Insurance and Weight Loss Surgery
I have to admit - sometimes I don't understand the American system.
In Canada, Ontario to be specific, if you need weight loss surgery you do it one of three ways
1. You pay for it yourself - usually done for lap banding since this is not covered by OHIP (provincial insurance that we all pay taxes into)
2. You get referred to a specialist and then you wait for surgery. The current waiting list is about 6 - 8 years depending on what (type of surgery) and where (province).
3. You apply to OHIP for out of country surgery approval. If you meet the requirements, based on BMI and co morbidities, you are approved for your initial counsult with your surgeon of choice. If the surgeon agrees to take you on as a patient then he deals directly with OHIP for the final approval. Once your consult is approved, the final is usually a given
As most of you know, my process was an easy one. It took two weeks.
I have a friend in Arizona who has been working on getting approval for years. She has done everything that has been asked of her, her file is inches thick. She recently went on a medically monitored diet to lose weight. She reapplied and was rejected again. Why? Because she was 5lbs short of the weight loss expected of her.
It all seems so arbitrary. People lose weight at different rates. The fact that she lost weight at all is impressive - the fact that she did is sensibly is truly heroic. Her own cause would have been better served by following a fad diet. Sad.
I am so frustrated for her - she has worked so hard for this. Much harder than I have. She has done her research. She has the required BMI and co morbidities but she is not getting the help she needs. I know that she filed an appeal last week. I hope that someone truly looks at her file and takes the time to understand her needs as an individual.
I don't know if you read this blog but please know that I am thinking of you every day
In Canada, Ontario to be specific, if you need weight loss surgery you do it one of three ways
1. You pay for it yourself - usually done for lap banding since this is not covered by OHIP (provincial insurance that we all pay taxes into)
2. You get referred to a specialist and then you wait for surgery. The current waiting list is about 6 - 8 years depending on what (type of surgery) and where (province).
3. You apply to OHIP for out of country surgery approval. If you meet the requirements, based on BMI and co morbidities, you are approved for your initial counsult with your surgeon of choice. If the surgeon agrees to take you on as a patient then he deals directly with OHIP for the final approval. Once your consult is approved, the final is usually a given
As most of you know, my process was an easy one. It took two weeks.
I have a friend in Arizona who has been working on getting approval for years. She has done everything that has been asked of her, her file is inches thick. She recently went on a medically monitored diet to lose weight. She reapplied and was rejected again. Why? Because she was 5lbs short of the weight loss expected of her.
It all seems so arbitrary. People lose weight at different rates. The fact that she lost weight at all is impressive - the fact that she did is sensibly is truly heroic. Her own cause would have been better served by following a fad diet. Sad.
I am so frustrated for her - she has worked so hard for this. Much harder than I have. She has done her research. She has the required BMI and co morbidities but she is not getting the help she needs. I know that she filed an appeal last week. I hope that someone truly looks at her file and takes the time to understand her needs as an individual.
I don't know if you read this blog but please know that I am thinking of you every day
posted by Aussieabroad at
9:08 AM
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