Out of province surgery, coverage by NB Medicare

barbiegirl_2272
on 6/14/11 11:54 am
I wondered if anyone had any information/experience with having the lapband surgery performed outside of New Brunswick and having NB Medicare cover it? 
It looks like there is a really long waiting list (>5yrs) if you want it done in NB so I would assume (but probably shouldn't) they would approve it providing it wasn't more cost than in NB.

I assume I would qualify, my BMI is 40 & I have diabetes, high blood pressure, etc. 
Any comments/help would be appreciated.
Kitty_mom
on 6/15/11 12:08 am - New Maryland, Canada
Medicare does not cover out of province weight loss surgery....at least not as far as i have ever heard.  I have heard talk about getting the procedure done then fighting with Medicare to have it covered, but I have not heard of anyone succeeding.  At the moment, the dept of health is considering de-listing all weight loss surgery- meaning they would not even cover it inside NB.
You would definitely qualify

 

darlin.1954
on 6/17/11 1:44 am - Canada
Hello I know for a fact as I attened the information session in Halifax that they DO NOT perform wls from province to province .If your Dr ask medicare for permission to do procedure he must ask the Medical advisior for permission to do so and my dR was willing to do this but the ppl in NS will not accept out of province as they has 2000 ppl on th elist so they do their pppl first right as we would do .We were told that we need to get our Government on board to do this here in Nb as it would save our Medicare loads of money as in obese ppl not being cardiac risk or diabetic takes a big load off the system .We need to write out MLA'S to fight for this .Hope I could help .Also they will not do this prcedure if you are over 400 lbs many ppl were shocked at that they must get down to that weight to have the surgery .You cannot consume alcohol for one year after surgery ...........Pam
barbiegirl_2272
on 6/18/11 3:17 am
thanks for the info - this helps
jjwbuster
on 6/15/11 1:33 pm - Saint John, Canada
 This is the reply I received when I inquired about out of province GBS:

 

 

Medicare may cover the cost of bariatric surgery when it meets specific criteria.  In order for such surgery to be considered out of province, it is necessary for physicians to request prior approval from New Brunswick Medicare.  Therefore, your physician must submit a written request with supporting medical documentation to Medicare's Medical Consultant at the following address:

Medicare's Medical Consultant
New Brunswick Medicare
Department of Health
PO Box 5100
Fredericton, NB    E3B 5G8
Fax: (506) 457-7671

 

The service in question must be rendered by a certified physician in a public hospital, and the hospital fees billed reciprocally to Medicare. The physicians may opt to bill Medicare directly, but the requested fees must be based on existing host-province fees. Neither the patient nor Medicare may be billed additionally. No “private arrangements" between patient and surgeon will be honoured by Medicare, even if rendered in a public hospital. It is always prudent to verify this with the physicians in question.

 

I trust this information will be of assistance.

 

Sincerely,

Linda Hay
Medicare/Assurance-maladie
Department of Health/Ministère de la Santé
tel: (506) 453-4227 fax:(506) 453-2726 

referral sent March 2009/ Approval signed March 2013/Surgery May 2013

HW: 404  Pre OP Liquid: 375   SW: 349   CW: 271

     

thinkinhaboutvsg
on 4/10/12 2:51 am
Thank you so much for this, gave me info I needed & a fight to get coverage from medicare in ON have a surgery date woooohooooo, couldn't be happier, yet nervous too. :)
barbiegirl_2272
on 6/16/11 8:49 am
thanks so much for the information, much appreciated!
thinkinhaboutvsg
on 11/16/11 2:35 am
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