Author Topic: Insurance - Beyond O.H.I.P. - Dr. Fielding  (Read 1891 times)

Offline London_Tonight

  • Member
  • *
  • Posts: 1
Hi Everyone,

This is my first post - And I must begin with offering thanks for all of the different postings which lead to scheduling with Dr. Fielding in mid-March.

Question - Has anyone tried or been successful claiming Dr. Fielding's extra fees through thier workplace extended health insurance?  According to my plan I have the following coverage with the following exclusions.  Anyone care to offer their thoughts on whether I have coverage for Dr. Fielding's fees beyond what OHIP pays?   Many thanks in advance.

Physician's Expenses
Where permitted by law, eligible expenses include charges in excess of amounts provided under your provincial health care plan for services provided in Canada. It does not replace provincial plan coverage when a physician opts out of the provincial plan.

Limitations and Exclusions
No benefit will be paid for

Expenses that private insurers are not permitted to cover by law
Services that you or your dependents are entitled to without charge
Services that don't represent reasonable and customary treatment of the person's medically diagnosed condition
Services or supplies associated with treatment for cosmetic purposes, recreation or sports, a change in gender, diagnosis or treatment of infertility (other than drugs), or contraception (other than oral contraceptives)
Services not specifically listed as a covered expense
Services or supplies received outside Canada, except as listed under out-of-country expenses and emergency medical travel assistance service
Expenses for completing claim forms, obtaining further medical information, medical screening or examinations for use by a third party, broken appointments, travel expenses or communication costs by a medical practitioner
Expenses arising from war, insurrection, or voluntary participation in a riot
Extra charges as a result of the physician's opting-out of the provincial health plan
Medical care provided by a government plan or charitable organization
Hospital or home-nursing care where significant improvement or deterioration of the medical condition is unlikely within the next 12 months

Offline brownman

  • Gold Member
  • ****
  • Posts: 260
" Services or supplies associated with treatment for cosmetic purposes,"

I believe thats where the problem comes in..


Sorry to say but you are probably not going to get the to cover it, i heard of one guy but he had a high rate of breast cancer in his family and id on't know if you wanna try that?

Offline Grandpa Bambu

  • Senior Member
  • *****
  • Posts: 5444
  • 31 Year Gynecomastia Victim...
Quote
" Services or supplies associated with treatment for cosmetic purposes,"

I believe thats where the problem comes in..



Ditto....

John.

Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
Pre-Op/Post-Op Pics


 

SMFPacks CMS 1.0.3 © 2023