Author Topic: Getting approved through public healthcare (Canada)  (Read 1562 times)

Patsfan1991

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Live in Canada, having my PS submit a letter to see if it will be covered. Anyone know how long this process takes to hear back about it?

Offline McGilli

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What are the reasons he/she is submitting why the Government should pay?

They might need medical history from a GP depending on what reasons are submitted.

I don't have my forms handy, but I was subsidized I am guessing about a 1/4 of the cost of the surgery through medical. I had to pay out of pocket for the rest.

The good thing was that if the Government pays for any of it - then you do not have to pay HST on the rest of the total that you pay.

If the Government won't pay and you pay 100% of it in Canada you must pay HST on it.

Patsfan1991

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How long did it take you to hear back from the government one way or the other?

Offline McGilli

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How long did it take you to hear back from the government one way or the other?

Oh. It was minutes.

After all the consultations and I decided to get it done - then I went to the waiting room. The surgeon made up the quote and then the lady at the desk called me over and looked at it with me. Everything was sorted out line by line, what the cost was etc.

So she said it would cost XYZ dollars. I asked why there was no HST on it.

She explained that part of the procedure is covered under Provincial (I'm in BC) medical. And since part of the procedure is covered by the Government, it then allows me to not have to pay any HST on the remainder.

The part that WAS covered by medical was not listed on the form.

But - if you look at my photos (i have a photo diary in the diary forum) you can see that my case was extremely simple. And instead of it all just being 'cosmetic' and me paying full price - I think the part that was covered was the fact that in my past - the fatty area of my pecs have hardened into lumps and I saw a specialist. I believe that was in all the notes my GP sent over with my referral.


Offline McGilli

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I had a followup appointment today so I tried to get a little information for you.

Again, my case was minor.

Referral from doctor does not factor in. That only gets you a free consultation (at least with mine)- if you are referred by a GP.

She said that if you are there because you want to 'look good' then you have to pay %100 out of pocket.

Because in my case there was excess glandular tissue - that is the part covered by medical.

I also had to pay a share because then on top of that I wanted the fatty tissue removed as well.

So - if your surgeon is sending it in for approval it looks like he is trying to find out if your bodies 'condition' is strictly caused by a medical condition that might cover you, or if it is of your own doing.

Hope it helps, good luck!



 

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