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sara
07-28-2006, 10:51 PM
Hi !

i am moving to Toronto (north York) in a few weeks time. Can anybody tell me to what extent does OHIP covers SLE patients in terms of lab tests and medications? If i need to see a doctor urgently what are the alternatives coz from i have been told it can take several months before you can get an appointment with your GP. I know private practising doctors are not there. :( .. I do hope somebody can help me out and answer my queries..

thanx

beautifulbeluga
07-29-2006, 05:47 AM
Hi Sara.

Welcome to Canada. I do not live in the Toronto area but one province over but I think OHIP and Manitoobe Medical work pretty much the same. First of all don't worry you will get in to see a GP quickly but you will have to wait to see a Reummy or any other specialist and yes several months or even longer may be correct. It takes that long in Manitoba for sure but Toronto area is a larger city than where I live and more physicians relocate to Toronto than what remain in Manitoba.

Secondly, the way our system works is that medical appointments are free so any visits to doctors (yes even specialists) are free as are hospitalizations. Any referral to alternative care like physio-therapists would not be covered unless it runs out of the hospital. Private alternative care is your financial responsibility unless you have some kind of extended health benefit through work which most people do. Medications also have to be privately paid for and again most people have extended health benefits that usually cover from 100 to 80% of that cost. I do not because I have been ill for so long and had to let my insurance go when I no longer was in private practice. But in Canada, at least in Manitoba and I think that is also true in Ontario that there is a ceiling on how much you have to pay for your drugs and that is based on you yearly personal or family income. For example, my limit for my husband and myself is somewhere around 700 dollars. So up to that amount we pay and after that the government pays. It however, only covers drugs approved by the government and usually only generic brands. So for example if you use Placquenil you would get the generic brand rather than the name brand as it is cheeper. New drugs to the market usually are not covered until there is a generic available in the country and many very expensive cancer drugs may not be available at all. Also medications in general are considerably cheeper here in Canada than in USA and Americans continue to get drugs dispensed from Canada over the internet pharmacies because of that.

Anyway, glad you are on your way. and I hope this info helps.

Patricia

sara
07-30-2006, 01:08 AM
dear patricia !

your detailed reply regarding my queries has been very helpful. I was not aware about the ceiling on drugs and will try to find out more about it once i am there.. I do hope i am able to find a good Gp in my area..There are too many things on my mind right now like settling down with kids, finding a job etc and sincerely hope lupus will not trouble me more than what it has already done in the past but with a disease like this you can never know what is in store for you..

thanx once again for helping me out...

take care







Hi Sara.

Welcome to Canada. I do not live in the Toronto area but one province over but I think OHIP and Manitoobe Medical work pretty much the same. First of all don't worry you will get in to see a GP quickly but you will have to wait to see a Reummy or any other specialist and yes several months or even longer may be correct. It takes that long in Manitoba for sure but Toronto area is a larger city than where I live and more physicians relocate to Toronto than what remain in Manitoba.

Secondly, the way our system works is that medical appointments are free so any visits to doctors (yes even specialists) are free as are hospitalizations. Any referral to alternative care like physio-therapists would not be covered unless it runs out of the hospital. Private alternative care is your financial responsibility unless you have some kind of extended health benefit through work which most people do. Medications also have to be privately paid for and again most people have extended health benefits that usually cover from 100 to 80% of that cost. I do not because I have been ill for so long and had to let my insurance go when I no longer was in private practice. But in Canada, at least in Manitoba and I think that is also true in Ontario that there is a ceiling on how much you have to pay for your drugs and that is based on you yearly personal or family income. For example, my limit for my husband and myself is somewhere around 700 dollars. So up to that amount we pay and after that the government pays. It however, only covers drugs approved by the government and usually only generic brands. So for example if you use Placquenil you would get the generic brand rather than the name brand as it is cheeper. New drugs to the market usually are not covered until there is a generic available in the country and many very expensive cancer drugs may not be available at all. Also medications in general are considerably cheeper here in Canada than in USA and Americans continue to get drugs dispensed from Canada over the internet pharmacies because of that.

Anyway, glad you are on your way. and I hope this info helps.

Patricia