Precision about Quebec health care coverage

[Guigz21]

Hi,

Today, I called a local surgeron to get some information about gynecomastia surgery.

The secretary told me that I could be covered for this surgery if I took an echography to know if my problem was from fat or gland.

She told my that if the problem was from gland, then it would be covered by quebec health care.

On this forum, I saw information that was quite different from what she told me. She seemed pretty sure of was she said anyway.. Could someone confirm?

Thanks

[G-Man99]

Hi,

Today, I called a local surgeron to get some information about gynecomastia surgery.

The secretary told me that I could be covered for this surgery if I took an echography to know if my problem was from fat or gland.

She told my that if the problem was from gland, then it would be covered by quebec health care.

On this forum, I saw information that was quite different from what she told me. She seemed pretty sure of was she said anyway.. Could someone confirm?

Thanks

The best place where you could call is "à la Régie d'assurance maladie du Québec". They are gonna tell you.

BTW, who's the local surgeon you called?

[Guigz21]

I called Felix-André Têtu. I know two friends that had surgery with him (girls actually, for different surgeries). He's overpriced but he has an excellent reputation (I didn't ask for the price of gynecomastia surgery), that's why I contacted him first...

I will try to contact "régie de l'assurance maladie"...

[G-Man99]

I called Felix-André Têtu. I know two friends that had surgery with him (girls actually, for different surgeries). He's overpriced but he has an excellent reputation (I didn't ask for the price of gynecomastia surgery), that's why I contacted him first...

I will try to contact "régie de l'assurance maladie"...

I've read on another forum that gynecomastia surgery could be covered in Quebec if you are under 18.

Anyways, please keep us inform of what you find at RAMQ. Thanks.

[Guigz21]

Finally, I decided to talk about gynecomastia with a doctor (general praticioner) I met today.

He confirmed what the surgeron's secretary told me. It's covered by RAMQ if it is gland related problem.

He seemed to know that problem very well and I can't beleive that all quebecers on this board aren't aware of this...

So I think the first thing to do, before directly taking an appointement with a surgeron, would be to meet a general praticioner so he can check if you have gynecomestia and then, get you covered under RAMQ for your surgery (if you're "lucky" enough to be covered).

I hope this will help a few people around.

[Guigz21]

Here's an update. I sent a message to RAMQ and I got this anwser with all the details to get it covered under the health care program.

Please note that the answer is in french :


"En réponse à votre courriel, j'aimerais vous informer que la cure de gynécomastie peut être un service assuré mais nécessite une autorisation préalable avant d'être effectuée. La demande d'autorisation doit être faite par le chirurgien qui prévoit effectuer l'intervention et doit inclure entre autres, des photographies récentes mettant en évidence la gynécomastie de même qu'un rapport de mammographie ou d'échographie selon le cas. La chirurgie est ainsi autorisée après analyse du dossier si la condition de la personne répond aux critères d'admissibilité.

Vous devez vous adresser à votre chirurgien qui, après évaluation et s'il le juge à propos, pourra nous faire parvenir la dite demande.

Espérant ces renseignements à votre satisfaction, veuillez accepter, Monsieur, l'expression de mes sentiments distingués."

[kingguarna23]

so that means what? ... we just need to send them a mammogram and a picture?

[bjonathan]

The surgeon has to take pictures and fill papers usually 100$ for this. Once the RAMQ has the papers, it takes about 3 months to give an answer. If it's not authorized, you can appeal of the decision by writing a letter to the RAMQ explaining how your condition affected, affects and will affect your life. It takes another 3 months.

If they evaluate that your surgery can be covered public healthcare, you'll receive a 24 months "certificate" that you can use with any surgeon affiliated with the RAMQ. Now, you hope that you Plastic surgeon will be able to operate you in time or that he/she will not disaffiliate with the RAMQ (that actually underpays surgeons). If it's happen, you have to ask for another 24 months "certificate".. In Montreal, I heard the waiting lists were about 4 or 5 years...