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Does OHIP covers tummy tuck in Ontario?

pa-cline
on 4/15/10 12:13 pm - Canada
Hi there

I haven't posted before but read often.  I was wondering, I was told that OHIP would cover the tummy tuck but not arms, breasts chin etc...is that true?  I have a consult with a dr and was wondering what do I have to do (or dr) to get approval from OHIP??

Any help would be greatly appreciated!  Thanks,
PC
Joyce J.
on 4/15/10 12:30 pm, edited 4/15/10 12:30 pm - Scarborough, Canada
Hi there

OHIP does not cover tummy tuck. They do sometimes cover the panniculectomy(the apron of hanging skin), but in most cases only if it is large and you have issues with rashes.
Also OHIP will cover something with the breasts, not sure if it is a breast reduction . Those are the only two things they will possibly cover

Good luck with your consult, keep us posted

Joyce----Today is the first day of the rest of your life

 

photomom
on 4/15/10 12:34 pm - Canada
 Yes OHIP will often cover the panniculectomy which is described above and involves no tightening of the muscles but you need to have documented rashes and i have also heard sometimes it has to hang a certain amount to qualify for coverage. Ohip does not cover abdominoplasty (tummy tuck).

OHIP does cover breast reduction if it is done for medical reasons i.e. back pain and not cosmetic.


Wendy
 
           HW: 264 SW: 243 CW:122 GW:161
pa-cline
on 4/15/10 12:38 pm - Canada
Thank you Joyce and Photomom.  I was mistaken in what I said.  I need to have the "apron" done...lots of skin hanging, and unpleasant odor not to mention what it does to your self esteem.  Don't get me wrong - losing over 100 lbs in itself is a miracle, but now I am facing this "sagging" skin..hahahah

Thanks for your help in this!
PC
mountainmike
on 4/15/10 12:45 pm - Mountain, Canada
RNY on 02/05/09 with

Most simply put, OHIP will cover any necessary physician and hospital services in Ontario.  If it is medically necessary to remove skin such as pannus (the apron of tissue in the lower tummy), OHIP will cover it.  If it's for esthetics, you're on your own!

Mike


For last year's words belong to last year's language.
And next year's words await another voice.
And to make an end is to make a beginning.
T.S. Eliot  
Karlalala
on 4/15/10 1:26 pm - London, Canada
Does burning my hanging arm flab in a candle flame when I reached across the table last week count?  Or dipping it in the gravy on my plate as I reached across for the pepper shaker a few weeks ago?  LOL!  Dang I wish I could get OHIP to see those as medically necessary..... I am going to work on it though!  I am going to document all of the crazy antics that my "hello helens" get into as they wave hello in the wind!  LOL!!!!

 

 

Karla  - Stayin positive and moving forward!!!

 

 

 

twins4meplus1
on 4/15/10 1:31 pm - St Thomas, Canada
Karla, I am right there with you! Also why don't they made tshirts with sleeves anymore??? I hate having my flabby batwings showing.

LInda

London and Area Support Group Leader
http://www.london-wls-support-group.com/
Come join the Ontario Plastics Patients Board
http://www.obesityhelp.com/group/Ontario_Post_Plastics 
Come join the Ontario WLS Vets Board
http://www.obesityhelp.com/group/Ontario_WLS_Vets/
To get your discounted subscription to OH Magazine
Follow the link below and enter the promo code "Terrio11
http://www.obesityhelp.com/magazine/subscriptions.
html

OH certified WLS Support Group Leader

 

 

mountainmike
on 4/15/10 1:53 pm - Mountain, Canada
RNY on 02/05/09 with
I love it - and believe me, I empathize totally.  

But if I was OHIP I'd tell ya to blow out the candles, and don't eat gravy lol.

OMG, the stuff we go thru here........

Mike

For last year's words belong to last year's language.
And next year's words await another voice.
And to make an end is to make a beginning.
T.S. Eliot  
pa-cline
on 4/15/10 12:50 pm - Canada
Thanks Mike

So I am sure if the Dr. says it's a possibility, they would do the paperwork, or do I?  I just wondered as I would like to be as prepared as I can before I go to this surgeon!

PC
twins4meplus1
on 4/15/10 1:30 pm - St Thomas, Canada
the dr does the paperwork

Linda

London and Area Support Group Leader
http://www.london-wls-support-group.com/
Come join the Ontario Plastics Patients Board
http://www.obesityhelp.com/group/Ontario_Post_Plastics 
Come join the Ontario WLS Vets Board
http://www.obesityhelp.com/group/Ontario_WLS_Vets/
To get your discounted subscription to OH Magazine
Follow the link below and enter the promo code "Terrio11
http://www.obesityhelp.com/magazine/subscriptions.
html

OH certified WLS Support Group Leader

 

 

mountainmike
on 4/15/10 1:53 pm - Mountain, Canada
RNY on 02/05/09 with
MDs do referrals and related paperwork!

Mike
For last year's words belong to last year's language.
And next year's words await another voice.
And to make an end is to make a beginning.
T.S. Eliot  
mountainmike
on 4/15/10 1:57 pm - Mountain, Canada
RNY on 02/05/09 with
B****ypically U will have to pay a private fee for the first consult with a plastic surgeon.  Mine was $100 for example.  I think if U proceed with self-pay elective plastics some of them will deduct that from your surgical fee.  I think my insurance (thru work) covered it for me.

Mike

For last year's words belong to last year's language.
And next year's words await another voice.
And to make an end is to make a beginning.
T.S. Eliot  
cushiebunny
on 4/15/10 8:27 pm - Canada
RNY on 08/11/09 with
I truly don't believe anything is written in stone.

I myself have a large incisional hernia that had already been repaired once.  At that time they place a piece of mesh 10X11 into my tummy.  It all occured from a c-section where they sliced me up and down instead of side to side.  My muscles were cut and have never mended properly.  I live in pretty constant pain from this and walk around with some of my insides hanging out of the normal encased area.  Trust me, when a three year old kicks it dead on you just buckle over.  Walking is painful, being constipated is painful, having the runs is painful, heck even ******s are painful.  The list goes on and on.
I return to my original surgeon, who did the last hernia repair and did my c-section, on May 11th.  I'm hanging on to the hope that the big, 'NO tummy tucks allowed' sign has some loopholes for those with enough issues. 

pa-cline
on 4/16/10 5:56 am - Canada
Hi everyone

Thanks for all the comments...I totally understand about the underarm thing...but my friend reminded me - "you said if you lose ??? pounds and your arms waves back and slaps you in the face, you would take it if it meant your health has improved..and you'd take that anyday"
hahahah she was right.

Although the arms (and even my apron) are bothering me, I will take these in comparison to being over 300 pounds, taking two insulin shots/day, high blood pressure pills everyday, being so very tired, not to mention the pain as a result of being overweight....and now, although flapping in the wind, on no medications whatsoever!!! and feeling so much better.

I am still hoping that they will be able to fix the apron (along with my hernia)

thanks for your replies!!!  Have a super day in your "new" lives"!!!
PC