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

Why the US is a Great Option for Private Surgery

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Why the US is a Great Option for Private Surgery

When you begin looking for private surgery options within Canada, you can quickly realize that for many ailments, there are limited choices.  While private surgery is not completely banned in Canada, there are a lot of rules and limitations put on the facilities that offer the services.  You cannot have a private surgery done within your own province, with the exception of Quebec.  So now what?  If you are in a place where nothing is available to you, you might start looking outside of Canada.  The first logical place is the US, however, many people automatically count that out because they are afraid it will be too expensive.  That is definitely not the case with many surgeries.  In fact, the cost(s) are comparable to what you might pay if you had it done in Canada if you know where to look.  There are also several other benefits to crossing the border  south as opposed to traveling to another country much further away:

Cost:  While cost is important, it should not be your deciding factor.  Many people think, it’s just breast implants or a simple knee surgery.  They do these every day.  What could go wrong?  If the right standards are not met, A LOT!  Sometimes you get what you pay for and your health should not be compromised to save a few dollars.  Having a safe, successful surgery should be your number 1 priority.   Doing a cost benefit analysis on how much you’d really be spending, or saving, by flying elsewhere, might surprise you when you add everything up, especially if the result is not what you expected.

Shorter Flights:  When you have a surgery, you become susceptible to complications such as blood clots for the first 10 days, however, that risk can go up to 3 months.  Your odds of developing one if you are flying increase significantly if you are on a flight that is longer than 4 hours.  Most flights to the US can be accomplished in 4 hours or less for the most part.  Going somewhere like Europe will most certainly be longer flights in the 8-10 hour range.  If you are going to India, it can be more like 14+ hours.  Surgery is not a pleasant thing to do.  Who wants to sit for hours on end, likely in pain?  And why add additional risk if it’s not necessary?

Everyone Speaks English:  While this might seem obvious, going to a country that does not speak English can create some situations where things get lost in translation.  It can be difficult to convey precise medical information to someone in another language if that person is not fluent in the native language.  In countries like Mexico, Germany, or France, you might be at a facility where your nursing staff taking care of you or even the surgeon does not speak English.   While there will most likely be an interpreter, things can still be overlooked or missed.  There is a lot of paperwork you sign off on as well.  How can you know for sure what you are signing if you can’t read it properly?  

Training and Specialty of Surgeon:  You do not want someone trained as a Pulmonologist or General Surgeon doing an orthopedic surgery. This is more common than you would imagine, especially for plastic surgery, in other foreign countries. The outcome will be more favorable when you have your surgery done with a licensed and trained specialist that is within the specialty of the surgery you are having.  Looking at your surgeons training and their specialty is a must.  You can easily check credentials for US doctors.  Other countries do not publicly provide this information so you could be having a surgery by a surgeon that has had no specific training on what you are having done or with an expired license.

Regulations:  US hospitals and out patient facility centers have the same regulations as Canada.  They all have accreditations and must adhere to specific standards.  Not all hospitals in other countries do.  This can increase your risk 10 fold if standards are not being met or followed. 

If you are in need of a private surgery, reaching out to a medical facilitator like Health Vantis can help walk you through your options to make a better informed decision.  Contact us if you’d like more information!

Health Vantis

www.healthvantis.ca

info@healthvantis.com

877-344-3544

Updated Cross Border Travel Guidelines for Medical Purposes

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Updated Cross Border Travel Guidelines for Medical Purposes

The rules regarding travel continue to change from what it seems like day to day or week to week.  In the past 2 years, getting across the border has been cumbersome to say the least.  We have tried to stay ahead of it so we know how to assist our clients so here are the latest rules per travel.cg.ca:

All travelers must be fully vaccinated to enter the US and return to Canada.  Fully vaccinated definition is someone who is 2 weeks out from their last vaccine dose.  Proof of a negative COVID-PCR test taken 24 hours prior to departure is required to enter the US.  Proof of a negative COVID-PRC test taken 72 hours before arrival back to Canada is required.  Antigen tests are not acceptable in either country.  A previous positive test is acceptable if it has been 14-180 days in both countries. The person must be symptom free when they arrive in either country.

Proof of vaccination needs to be uploaded to ArriveCAN before they board a flight or reach land in Canada.  A paper or digital copy of proof of vaccination also needs to be carried with you.  If you meet these guidelines, you will not be required to quarantine.

Leave for medical treatment and return to Canada exempt from standard rules:

Persons who must leave and return to Canada to receive essential medical treatment or services in another country are exempt from standard rules.  This does not include surgeries or diagnostic tests that are deemed elective or non-urgent.

For individuals who require medical treatment or services (for example, life-saving treatment) outside of Canada, they must have:

  • upon leaving Canada, written evidence from a licensed health care practitioner in Canada indicating treatment or services outside Canada are essential; and
  • upon return to Canada, written evidence from a licensed health care practitioner in the foreign country indicating treatment or services were provided in that country

And 

If you’re the person requiring medical treatment, you may have 1 person accompany you if:

  • you’re a minor or dependent child or
  • you require assistance in accessing the essential medical services or treatment

The accompanying person must meet entry requirements for their return to Canada. The accompanying person is exempt from quarantine and arrival testing, but will still be required to:

  • follow local public health guidance
  • wear a mask when in public, and
  • keep a list of close contacts for the 14-day period after arrival
  • if qualifies as fully vaccinated and they have no signs or symptoms of COVID-19, they would also be exempt from pre-entry test requirements.

If you are interested in private surgery and need help navigating the current rules, please contact Health Vantis to assist you in your journey so no detail is left out at 877-344-3544 or Info@healthvantis.com.

Travel Insurance vs Complications Coverage

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Travel Insurance vs Complications Coverage

We get a lot of calls from people looking for complications coverage if they are traveling for medical treatment.  This can often times be confused for traditional travel insurance.  You will quickly find that they are not the same kind of coverage.  Below we will explain the difference:

Travel Insurance

Travel policies were created to cover the cost of damage to personal property, for instance, baggage, rented equipment such as rental cars, trip cancellation, acute medical expense coverage, accidental death and/or flight accident coverage.  Other things it might cover could be emergency assistance for lost passports, cash wires, and re-booking of canceled flights.  

There is also a different kind of travel insurance called interruption coverage.  This is to cover you should there be an illness, death in the immediate family, sudden business conflict or weather related issues.  This coverage will reimburse you for pre-paid, non-refundable travel expenses.

Keep in mind that there are all kinds of clauses and exclusions to these polices.  One important one is the misunderstanding that ‘medical coverage’ is available for pre-existing conditions such as diabetes or high blood pressure   Nearly all of these policies exclude pre-existing conditions.  If you are traveling for a scheduled surgery, this kind of policy will not cover you.  If you have a heart disorder and have a heart attack while traveling, this policy will not cover you.  What it will cover are instances where accidents occur and need immediate attention such as  a fall that required stitches or a car accident that required medical care.

The best advice is to read your contract in full detail to know and understand what is and what is not included.

Complications Coverage

When you realize travel insurance will not cover a scheduled surgery, you will likely spend hours looking for options that will.  We can save you a lot of time.  There is only 1 company we know of that provides complication coverage to Canadians traveling for medical care due to the uniqueness of the travel.  That company is called Global Protective Solutions (GPS).  It is designed to cover you should there be complications as a result of a scheduled surgery.  

The policy will cover you for up to 180 days post initial surgery.  Additional medical or surgical treatment must be completed within a 270 day period.

Like most policies, there are limitations.  For example, if you do not follow all of the pre and post operative medical instructions, you will not be covered.  If you have an aesthetic procedure and you do not like the outcome, you will not be covered.  Just like a travel policy, read the details close to know what is an acceptable reason for reimbursement.

Also keep in mind that most coverages on either kind of policy have maximum benefits for each specific need.  Key take away, be sure to read the policy fully.  If you do not understand a certain clause, contact the company for clarification. 

New Travel Guidelines Effective Nov 30, 2021

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COVID has been around now for nearly 2 years and there doesn’t appear to be an end in sight.  That means we still have to follow guidelines and endure inconveniences, especially if we decide to travel.  The good news is that effective Nov 30, 2021, fully vaccinated individuals crossing the border for land or air travel, are exempt from providing a COVID-19 molecular PCR test to re-enter Canada.  The exemption only pertains to Canadian citizens, permanent residents or individuals registered under the Indian Act, who’s trip originated in Canada via air or land, that can show they have been away from Canada for less than 72 hours.

The exemption also applies to:

  • people with medical contraindications as defined in the Orders in Council (OIC); and
  • unvaccinated children under 12 who are accompanying their parent, step-parent, guardian or tutor.  The accompanying adult must be fully vaccinated (or have a contraindication) and have right of entry to Canada.

The 72-hour period runs from the initial scheduled departure time for flight leaving Canada to the scheduled departure time for their flight back into Canada for those with the right of entry in to Canada traveling via air.  Proof of the 72 hour window of travel will be required to border officials.  Acceptable proof will be via boarding pass and/or travel itinerary.

Stay tuned for additional changes to occur January 15, 2022.

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

Updated Border Crossing Restrictions

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Updated Border Crossing Restrictions

On September 21,2021, the US decided to extend their non-essential travel restrictions between the US and Canada through October 21, 2021.  This includes fully vaccinated individuals.  The goal is to ease the restrictions to fully vaccinated individuals beginning November 2021.  These restrictions do not apply to people traveling for medical purposes.

Non-essential travel into Canada has been approved.  All travelers coming back into Canada must submit a negative PCR-COVID test taken within 72 hours of getting on a flight or crossing the border via car.  Rapid antigen tests will not be accepted.  If you are NOT fully vaccinated, you will need to quarantine for 14 days on your return flight/drive back into Canada and provide another negative PCR-COVID test 8 days after your return.  If you are fully vaccinated, you are exempt from quarantine and 8 day testing requirement.  You will need to upload a copy of your vaccination card through ArriveCAN within 72 hours before your travel along with your negative PCR-COVID test.

If you are considering medical travel, we can assist in making sure you understand and are aware of all current requirements.  Medical travel is considered essential travel and there would be no issues coming to the US should you travel there for treatment.

Health Vantis

www.healthvantis.ca

info@healthvantis.com

877-344-3544

6 Things You Should Not Do When Traveling After a Hip Replacement

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6 Things You Should Not Do When Traveling After a Hip Replacement

Hip replacement surgery is considered a major surgery.  It can take weeks to heal to get your full mobility back.  The surgeon will prepare you for your rehab and how you need to care for your new hip but what about your trip home?  This is something surgeons might not always think about so here are 6 tips for you to consider prior to your travel home.

  1. Avoid traveling too soon – Your doctor will tell you when its safe to drive or fly home after your surgery.  If you don’t feel like you are well enough to leave when you’ve been released, then trust your own body and stay an extra day.  It will be worth it in the end if you feel healthier during your travels.  
  2. Make your trip comfortable – Flying can present some issues after a surgery.  Any flight over 4 hours can increase your risk for a DVT.   The best way to avoid this is to be sure and get up and move as much as you can.  You can also ask your doctor for TED hose, which will help with circulation.  Be sure to have your pain medication, bottled water and a blanket or pillow to make the journey as comfortable as possible.
  3. Never take your trip alone – One requirement in traveling for surgery is to take a travel companion.  None of the facilities within the US and Canada will allow someone to have surgery if they do not have a trusted adult staying with them for the first 24 hours after surgery.  Taking an Uber back to your hotel by yourself is not acceptable and not in your best interest should you need immediate care while you are resting in your hotel.  It is also helpful to have someone else there to assist you as you are recuperating in the hotel and on your travels back to help with luggage and getting to and from the gate.
  4. Pack essentials – Packing things ‘just in case’ is always smart.  These should be kept on your person or carry on bag for easy access.  Things like pain medications, blankets, pillows, comfy clothes, headphones and extra bandages are examples of items you might consider taking.
  5. Ask for anti-nausea medication – Anesthesia can make people very nauseous post surgery.  Motion sickness is also very common.  If you have ever experienced either of these in the past, ask your doctor to write you a prescription for an anti-nausea medication and keep it with you in the event you have an episode.  Be sure to pack some crackers, ginger ale or other things that are light on your stomach.  Try not to skip meals as having some food in your stomach will help.  Taking some medications on an empty stomach can also cause nausea or upset stomach problems.
  6. Take it easy – Be sure to take things slowly.  You will have days where you feel great but always follow your doctors recommendations on your limitations so you do not over do or undo what was just fixed.  Surgery creates a lot of swelling and this can take weeks to subside.  Pushing yourself too hard too early can sometimes reverse what was just done.  Give your body the time it needs to heal.

If you are considering a private surgery, give Health Vantis a call.  We have experience in making your journey a safe and successful one.  

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

New Travel Guidelines Aug 9, 2021

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New Travel Guidelines Beginning Aug 9, 2021

Due to the increased vaccination rates in Canada, declining COVID-19 cases and less pressure on the health care system, the government plans to lift travel restrictions August 9, 2021. Fully vaccinated Canadians, US Citizens and permanent residents of the United States, currently residing in the U.S., will be allowed to enter Canada for discretionary (non-essential) travel. Per the Government of Canada website ‘Entry to Canada will continue to be prohibited for U.S. travellers who are not fully vaccinated and for all other foreign nationals, unless they already meet an exemption set out in the Orders made under the Quarantine Act.’
It also indicates ‘To be eligible to enter Canada, fully vaccinated American citizens and permanent residents must have received the full series of a vaccine – or combination of vaccines – accepted by the Government of Canada, at least 14 days prior to entering Canada. Currently, those vaccines are manufactured by Pfizer-BioNTech, Moderna, AstraZeneca/COVISHIELD, and Janssen (Johnson & Johnson). Travellers can receive their vaccine in any country, and must provide evidence supporting their vaccination in English, French or with a certified translation (along with the original).’
In addition, fully vaccinated travellers must also:
  • provide COVID-19-related information electronically through ArriveCAN (app or web portal) including proof of vaccination prior to departing for Canada (subject to limited exceptions);
  • meet the pre-entry testing requirements;
  • be asymptomatic upon arrival; and
  • have a paper or digital copy of their vaccination documentation in English or French (or certified translation, along with the original) ready to show a government official on request.
All travellers must still present a suitable quarantine plan, and be prepared to quarantine, should they not meet all of the conditions required to be exempt from quarantine. They will also be required to follow public health measures in place, such as monitoring for signs and symptoms of COVID-19, wearing a mask when in public and keeping a copy of their vaccination documentation and test results – as well as a list of close contacts and locations visited – for 14 days after entry to Canada. For air travel, passengers continue to have to wear a mask in Canadian airports and on board flights to, from and within Canada, with few exceptions, and regardless of their vaccination status.
For more information, please review the new guidelines to take effect Aug 9, 2021 here.
Health Vantis
877-344-3544
info@healthvantis.com

Are There Private Surgery Facilities in Canada?

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If you have been told you need to have a surgery, the most common reaction is to have it done asap.  In Canada, most people have already been waiting quite a long time to know that they will need to have surgery.  Being told there is a long wait is not anything one likes to hear.

Will this ever change?  It is anyone’s guess.  New Conservative leader Erin O’Toole has indicated he would allow patients more choice when it comes to private options.  This of course is quite a ways down the road.  With COVID added to the delays, it really presents additional challenges. 

Where Are The Private Facilities?

As of now, private facilities are very limited in Canada.  For instance, there are no known private surgical facilities within the Maritimes.  In all other provinces, there are a handful of private facilities, however, they are limited on what kind of surgery they can do.  For example, there are only a couple facilities that can do a knee and/or hip replacement.  None of the private facilities can accommodate over night stays.  The surgery would need to be on an outpatient basis, otherwise, you will have to wait and go through the system.  Not everyone is a candidate for an outpatient surgery so an evaluation needs to be done.

What Are The Rules For Going To A Private Facility?

Back in September of this year, British Columbia determined private facilities could no longer perform private surgery if you are a resident of BC.  This prompted closures and services offered to BC residents on a private basis to no longer exist.  They do, however, allow someone from another province to be treated at their facilities in a private manner.  In Saskatchewan, Ontario, Manitoba and Alberta, the same rule applies.  The facility is not able to provide private services to residents within that province.  This is only for those procedures already covered by their provincial insurance. Things like dentistry and cosmetic surgery would not apply.  The only province we are aware of that can take residents within their own province is Quebec.  

This presents a challenge because it requires travel.  Not everyone is willing to and in COVID times, it can be tricky with constantly changing rules and gray areas.  If you’d like to know what your options are within Canada, please give us a call and we can help assist in finding a facility that can meet your needs.

There are also other private facilities for MRI and CT Scans  For more information on those, see our other blog post here.

Health Vantis

877-344-3544

info@healthvantis.com

www.healthvantis.ca

Snowbird Surgery

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Snowbird Surgery

It is the time of the year that ‘Snowbirds’ start making their plans to travel south for the winter.   Most true Snowbirds own a second home/vacation home in the US.  Unfortunately, traveling for leisure is completely different this year in light of the COVID pandemic.  As of now, travel for leisure, even if you own a home in the US, is deemed non-essential. It is, however, considered essential if you are traveling for medical reasons. If you’ve considered having a surgery done privately, your winter trip can happen.  There will be many state and provincial regulations you have to abide by, however, it just may be the way to still get some of the sunshine you’ve been craving AND get you in a better, healthier place.

Benefits Snowbirds can still have if they schedule a private surgery:

  • You can recover in the comfort of your own home that you own in the US.
  • Most people who travel for surgery will stay an average of 5-7 days and then return to Canada.  Being local and having the ability to stay longer and do your follow ups in person is more optimal.
  • There is less risk to you for complications since you do not need to fly home right away.  Flying during COVID is more challenging with more hoops to jump through.  If you combine your surgery with an already planned trip to stay for a couple of months, that risk element is removed.  When the time comes for you to go back to Canada, you will likely be in a healthier place with more energy and the ability to do so easier.
  • By coming to the US, you may have access to treatment for procedures or surgeries that are not available in Canada.  There are many things unavailable to Canadians that are available in the US.  This would be an optimal time to explore alternative options.
  • There is convenience of already being in the area so you avoid an additional trip and expense.  If you combine your south of the border winter trip with a surgery, you will save money by not making a separate trip to do so.

Contact Health Vantis to connect you to an already vetted, safe and affordable facility in the area you are traveling.  We take the guess work out of finding the appropriate surgeon for your needs.

Health Vantis

877-344-3544

info@healthvantis.com

www.healthvantis.ca