Hi,
I was told by Dr.N that I should save around 10,000.00 so I can have the surgery when I am ready. I am pissed that the MSP can cover the surgery but not the excess skin removal so I wrote an e-mail to Christie Clark. I did this before I had my surgery (Mar 26/2012) and a response was sent to me. If you get a pre-authorization form (on the website) and take it to your surgeon, they can fill it out and if they feel that you require the surgery for health reasons, not vanity, MSP will cover it. So, since I have had my surgery and have lost 75 lbs now I decided to send another letter to the government to make sure that this can still happen.....here is the response that I received:
Thank you for your email of July 18, 2012, regarding your bariatric surgery and Ministry of Health (the Ministry) plans to extend provincial health care coverage for bariatric patients. I would like to clarify that the Ministry is the government agency responsible for administering public health insurance programs. It does not have the authority to direct patients to specific treatments. Your treatment decisions should be made in consultation between you and your physicians, as they are the most acquainted with your health care and history, and are in the best position to assess your needs and recommend appropriate treatment. As such, I can advise that you consult with your physician/physicians to determine the appropriate next steps, including when to contact the surgeon. As you may be aware, the Medical Services Plan (MSP) is governed by the Medicare Protection Act and Regulations. This legislation stipulates that only those services considered medically necessary may be insured by MSP. Under the Terms and Definitions of The Preamble to the Payment Schedule (16), it is indicated that surgery to alleviate significant physical symptoms, or to restore or improve function to any area altered by disease, trauma, or congenital deformity is, normally, a benefit of MSP. Medical procedures which are obtained, not to improve or restore function, but solely to alter appearance (cosmetic) are not generally eligible for coverage. Coverage is given consideration after the specialist involved in a patient’s care, submits a formal written request for payment authorization to MSP, providing details as to the nature of the condition and including why the procedure is considered medically necessary for the patient. At this time there have been no further plans to extend coverage for non-medically required removal of excess skin. Thank you for the opportunity to respond. Sincerely, Dianne Kirkpatrick A/Director Medical Services Operations and Policy
So, when it is time for me to get the surgery I will bring this letter with me along with the pre-auth forms and see what happens. I personally cannot afford to pay for the surgery. I feel it should all be a package deal, it seems logical to me that if you are losing alot of weight that there will be excess skin left to deal with. The government should be more than willing to pay for this as it is helping alot of people get healthy and therefore not relying on the medical system so much.
Fingers crossed that it can work for all of us!! Good luck :-)