initial decision and contacted her local MHA, NDP Leader Jim Dinn, who took up her cause and wrote to Health and Community Services Minister Lela Evans on Feb. 24.
Three days later, Warren’s appeal was accepted, but her expenses for travel to Ottawa were still only partially reimbursed.
N.L. NDP Leader Jim Dinn takes part in a media scrum following an announcement at Confederation Building in St. John’s on Jan. 28, 2026. (Patrick Butler/Radio-Canada)
In the end, Warren received $1,400 of the $5,000 she said she spent, with MTAP refusing to cover more than three days’ expenses given the surgery was cancelled.
Warren said that on her surgeon’s recommendation, she had booked a hotel near the Ottawa Hospital for a week to allow time for pre-op, surgery and recovery before returning to Newfoundland. She said her hotel stay wasn’t refundable and that she wasn’t sure whether the province would pay for expensive changes to flights.
“Even when it gets to my level, they’re still not gonna fund it fully,” said Dinn. “The person’s still out of pocket for a procedure that could not be done here and if she’d waited any longer for the approval she’d probably be dead.”
“It’s almost like they’re punishing people for being sick,” said Dinn. “They’re very good at entangling people and not lifting them up.”
MTAP ‘working as it should be,’ says minister
On Friday, Evans said patients relying on MTAP need to read the policy governing the program attentively so they are aware of exactly what expenses are eligible for reimbursement and to what extent.
She said the program as it stands “respects the patient and the patient’s needs and is fiscally responsible.”
Newfoundland and Labrador’s Health and Community Services Minister Lela Evans responds to questions outside the House of Assembly in St. John’s on March 11, 2026. (Patrick Butler/Radio-Canada)
“The MTAP system is working as it should be,” said Evans, who declined to speak to Warren’s case specifically but said that “a reimbursement for a trip of $1,400 sounds about right.”
“I certainly don’t think she is being nickel and dimed,” said Evans, adding that her Progressive Conservative government is committed to modifying MTAP so it fully reimburses expenses for which only a portion of the cost is currently covered.
Calls to streamline MTAP
Dinn and Warren said MTAP needs to be streamlined and that the process of getting reimbursed for necessary medical travel needs to be easier.
“Because I’m in Newfoundland and I’m a Newfoundlander, it’s like I don’t have the right to the same standard of care as everybody else in Canada,” said Warren.
“All of these hoops that you’re forced to jump through, the denials, the roller-coaster of it all, should any of that have happened? No.”