Out of Province Coverage

beckymay26
on 6/20/13 11:54 am - Canada

Hi everyone , i am currently in the works of getting my revision surgery date with Dr.Gagner in Montreal, can anyone help me with what I have to do next for MSI coverage. He has said he had no problems with Sask,Manitoba or Ontario coverage , and as long as my Family Doctor is on board and referrals are sent , then it shouldn't be an issue , I am so nervous about this , i don't want anything to go wrong , can anyone help me with any info :)

Jackie00
on 6/23/13 11:17 am
Well I am not sure why you are getting a revision. I know with our long wait here in NS. That msi said because the surgery is offered here they will not approve it to be done in another province.

Now revision of what to what and why it needs to be done might be a total different story.
Sleeved 15-Sept-2011 HW 294 Pre op weight 285 SW 279 GW 145?
Pre op 6 lbs lost, M1 - 23 lbs M2 - 11 lbs M3 - 12 M4 - 6 M5 -10 M6 -10 M7 -7 M8 - 4 M9 - 4
M10- 4 M11 - 5 M12 - 0
   

   
beckymay26
on 7/1/13 10:22 am - Canada

I had a gastric bypass in Sept 2002 and I have a bunch of complications , i have gained back all my weight and my pouch is leaking , Dr.Ellemere I have seen him twice and was told where he did not do the surgery he will not help me and when I call my original surgeon , all he offer me is the lap band and it is $16,000 and doesnt help my leak , so i am at a loss , Dr.Gagner does revisions and I have had all my tests as of today , I just was wondering if MSi will give me grief or is it as simple of applying?

Jackie00
on 7/3/13 1:49 am
Well if you have medical complications they may help cover the cost in another province if deemed necessary and the one dr here said he will not do it.
Sleeved 15-Sept-2011 HW 294 Pre op weight 285 SW 279 GW 145?
Pre op 6 lbs lost, M1 - 23 lbs M2 - 11 lbs M3 - 12 M4 - 6 M5 -10 M6 -10 M7 -7 M8 - 4 M9 - 4
M10- 4 M11 - 5 M12 - 0
   

   
megan1emma2lilly3
on 7/1/13 12:50 pm - dartmouth, Canada

I live in NS and too want to go to the Montreal clinic with Dr. Gagner, were you able to find out if this is cover by the NS government MSI, any help is appreiated I am just starting my journey

Jackie00
on 7/3/13 1:56 am
Read my post above with what msi said to me. You can also call them and see and update what they say. I don't imagine they have changed their minds.
Sleeved 15-Sept-2011 HW 294 Pre op weight 285 SW 279 GW 145?
Pre op 6 lbs lost, M1 - 23 lbs M2 - 11 lbs M3 - 12 M4 - 6 M5 -10 M6 -10 M7 -7 M8 - 4 M9 - 4
M10- 4 M11 - 5 M12 - 0
   

   
beckymay26
on 7/3/13 11:05 am - Canada

I spoke with Dr.Gagner today and he was very helpful , and we are proceeding with all the paper work , I then called MSI and I was told by their office where I have the referral and the procedure would be covered here if Dr.Ellsmere had did my original surgery , which he did not so he will not do my revision , but they told me any procedure covered in the province is covered fuy in any other province in Canada, so I will keep you updated :)

megan1emma2lilly3
on 7/3/13 11:57 am - dartmouth, Canada

I am going to have a consult with Dr.Gagner in July but was hesitating because I am not sure MSI will cover. I will call them tomorrow. Did they say if there was paperwork you needed to do or does Dr. Gagner do that and submits to our province?

I am so excited if it is covered, wait list is 10 years! and you cannot even call the clinic to see where you are on the list.

Keep me posted and I will do the same.

Here to hope in Montreal

heather

Jackie00
on 7/3/13 9:10 pm
Heather I would definitely make your own personal call to msi. Cases are different here unless you hsve complications as well from a previous WLS. I just don't want you to get your hopes up. I even went to ask my medical insurance if they would cover it as well.

Things could have changed where the news was all over the wait times in NS.

Dr Gagner was close to 25000 a few years ago for the VSG. If you can come up with 7000 I would certainly be looking at Mexico where the prices are cheaper.
Sleeved 15-Sept-2011 HW 294 Pre op weight 285 SW 279 GW 145?
Pre op 6 lbs lost, M1 - 23 lbs M2 - 11 lbs M3 - 12 M4 - 6 M5 -10 M6 -10 M7 -7 M8 - 4 M9 - 4
M10- 4 M11 - 5 M12 - 0
   

   
Frank P.
on 7/9/13 3:49 am - Aylesford, Canada

MSI will not pay for work in most of Quebec.....They (PQ) do not have a reciprical billing agreement with NS... Also MSI will not pay for any work done at a private clinic/hospital (to my knowledge)... Just a suggestion, but why don't you try Ontario? They have set up Bariatric Centers of Excellence, these are public hospitals and MSI is Ok with them.  ( FYI I know of a lady who just was operated on from NS) so they will do NS patients...  :)

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