Plastics consult

kellybelly333
on 8/22/12 4:33 am - Toronto, Canada
 Well after my nurse's appt at TWH I went to St. Michael's for my plastics consult with Dr. Musgrave. She was firm an to the point. I JUST meet the criteria for a panni removal to be covered by OHIP. So she is putting forward the application. I will know if I'm approved in 6-8 weeks. She said two years ago I would be approved with no problem. Now it's much harder to get approvals for pannis and breast reductions. She told me to appeal if I'm not approved. So I will prepare myself for that. Other than that is going to cost me at least $6,000 to have it done. That will be a few years of saving for me. 
She also told me that OHIP is cash-strapped and that she herself hasn't been paid by OHIP in three months. So fingers crossed for me and everyone down the road!

Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!

Megan M.
on 8/22/12 4:35 am - Canada
Did she describe what the requirements are?  I know it has to do with the amount of overhang, but do you know how they measure that?  Hope all goes well for you.

Had RNY surgery July 22/11, St. Joe's Hamilton, with the awesome Dr. Scott Gmora.  Had abdominoplasty August 2/13, Scarborough, with equally awesome Dr. Michael Kreidstein.

Karen M.
on 8/22/12 6:05 am - Mississauga, Canada
My PS just sent in an application to OHIP for a panniculectomy last week.  He is extremely confident that I will be approved.  Mine isn't huge, but it is causing skin infections, hence my hope to have it removed.  Good luck! 

 

Karen

Ontario Recipes Forum - http://www.obesityhelp.com/group/ontario_recipes/

Mary A.
on 8/22/12 8:29 am
good luck..my surgeon also told me that I met the criteria &

.I was denied in February 2012 after they had my applicaiton since Sept 2011, it took them 5 months to come back after several further requests for teh photos, descriptions etc


..and the only thing that OHIP stated was borderline

..that was it NOTHING else

Currently I am in the appeal process with the Health Services Appeal and Review Board and have a date of Oct 1 to bring forth my case.

As I stated on this board previously a large overhang doesn't automatically get approved, there are several items specifically laid out in Appendix D (16).

I would suggest that ANYONE applying for this procedure and hoping that OHIP will cover the costs, read and fully understand the guidelines set out.  It truly isn't based on just one item and from what i have seen it's not (cut and dried).

I truly hope your outcome is better than mine was...because it's a pain in the rump to have to then fill out the paperwork, do homework, and provide documentation and reasoning why OHIP should in fact cover the costs of your surgery.

Let us know how it goes~!





prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss. 

life is AMAZING when you continue on the right path~!.  Use your surgeons gift to the fullest~!

Mary
surgery done in Duluth, MN

kellybelly333
on 8/22/12 3:49 pm - Toronto, Canada
 T for the info. I don't have much faith and expect to appeal.

Surgery March 23/2011. Completed three full marathons and two half marathons, two half Ironman distances. Completed my first Full Ironman distance (4 km swim, 180 km bike, 42.2 km (full marathon) run) in Muskoka August 30/2015. Next Ironman Lake Placid July 23/2017!

Mary A.
on 8/23/12 12:28 pm
On August 22, 2012 at 3:49 PM Pacific Time, kellybelly333 wrote:
 T for the info. I don't have much faith and expect to appeal.


if it happens give me a hollar and I will share any wisdom or suggesitons that I have gained during my appeal

prior to surgery 323lbs....4 years post-op maintaining between 108- 114 lb loss. 

life is AMAZING when you continue on the right path~!.  Use your surgeons gift to the fullest~!

Mary
surgery done in Duluth, MN

Megan M.
on 8/22/12 8:37 am - Canada
Mary, can you post a link to this Appendix - I can't find it.  Thanks.

Had RNY surgery July 22/11, St. Joe's Hamilton, with the awesome Dr. Scott Gmora.  Had abdominoplasty August 2/13, Scarborough, with equally awesome Dr. Michael Kreidstein.

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