OHIP question, please help!

[klgk]

Hello everyone!

Im from Ottawa Canada and I have gyno. I know OHIP covers the hospital fees and the surgery (luckily im skinny/lean and don't need lipo). My questions:

1. When you say OHIP covers surgery and hospital fees, does that mean I have to pay for it first out of my pocket and then file for a claim through OHIP and then they will take care of the fee from there? Or does the doctor automatically bill OHIP directly?

Im asking because spending 2000$ out of my funds for any amount of time would be hard (im a student), if anyone knows a way around that please let me know.

2. My other question is do I have to I have to provide some documents from my doctor stating that I do actually have gyno, or can I just walk in and get it done?

Im asking that because I have lived outside Canada for a lot of my life and just came back, don't really have a family doctor here yet.

From what it sounds like from what ive been reading I can just walk in there have gyno sugery for free?? Can it really be that easy or is it too good to be true? And do all surgeons understand the OHIP deal and will do it for me hassle free?

Thank you guys so much for your help!!!

[monsterclean]

Hey,

Unfortunately, not all surgeons will cover your costs through OHIP.  So if money is a major issue, the first step would be to identify a surgeon who bills OHIP for the procedure.  An example would be Dr. Fielding in Toronto.  Dr. Lista is another popular option in the GTA, but doesn't use OHIP.

Secondly, you don't need a family doctor to get a consultation with these guys.  So you're lucky in that regard.

Finally, if the surgeon does agree to do the surgery, OHIP will pay for your surgery.  You will not have to pay out of pocket first, OHIP will make the payment upfront for you.

However, the entire cost of the surgery may not be covered by OHIP.  For example, if you need some fat liposuction, you will have to pay for that.  And that may run you in the neighbourhood of $2000 with Dr. Fielding.  In comparison, I'm paying the entire cost with Dr. Lista, and that's going to run me about $6300.

Hope that helps.

[monsterclean]

I just noticed that you are in Ottawa.

If you want someone who is likely to bill OHIP, your best bet would be someone who works out of a hospital setting, as opposed to a private clinic.

So try to find someone in the Ottawa hospitals!

[klgk]

Guys thank you so much for the info/advice seriously!

Im a slim and lean guy and have very little body fat, from the research Ive done I highly doubt I would need Lipo, just the incision. I just have very puffy hard sore nipples not fat. So basically (from what I understand) I can get this all done for free which makes me so freaking happy.

Im a student w/o a car, and most surgeons charge for the first appointment/evaluation (like nearly $100), so its hard for me to go around finding out which surgeons go through OHIP.

In this regard Dr. Fielding seems like the best option. If anyone else knows another Dr that might be good for my situation please let me know!

Btw if anyone has had surgery (just incision, not lipo) and would like to share their experience w the surgery or some photos please post a link or message.

thanks guys

[monsterclean]

Hi klgk,

Your welcome.

HOwever, I would caution you to not assume your surgery is going to "free".

The majority of cases of gynecomastia involve both gland and a varying amount of lipo.  I would arrange a consultation to estimate how much lipo is needed and what your cost is going to be.

[mc88]

Are there any requirements in receiving ohip?

Like being employed or anything?

[monsterclean]

No, you do not need to be employed to qualify for OHIP.

As long as you are a Canadian resident, and have lived in Ontario for 3 months, you can apply for OHIP.