Canadian medical coverage

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Canadian medical coverage

Postby Mechanicallyinclined » Thu Jan 07, 2010 9:44 pm

What I'm wondering is in Canada
1. Do we have a right to request from our Doctor a script for the Doppler and MRV tests in False Creek . With that in mind should there be any coverage for that? I'm from manitoba ( Someone from Ontario suggested that if a Doppler showed positive from Barrie Ont that their provincial coverage would cover the cost of the MRV in False Creek.I'm not suggesting going from Manitoba to Barrie then False Creek. The provincial coverage as it applies to the testing process is what I'm more interested in.

2. Even we have to pay to get that testing done----- If that proves that we have a problem (Stenosis) , does that give us a right to then go back to our Doctor and then demand to see a vascular surgeon to get this fixed based on a Venous Issue.

3. Cheerleader says something to the extent that in the US, most insurance plans cover you if you are shown to have more than 50% stenosis. Does any Canadian know how this situation would apply to our Canadian system?

There has to be some kind of rights here to seek medical attention.
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Postby mangio » Thu Jan 07, 2010 10:28 pm

I believe the answer is no. Looking back I'm sorry for the way I worded
that last post as it obviously caused some confusion. My understanding
is with my own provincial insurance with proper requisitions Alberta
would cover the doppler portion of exam. I don't know what else. I am
sorry for the mix-up and will be more careful in future.
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Postby Mechanicallyinclined » Thu Jan 07, 2010 10:47 pm

No Problem Mangio. I guess I'm more interested in the right to seek treatment in Canada if you get a confimation that there is restriction or blockage of your veins.

I started looking up our rights in seeking medial attention and it's mindboggling.
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Postby dialed_in » Fri Jan 08, 2010 7:14 am

I think the biggest stumbling block will be that it's not an approved treatment for MS yet in Canada. This is why Cheerleader and the other Stanford people used something like chronic headaches as a dx that could be treated by opening up the veins again. So if your doctor has been treating you for headaches for a long time you could possibly use results from False Creek as evidence to send you to an IR for surgery.

Like cheerleader has been saying for a long time now. Don't even bring up the MS. You have to make them look at it like you are someone with a problem unrelated to MS.

Then you have to think about stents. Again, you have to go back to the approved treatments stuff. What if angio won't be enough to keep them open because of where they are? Then you'd probably need stents. Has health canada, or whoever approves these treatments, approved them to be used in veins? You'd have to do some research on that.

Best of luck M.I.
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Postby happy_canuck » Fri Jan 08, 2010 8:38 am

I don't know anything more about requesting testing or treatment for a new medical issue, but I know a few years back lots of people were sent from at least Alberta to have medical testing and treatment in BC. I know this b/c I lived in Vancouver and some firends from Alberta did this and stayed at my house! Their provincial health plans covered all expenses plus gave them something to give towards a gift for the person if they stayed in a home instead of a hotel.

That was a few years ago...now Alberta has a better health care system and likely doesn't send people here anymore, but at least it shows interprovincial transfers are possible.

Sandra
National CCSVI Society: <strong><br /><a href="http://tinyurl.com/44znbct">http://tinyurl.com/44znbct</a> ~Website<br /><a href="http://tinyurl.com/3wzmkmg">http://tinyurl.com/3wzmkmg</a> ~Facebook</strong><br />
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Postby Mechanicallyinclined » Fri Jan 08, 2010 9:24 am

dialed_in Posted: Sat Jan 09, 2010 1:14 am Post subject:

--------------------------------------------------------------------------------

I think the biggest stumbling block will be that it's not an approved treatment for MS yet in Canada. This is why Cheerleader and the other Stanford people used something like chronic headaches as a dx that could be treated by opening up the veins again. So if your doctor has been treating you for headaches for a long time you could possibly use results from False Creek as evidence to send you to an IR for surgery.

Like cheerleader has been saying for a long time now. Don't even bring up the MS. You have to make them look at it like you are someone with a problem unrelated to MS.

Then you have to think about stents. Again, you have to go back to the approved treatments stuff. What if angio won't be enough to keep them open because of where they are? Then you'd probably need stents. Has health canada, or whoever approves these treatments, approved them to be used in veins? You'd have to do some research on that.

Best of luck M.I.
Excellent points you make here. Stent use approval is also somethink I'm wondering about. Anyone who can share information relevant to all of this will help us all.
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Postby oreo » Sun Jan 10, 2010 8:39 am

Each province / territory administers its own health insurance system so the rules vary from one province to another BUT the general principles apply across the system.

All provinces wll pay for medical services provided in another province IF that service is provided on an emergency basis. They will also pay for services provided out of province IF the service is NOT available in province or if an out of province facility is closer than an in province one.

If you ask your doctor and he does issue a requisition for a doppler ultrasound it should be for headaches or somthing similar, not for MS. Most GP's know their way around their provinces health insurance practices and if they order something that will not be covered, they should tell you but if you are in doubt ask them. If your GP sends you to a specialist because of the results or even just to interpret them the same thing applies. They can tell you BEFORE you proceed what is covered and what is not, just ask.

Also, if you travel more than 40km (one way) for any medical service, keep a record. Travel / accomodation & meal expenses are considered to start becomming MEDICAL EXPENSES for Income Tax purposes at this point. There are detailed rules that apply. Detailed information can be had from the Canada Revenue Agency.
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Postby vendredi5h » Sun Jan 10, 2010 9:55 am

My understanding of the situation:

1- For the patient:

Is the test/treatment prescribed by a medicin?
    No -> You won't get the treatment even if you're willing to pay for it.
    Yes -> Is the test/treatment done in your province?
      Yes -> Treatment paid
      No -> Was the treatment available in your province?
        No -> Treatment paid
        Yes -> You pay for the treatment
2- For the medicin that prescribe a test/treatment:

Was the test/treatment known and accepted by pears?
    Yes -> You're fine!
    No -> Did the test/treatment turned bad?
      No -> You're fine!
      Yes -> Did this test/treatment makes sens?
        No -> You're in big trouble!
        Yes -> You're in big trouble even though!

If my understanding is correct, to get the testing done you'll first have to find a doctor willing prescribe this testing (and for the angioplasty or stenting, willing to risk his licence). Since all equipement and professionals necessary for this kind of test (MRV, Doopler, ...) are available in all provinces, you will not be able to get the treatment paid simply because you supposedly need a knowledgable specialist to do this test.

In my opinion, with a prescription in hand, you'll have to pay or to convince a specialist in your province to get use of the protocol to investigate CCSVI.

Yannick
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Postby DizzyLiz » Thu Jan 14, 2010 1:46 pm

It is my understanding that the proper medical equipment for this testing is NOT available in all provinces.

Check out MSLiberation - under CCSVI in the heading, for info on the MRI machines in Canada - (Info from Stats Canada on this site.)
The msLiberation Group are working to raise funds for the testing and are also lobbying on our behalf. Join the group and donate and help all Canadians get tested!

http://www.msliberation.ca/MS_Liberatio ... CCSVI.html
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Postby Billmeik » Thu Jan 14, 2010 3:00 pm

false creek has a low success rate at seeing ccsvi. There is probably a clinic in alberta that will take your money to take sketchy pictures too. The bottom line is a flattened garden hose is hard to see from some angles. You need 3d to find stenosis and a trained doctor.
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Postby DizzyLiz » Thu Jan 14, 2010 4:03 pm

Regarding testing...
According to the MSLiberation website:

In order to test for CCSVI, the most effective means is to use a 3Tesla magnetic resonance imaging (MRI), following a specific protocol. Unfortunately, as of January 1, 2009, the number of MRIs in Canada is only 6.8 per Million, well below the rates of 26.6 MRIs per million in the U.S. and 40.1 in Japan. As well, only 3% of the Canadian MRIs are of the right calibre (3 Tesla), and they are quite old given that the average age of Ontario’s MRIs is 5.3 years.
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Postby Mechanicallyinclined » Thu Jan 14, 2010 9:47 pm

I don't know the exact model of a MRI in Manitoba , but I do know it does have 3D capabilities .
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Postby Algis » Thu Jan 14, 2010 9:50 pm

@DizzyLiz: may I ask: where did you get those figures?

OK - Sorry my bad :oops:
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