Ontario Health Insurance coverage

kacey · May 6, 2006

Has anyone successfully received OHIP coverage for their banding? or has anyone in Canada in another province received coverage for their banding from their Provincial Insurance Plan? Can anyone share their Insurance advice with me? I have already been banded. (13 April 06).

argon · May 6, 2006

Never heard of anyone getting anything for the band out of Ontario. Alberta is now covering it, but it's still in a trial-type thing, so they do very few.

In NB, they'll pay for everything BUT the band itself.... not sure if it HAS to be done in NB for that though. I know of someone in MB who's getting a little bit of recompensation for her costs, but not much.

My prov. (SK) says no to paying for anything, but I'm still planning on sending them my receipt and a looooong letter, and hoping for at least a little something back. I'm sure I won't, but I'll know I tried.

CLOE · May 6, 2006

Sounds like a good idea Mandi. I called OHIP(Ontario Insurance) they said no, and told me to talk to the surgeon. But it has nothing to do with him. So I already sent a letter to my private insurance and I think I'll send one to OHIP too, can't hurt, like you say. I'm not counting on either of them though!

HUGI · January 11, 2007

:huggie: :tape2: :o :o

Never heard of anyone getting anything for the band out of Ontario. Alberta is now covering it, but it's still in a trial-type thing, so they do very few.
In NB, they'll pay for everything BUT the band itself.... not sure if it HAS to be done in NB for that though. I know of someone in MB who's getting a little bit of recompensation for her costs, but not much.

My prov. (SK) says no to paying for anything, but I'm still planning on sending them my receipt and a looooong letter, and hoping for at least a little something back. I'm sure I won't, but I'll know I tried.

could I have a copy of that loooooooooog letter for ont??

somehow I think you'll write a great one

hugi

argon · January 11, 2007

You know, I started it, got side tracked, went back to it a couple times, but never finished it :huggie: I thought it was worth a try, and I wish I had...I know I'll regret it forever. Kinda screwed me up that I moved out of province a few months later, so I'd be in for even more of a hard time, trying to hassle them from here.

All I really said was my story, about trying to better my life, trying to keep/get myself healthy to live out my life (in beautiful SK... haha, had to get that in to try to make them think they need to keep the youngins in SK), that it was unfair to make people wait 5-7 years, and only offer one option (bypass), and not even have a surgeon in the province (anymore), so in turn, relying on the few bypass surgeons in the west to handle the entire flow of overweight people in BC, AB, SK, ans MB. Luckily AB is covering it now (to an extent) and that takes some of the weight off (haha, pun!), but the Lapband in AB is just going to turn into how the RNY/bypass is... a several year wait! Ok... that turned into a rant.

I think you should just state your case, tell how certain provinces cover it, why you're doing it, how you'll be less of a drain on healthcare with ____ lbs less that you'd be if you continued to inevitably gain, an get more and more unhealthy.

Sorry I can't be more help. :phanvan

HUGI · January 12, 2007

Anyone else out there in Ontario want to get together with me and prepare something to try and get this surgery covered by OHIP??:bandit

JO

argon · January 15, 2007

Alberta is now covering it, but it's still in a trial-type thing, so they do very few.

I want to edit this to say, that when I said this, I meant "Calgary" not Alberta. They've been doing lapbanding in Edmonton (Dr's Davey and Birch) for a while now. The banding in Calgary is new. I don't know if the lapband program they do at the Royal Alex in Edmonton is subject to the same restrictions they have in Calgary (like only doing 25 a year)... but probably.

Clarification, I hope!

Gaffer · January 15, 2007

I want to edit this to say, that when I said this, I meant "Calgary" not Alberta. They've been doing lapbanding in Edmonton (Dr's Davey and Birch) for a while now. The banding in Calgary is new. I don't know if the lapband program they do at the Royal Alex in Edmonton is subject to the same restrictions they have in Calgary (like only doing 25 a year)... but probably.
Clarification, I hope!

I am pretty sure that they are limited in Edmonton too as far as the number of procedures that they do. This is my best guess due to the significant wait times, and the fact that prevention is not high on the list of AHC priorities.

Andrew

argon · January 16, 2007

This is my best guess due to the significant wait times, and the fact that prevention is not high on the list of AHC priorities.

Ahhh yes... Alberta and pretty much everyone else. Kudos to NB though... how they came about (mostly) covering it, I don't know. Maybe the surgeon moved here, and there was no one else doing bariatric surgeries? Who knows.

sg_sg · January 17, 2007

maybe your work place will let you use your sick time benefits for any time off you need for recovery......

my occupational health department never heard of the band before and when i went to them explained what it all was.... they decided to allow me to use my time off as 'sick time'.... which in my case is paid.

at lease it was some source of income.....