Out of province coverage for BMI>50 surgeries

1onthemove
on 10/21/09 4:06 am - Canada

Does anyone have any suggestions/experience with getting MSP to pay for out of province surgeries? Obviously the BC surgeon needs to submit the request to MSP but is there anything else that can be done to ensure a smooth and speedy approval process?  Any tricks or best practices greatly appreciated!!

Thanks
Lori 

suzanneb
on 10/21/09 8:04 am - North Vancouver, Canada

Yes write a letter that goes with your out of country form that your bariatric surgeon fills out for you.  You need to tell MSP in your letter how your weight has affected your life and be specific.
Tell them everything you have tiried to lose weight, groups you have gone to, and what you are doing to get ready for surgery, exercise program, eating program etc.  The more you put in your letter the better chance you have on this.  There are two other websites in Victoria that you can ask the same question as well, www.blazeonline.com/wls and www.wlsforum.net

Also your bariatric surgeon needs to list your co-morbidites, sleep apnea, diabetes etc.,

If you get turned down the first time keep appealing it you have the right to do that.

Suzanne
1onthemove
on 10/21/09 8:09 am - Canada
Thanks Suzanne! Will definitely have a letter ready.  Do you have any idea how long the review process is once the paper work is in?  Or is it on a priority basis ?
Lifad
on 10/24/09 9:31 am - Maple Ridge, Canada
with the application, (which can be done by another specialist as well just not a GP) send in copies of recent tests for comorbidities like sleep apnea, etc.. and recent articles showing cuts made. Try and complete the application with your Dr so you know what is being written and how its being worded.

StephanieEllen
on 11/16/09 3:25 pm - Smalltown, Canada
 what if you don't have a bariatric surgeon? I have only seen my gp so far. Do I need a consult with a surgeon too? I am in the interior, and no such surgeon is nearby. 
1onthemove
on 11/18/09 2:20 am - Canada
Yes you will definitely need to do your research and find a surgeon.  Once you find one that you feel confident in, then have your gp send in a request for a consult.  It is a long process...even longer if you want MSP to pay for the surgery.

Good luck....and just do your homework and be informed!
Lifad
on 11/20/09 11:49 am - Maple Ridge, Canada
Hi

Doesnt need to be a surgeon, if you have another specialist of some type that supports the surgery. I had an Endocrinologist do mine, as long as they are a specialist and not just a GP
StephanieEllen
on 11/20/09 4:26 pm - Smalltown, Canada
 good to know. So, what kind of specialists did you all use? I saw my orthopedic surgeon today to get cortisone shots in my hands for severe carpal tunnel.. would that count? She also does joint  stuff, and I have a lot of bad joints. Would this kind of specialist count? 
Thanks in advance. :)
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