Can I Get Reimbursed for Private Surgery in Canada or Abroad?

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When we help our clients arrange their private surgery, this question comes up a lot. No surprises here, as we Canadians pay a lot of taxes that are supposed to pay for our medical care, but instead we wait and wait and wait. So, when someone decides to take matters into their own hands, they want to know if they will be reimbursed by their province for their private surgery.

In general, the answer is no. If you are traveling to get surgery or treatment at a private medical facility your expenses will be out of pocket and not eligible for provincial reimbursement. However, there are special cases for reimbursing costs for access to medical care in a different province or out of the country. Those are not normally the cases that we handle, as there is quite a bit of red tape and prior approvals requirements. Rules differ from province to province.

In the province of Nova Scotia, residents of Nova Scotia have to be medically referred outside of province for insured treatment. Those services must be received in an accredited public hospital and billed reciprocally in accordance with the Interprovincial Reciprocal Billing Agreements. Prior approval is required. Your Nova Scotia Health Card must be presented in order to receive out-of-province medical treatment. There is an out-of-province travel and accommodation assistance policy in place and the rules can be found here.

If someone is to travel outside of Canada, prior written approval is required from the Department of Health and Wellness. The referral must be from a specialist registered in Nova Scotia. If the claim receives prior approval from the Department of Health and Wellness for out-of-country treatment, all medically necessary services, whether provided on an in-patient or out-patient basis, will be insured at 100 per cent. This is mostly for those seeking medical treatment that is not available in Canada but is medically necessary. Preferred accommodation, take home drugs, etc., are not covered under the provincial health plan.

A recent change was added for reimbursements of travel expenses to low-income families if someone decides to travel inside the province for surgery, endoscopy or cystoscopy. This is currently a pilot program. It provides some financial help with transportation and accommodations for the patient and their companion if a companion is deemed essential for the patient. More information can be found here.

So if you are choosing to travel out of province and country to get a private surgery that is covered by your provincial healthcare plan, there are no reimbursements available, unfortunately. However, the expenses can be used in your yearly tax filings. You would need to consult with your accountant about how to do it properly to get the most benefit.

As well, many airlines offer a free return ticket for the companion of someone traveling for surgery and requiring assistance. There are certain rules of booking that need to be followed as well, and your surgeon will need to state that you are not able to travel by yourself.

If you are interested in exploring your options in private surgery we are here to help. Please call us toll free 877 344 3544 or email us at info@healthvantis.com

Myths About Private Joint Replacements

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Being Too Old or Too Young

Osteoarthritis can start at an early age, and being in increasing pain is rarely the answer to treating it. Lifestyle changes to accommodate chronic pain will lead to less activity and other health issues possibly arising. If you have difficulty walking or enjoying other normal daily activities, it is time to see a doctor and get an X-ray done. Newer materials make implants more dependable and long-lasting, thus providing younger people with a longer time to go without any revisions down the road. Many people who undergo a joint replacement return to their enjoyable life within 1-3 months, depending on the person and their health prior to surgery.

My Pain is Mild I Can Wait to See a Doctor

Some people are hesitant to see a doctor if their pain is mild. However, mild can be a relative term. Osteoarthritis is a progressive disease and there is no cure. It will progress and you will experience more pain. Seeing your doctor when the pain is mild can start the process. Your family physician can order an X-ray, prescribe non-surgical treatment to relieve the pain, and refer you to see an orthopedic surgeon. This process takes time. Anecdotal evidence from some of our clients is such that at some point the pain becomes much worse and it happens pretty fast. Having a conversation with your family doctor about your options early is always a good idea.

I Have to Stay in the Hospital for Joint Replacement Surgery

In the past joint replacement were done in a hospital setting. A number of days were spent in the hospital recovering. While hospital setting may seem safer to some, the truth is that staying in the hospital is not necessary and it is much safer to go to an outpatient facility.

Most people qualify for a safe day surgery when they are looking for a private hip or knee replacement. Day surgical centers are common now. Patients check in very early, have their surgery first thing in the morning, and go to a hotel or home to recover in the afternoon. Usually, physiotherapy starts the same day, after the patient wakes up from anesthesia and goes to a recovery room. There are fewer chances of an infection, as day surgical centers tend to have very low infection rates compared to hospitals.

If you are curious about private surgery and would like to discuss your options at home or in the US we are here to help. Contact Health Vantis toll-free 877 344 3544 or by email info@healthvantis.com

Private Surgery in the USA: International Medical Travel Pros and Cons.

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If you are facing a long medical wait time for surgery or treatment in Canada and do not wish to wait, you are probably considering your private options. There are some in Canada, and we wrote a blog about the pros and cons of staying in Canada. Today we will look at the pros and cons of traveling internationally, including the USA.

Pros

Access to Specialized Care

Many surgeons in the US are highly specialized. They see a lot more patients for just a few issues that they excel at treating. This allows for an experience and expertise combination that their counterparts in Canada may not be able to offer. We helped a client who had hip surgery before in Canada only to find out she is still in pain. When she scheduled a visit and surgery with a highly specialized orthopedic surgeon we work with in the US, her issue was addressed with the highest level of expertise. In her own words, “I would have been disabled if I stayed in Canada”.

Fast Access

Health Vantis works with medical facilities in the US that can accommodate surgery as fast as 3-4 weeks. A lot depends on how fast our clients are willing to travel. However, the only caveat here would be your medical records such as diagnostics. If you have your MRI/Ultrasound/X-ray we can get you to surgery as fast as you can get to the destination. For comparison, some private facilities in Canada schedule 3 months out. While still faster than the 1-2 year public wait list, to many of our clients it is not satisfactory as they would like to get their treatment or surgery done asap.

Extensive Information About the Medical Facility and Surgeons

Doctors and hospitals are rated and given different achievement awards n the US. As well, many make their infection and re-admission rates public so that you can make an educated decision about where to go. Extensive biographies are available to familiarize yourself with the surgeon. Health Vantis also obtains such data as nurse-to-patient ratio and number of surgeries performed per year.

Cons

Can be More Expensive

Paying in the USD right now means paying up to 30% more in Canadian dollars due to the current exchange rate. This is not insignificant and we recognize this fact. However, we also advise our clients to choose based on expertise and not solely on the price. After the initial consultation with a surgeon, you will be able to get an idea of how they treat their patients. It is an opportunity to connect and judge for yourself if this is the surgeon of your choice.

Need medical Complication Insurance

We have not had any surgical complications cases; however, complications do happen. Since healthcare costs in the US hospitals can be quite high, you may want to consider getting complications insurance. This is an additional expense.

Travel Costs Can Be Higher

Another expense – and as Canadians we have no control over what airlines charge for their airfare. It may not necessarily be much more expensive, depending on where you live. If you are in Toronto or Calgary, the costs increase due to travel can be very minimal or non-existent, however, if you reside in the Maritimes, it can be about CAD$100-200 higher per person.

If you are curious about private surgery and would like to discuss your options at home or in the US we are here to help. Contact Health Vantis toll-free 877 344 3544 or by email info@healthvantis.com

Private Surgery in Canada: National Medical Travel Pros and Cons

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Long medical wait times force Canadians to look for medical help elsewhere in a private manner. Although in Canada private surgical facilities can not treat people from their own province (with the exception of Quebec), they can offer private surgeries for people residing in other provinces.

What are the advantages and disadvantages of staying in Canada to Canadians seeking private surgery?

Pros

Lower surgery costs due to currency conversion

One of the biggest pluses of staying local is that your surgery cost is in Canadian dollars, and you do not have to convert to USD. Most surgeries such as private hip or knee replacement cost roughly the same amount in USD or CAD. However, CAD is not doing so great right now, so there is value there in the conversion rate.

Lower travel costs (possibly)

Flying within Canada vs flying to the US can be less, but not always the case. It will depend on where you live and the destination you choose. We had people flying in from Vancouver to Montreal, and the cost can be about the same as flying from Halifax to Boston. If you live in Halifax, then flying to Toronto or Montreal may be less than flying to the US.

Access to home country emergency medical services in case of a complication

If you are staying in Canada for your private surgery, then you will not need complications insurance. Every Canadian is covered in case of an emergency, even if you went to get something done privately. If you travel to the US then we advise our client to at least check into and price complications insurance. Even though none of our clients have used it for a medical complication, it is a good feature to have, just in case, as US hospital bills can be very high.

 

Cons

Limited options for specialized care

Even though private medical facilities exist in Canada, their offerings do not cover all areas. One of the missing pieces are GYN and some urological procedures. Another one is pediatric surgeries. As well, many newer techniques or approaches may not be offered in Canada. If you are looking for a specialized or cutting-edge treatment you may need to look outside of Canada.

Limited information options in choosing your surgeon and medical facility

Not many surgical facilities in Canada offer extensive biographiess and stats on their medical facilities and surgeons. The information can be hard to find or not available at all. This makes decision-making a bit more complicated. We here at Health Vantis try our best to provide as much information about the number of surgeries performed, infection rates and nurse-to-patient ratios.

Longer wait to get to surgery, even private

Even at private facilities in Canada scheduling your private surgery can be 3 months out. Usually, by the time people make a decision to seek a private surgery they do not want to wait 3 months and would like to get it quickly. Health Vantis has arranged surgeries within 3-4 weeks from the date of initial contact. A lot depends on medical records here, however. If someone has their medical records we can get you to surgery asap. If medical records have to be requested from the health care authority, it can take up to 30 business days to receive.

If you are curious about private surgery and would like to discuss your options at home or in the US we are here to help. Contact Health Vantis toll-free 877 344 3544 or by email info@healthvantis.com