Trying to save money

[newdawnings 0]

I was reading somewhere on this board that someone said they purchased their band directly from the manufacturer and then OHIP (I think they said OHIP) paid for the surgery. I can't remember who said it but I'm postive I read it somewhere. Maybe it wasn't even on this board (I've been doing so much research that I can't remember where I've been!!). Has anyone heard of this? I need to have this surgery and I am trying to find the most cost efficient way to get it done as we are a low income family. I know that money/cost is an issue for alot of people. I don't mind paying for it (provided we get the loan that we've requested) but if I can find a better way that I could afford it, that would be awesome! It just blows me away that the government won't pay for the lapband even though the risks are much lower than gastric bypass. What..is there no fat people in parliment that would understand why we need this covered on our provincial health plans? Nah, they can afford to pay for it...considering how well they can squander away our tax dollars. Sorry for the rant. Just in that kind of mood! Ticks me off!:girl_hug:

~Dawn~ :D

[susansilver 0]

Both of the centres in Toronto offer credit as well through a 3rd party. If you don't get a positive response from the bank, you might look into that.

Good luck.

Susan

[Dame J 0]

There was an article in the Toronto Star yesterday on this topic. They were saying that even in situations where surgery is covered the wait it something like 3 years and they have to send people to the US to get it done. Anyway to my knowledge the lapband is not covered in Ontario. It would be great if it was. According to the Star article the governement is not covering it because they don't believe that it is as successful as the other surgeries. I agree though it is a really difficult situation. I paid for the surgery with the help of Medicard.

[LeslieLee 0]

I here you loud and clear on that one! I wish they would get it approved and more people could get the quality of life we all deserve.

I know when I was looking I did look into going to Mexico to have it done it was considerably less.

[Heldie 0]

I saw the article in the Star too. I wonder what the government considers "more successful" when comparing banding over bypass? If they are looking a pure weightloss there may be a point (but I am not convinced of this yet,) but have they calculated the cost of treating some of the long-term complications/side effects of the bypass? Flawed reasoning if you ask me - seems to me the band is much more cost effective long term solution.

We have seen some added financial benefits that we did not anticipate when I got my band. My husband and I go out for restaurant meals less and I have been bringing my lunch instead of buying my lunches.

[susieq321 31]

If you want to know what it takes to get covered by OHIP it is not simple nor is it in our doctors best interest to have it covered. I only mildly understand the process so I might have some steps wrong I am not in the medical industry but had it explained to me by people who are. And it varies province by province so this is only ON.

First you would need to go to the board of people who reccomend things to OHIP it is made up of OMA member or doctors. This is a pretty closed board and they do not consider to much so you kinda need an in with them. So once you get on the OHIP board agenda, you present your case to them for them to consider reviewing the new procedure you want covered and they say nay or yay. Only doctors who perform the procedure can apply to have it covered. Once they say yes they will consider reviewing the procedure you have to go to them with all the research that supports this procedure being covered by OHIP and prove to them it is worth it. And then they decide to cover it usually no is the answer or it needs more research.

So if you look at this our surgeons in ON will never ever apply to OHIP to cover it and they are the only people who can apply to the board. It takes cash out of their pockets to get it approved and once it is approved it takes a ton of cash out of their pockets to do the surgery. I know with the RNY they only get paid about $1500 from OHIP and it takes 90-120 days for OHIP billing to go through and costs them money to have someone take care of OHIP billing. They have no incentive ever to go from earning $17 K down to $1500. Keeping in mind the cost of the average band is $5000 to $5500 from the manufacturer and the clinics get a bit of a bulk discount on the bands when they buy mass amounts.

The other flip side of this is Dr Yau as a bariatric surgeon has a waiting list so long for RNY that he doesn't even add new people to it. Joffe was up to 7 years I think at one point in time. OHIP doesn't allot money to hospitals based on individual surgeries they alot by type of surgery. So for they alot money to Weight Loss Surgery not to RNY, Banding, VBG, DS etc. So you end up with people waiting 7 years for all the surgeries with no self pay for banding.

The third side of the coin is if OHIP covers banding the docs can't do it privately for any self pay patients. Right now the way the Health Canada act is structured you either self pay or it is a covered procedure and you aren't allowed to have self pay on a covered surgery for some people and OHIP coverage for other people it is an all or nothing proposition.

So coverage for docs in ON is a massive losing entreprise for the clinics and patients with the way OHIP, Health Canada etc are structured as of today.

As I said I might not have this totally accurate but as far as I remember it isn't too far off.

[Gaffer 1]

According to the Star article the governement is not covering it because they don't believe that it is as successful as the other surgeries. I agree though it is a really difficult situation.

Governments are so ridiculous when looking at things like this, I wonder if there is some other motive that is preventing them from approving bands as an option in all provinces.

The band has proven to be a safer procedure with less recovery time and risk of complications that other techniques, while having no significantly different weight loss after 5 years compared with the other surgeries.

When you look at factors like time lost to employers and the cost if the surgery overall why would they not want to do more bands. In my opinion they should stop doing RNYs etc and go strictly to band, only reserving the other options for cases where the band is not appropriate.

Andrew

[susieq321 31]

I was reading somewhere on this board that someone said they purchased their band directly from the manufacturer and then OHIP (I think they said OHIP) paid for the surgery. I can't remember who said it but I'm postive I read it somewhere. Maybe it wasn't even on this board (I've been doing so much research that I can't remember where I've been!!). Has anyone heard of this? I need to have this surgery and I am trying to find the most cost efficient way to get it done as we are a low income family. I know that money/cost is an issue for alot of people. I don't mind paying for it (provided we get the loan that we've requested) but if I can find a better way that I could afford it, that would be awesome!

~Dawn~ :Banane27:

I do know of one person who appealed to OHIP directly and I forgot to post this... apparently you have to appeal prior to banding and he did for both him and his wife about a year before they were banded they applied for an appeal. They spent time doing a ton of research preparing their case both pre and post banding about a year after they were banded they had their hearing.. they presented their case and were told no after all that OHIP wouldn't pay for anything with the band. I think the results of the hearing are posted on Canadian Lapbanders, or you can get it on OHIP's website.

[newdawnings 0]

Well, the bank denied us (I was expecting it anyway) even though we had a co-signer. Our co-signer (my Dad) lives in BC and the bank said that they couldn't do it because they didn't think that the loan would be secure enough between provinces. My Mom and Step-Dad co-signed for our van so they arn't prepared to co-sign anything else. Now, I am back to square one. We don't want to go with the finance company through the clinic because of the high interest rate. I don't what to do. I am kind of depressed now *sniff, sniff*. My Mom says not to give up hope but right now I feel hopeless!!

~Dawn~

[joe7777 1]

If money is a huge factor for you the TCC toronto cosmetic clinic is 1000$ less than the 2 others in toronto.

In my humble opinion: What you can do now is go see a nutritionist, change your eating habits, maybe get your food addiction in control (assuming we all have one if we're here) Also, you might lose a bit of weight, and if you don't think you'll have any more money in that time than you do now...then i'd say go for it...because what is your health and your life worth.

[Alex R. 0]

<p>Excellent post. I hadn't realized that having OHIP cover banding would be counter-productive for the doctors - but your argument makes sense.</p> <p> </p> <p>In the alternative, how would we go about getting our extended health plans to cover banding - ie Great West Life, etc.</p>

[joe7777 1]

Alex R. I contacted my company and they say they don't cover anything that OHIP doesn't simple as that....how great is that. So yeah...that sucks.

[newdawnings 0]

Hey Everyone,

Thanks for all of the info. I can completely understand when the tables are turned and you look at it from the Dr.'s point of view. It makes perfect sense to do it privately BUT I think that with a much more safer alternative, that being the lapband, that more would be done if it were covered by OHIP. For those of us that are currently not banded yet, we can only hope that in the near future it will be covered!

Speaking of that, we had another appointment at another bank for a line of credit and yet again were turned down. It's too bad that there isn't a way to have it paid for for those on a low-income! We just simply don't make enough to qualify for a loan of any sort, even with a co-signor. However we were approved by Medicard with a co-signor, but we know it would be a high interest rate (not even sure what it is) and fear we wouldn't be able to afford the payments. Go figure!! I can't think of any other way to pay for this other than that. I have never been much of a patient person (I want it, and I want it now!! LOL!!) so I am getting very frustrated. Maybe it is the universe's way of teaching me to be patient. Well, would it hurry up and get this lesson over with, I got things to do!!

I'm not giving up, yet. I just don't know what to do now.

~Dawn~