ohip

[Simenad]

Anyone from ontario canada know if ohip will pay for 2 level adr overseas? Been waiting 12 yrs with no end in site and I have to get off the meds because my liver is about done. If not anyone know about finacing?

[Jerry5]

Need to find a PA, Patient Advocate.

Look for help with your condition

[Optimistic]

I met with another member recently. Her name is Maddie and she informed me that OHIP does not pay for ADR surgery abroad. While she spent significant time fighting OHIP, she was unsuccessful in the end. However, she did travel and was glad that she did. You may have better luck as my recollection is that she had surgery a few years back. You may want to PM her. Good luck.

[Stonewall_Boris]

I'm from Manitoba and from what I checked there is no health insurance that covers ADR surgery in another country available in Canada. You can write off some of the cost as a medical expense on your taxes but that is about it.
I spoke with a number of local back surgery patients that went to Germany and they all basically told me that. From what I gather ADR surgery is considered experimental in Canada. I have yet to hear from any Canadian being reimburesed for adr surgery in another country. If there is one I'd love to hear from them and let me know how they did it. I have heard that some that have their own business can get a certain insurance policy that would cover the surgery, problem being is that the premiums are so high they were uncertain that it wouldn't cost more in the end.
Why do you think you need a 2 level ADR?

[Brewster]

I've found two hospitals that do minimally invasive spinal surgery in Ontario, one is not taking new patients and the other is a 1-1 2/2 year wait for an appointment. Have you looked at the OHIP site and the Out of Country section?

[Simenad]

Been doing some research and OHIP will accept out of country referrals. I know that they have a come a long way with ADR and do not know much about 2-3 level ADR but they will look at it if you can present new information that demonstrates the value etc. I know Prof Dr. Bertagnoli has a lot of scientific studies etc on his website just for this purpose but he will not accept health care insurance. Does anyone know of a quality doctor/clinic that is willing to accept the Ontario Government Insurance (OHIP) payments? I have also inquired through some of the websites that offer assistance.

[Brewster]

Simenad
I know the University of Pittsburgh Medical Center will accept OHIP but I don't know if they do multiple level ADR procedures. I got as far as going there for an exam ($200) and was most impressed. Unfortunately shortly after returning home I had a minor stroke, so I'm out of it. LOL, just had lumbar nerve blocks and they seem to be working, for now.
You absolutely have to have your Dr. on board, he has to complete and submit the forms to OHIP. As I understand it OHIP will pay a sizeable portion but not all, UPMC has an individual that handles the transaction.

[Simenad]

Have all the out of country forms filled out. I know OHIP does cover one level ADR that is done in London Ontario but the consider 2 or more levels experimental. They also state that they will look at the new research if we present it to them so that is where I am now, trying to educate them on the 97% success rate multiple ADR has been experiencing the last 2-5 yrs.

[Maczoid]

Simenad,

im Mac living in Ontario need a multi lever ADR. Your post is dated 2011. Can you update me on any new information?

Mac

[Simenad]

No change, found some wording that OHIP will look technology if you can present data etc but have found no matter how many stats you present them with, they do not even look at it. Our basic medical community is not interested in repairing it especially if it means we will no longer be supporting the pharmaceutical companies.:insane:

[Maczoid]

I found out there is an orthopaedic surgeon in Calgary doing single level ADR using the Podisc. 1 year plus waiting list. Health Canada gives them a hard time when they accept out of province patients.

The gal running the office told me about a surgeon in London Ontario who I got a referral to who is also doing single level ADR using Prodisc. I just got a letter back to my Doctor last Friday and that letter states I'm non- surgical with my condition.

So again ADR is just beginning in Canada and Europe is at least 18 years ahead with ADR process & procedure.

I have not contacted OHIP yet but I am n the process of research right now. I spoke with a Nurse friend 28 year veteran and even she is under the impression that if you can't get a type of treatment in Ontario, and you go outside the country for the treatment OHIP will cover the cost. I have my doubts having dealt with Government agencies most of my career. :angel:

Maczoid

[Simenad]

Single level ADRs have been done for a while in Canada, problem is we are 20 years behind on this technology and still do not do multilevel ADRs. I consulted a surgeon in Ontario about 10 years ago and he advised me that I required a 2 level ADR but it would create too much instability with the current implants. I know they have improved implants to address this but Canada has just not caught up with the rest of the world. Any specialist I have seen would not recommend me to go out of the country for this because they do not have the research to say if it is a valid alternative or not. If I could find one doctor to support me, it would be a better battle with OHIP.