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So my son has a procedure done and MSI only wants to pay for the procedure, NOT the exam to determine the need for the procedure. Why?
BECAUSE THEY HAPPENED ON THE SAME DAY!
So our government wants to give money to people in need…HELLO here I am dumb fucks!—Making Calls All Day, Apparently
This article appears in Feb 18-24, 2010.
18 Comments
MSI Is fucked. They did the same for me – they covered a surgery that would have cost me $50,000 or more out of pocket to correct degenerative joint issues in my jaw (a joint that can’t be replaced when it fails) yet one of the conditions of having this surgery is that my teeth needed to be perfectly aligned. The surgeons would refuse the surgery if my teeth werent aligned (if they weren’t aligned then the re-alignment of the jaw would relapse) then msi would have to dish out another 50-60 k for a second surgery etc etc….
Anyways, the only way I could get this surgery was to drop $8,000 out of my own pocket for braces – which I did not want nor feel I relaly needed – my teeth were “ok” before the surgeon would even consider me a candidate to fix my jaw from falling apart. Makes me wonder… So much for free healthcare.
YEAH BUT, ONE IS THE ACTUAL PROCEURE, THE OTHER IS JUST A TEST. DON’T SEE THE DIFFERENCE, THEN YOU SHOULD BE A POLITITION.
Dental is not covered under MSI
MSI use to cover dental cause 2 of my wisdom teeth were covered by MSI. I onlt had to pay for 2 to be pulled.
I thought MSI covered dental only up until a certain age ?
MSI does cover dental…. I have a slip right here for a procedure they covered THIS month….
Also as far as the procedure and the “test” are concerned, of course they are different, I don’t think OP was trying to deny that….I think the problem is that the test is not paid for because it happened on the same day as the procedure, as opposed to another day…..totally stupid!
I’m pretty sure wisdom tooth removal is not considered dental anywhere due to the fact it’s performed by a surgeon – not a dentist.
MSI does indeed suck, and this is indeed a province where it’s worthwhile to get private insurance in addition to MSI. BC’s system wasn’t too bad when I was there, but at the time I wasn’t making much $ so I didn’t have to pay much for it. The (only) good thing about MSI is there are no monthly payments like in BC.
Makes me some happy to have excellent Blue Cross coverage in addition to MSI.
What gets me about MSI is how they restrict access to some procedures that other provinces don’t. In order to have a breast reduction, your BMI has to be 25 or below — no exceptions. I know people who would look emaciated at a BMI of 25 because the BMI is a shitty way of calculating whether or not someone’s fat (think of athletes with high muscle percentages). Anyway, they also don’t account for the fact that each boob probably weighs 10 pounds each or more if they’re massive.
Yet, in Ontario OHIP covers breast reductions regardless of BMI. They also cover foot care too.
Plus, MSI should start covering dental for diabetics. They cover eye care, but not dental, and the thing with diabetes is one of the main complications is mouth diseases and eventual tooth loss. And if one of those diseases (like gum disease) gets into the rest of the body, you’re FUCKED.
I’m having surgery tomorrow to have my gallbladder out. Thankfully MSI is covering it as an inpatient procedure because I am diabetic. And I basically got to pick the date. However, they still won’t cover my rapid insulin or long lasting insulin, but now they will cover zyban (if you get it under the wellbutrin label). *smacksforeheadwithpalm*
the most pathetic i case i heard was in Que. where lots of procedures aren’t covered but they covered a 14 yr/olds breast reduction surgery because it was effecting her self esteem or shit like that
best wishes PK.
you didn’t need that anyways…
Yeah PK, good luck.
That’s pretty fucked, martym. At 14, your breasts are not even fully developed and it’s very irresponsible to perform such a surgery on children who are still not fully developed.
The problem with larger breasts is that they can cause a whole host of PHYSICAL problems — usually chronic back pain, and it can also cause back and spine deformities from hunching over as well as shoulder pain and grooves in said shoulders. Most who really do require breast reduction surgery will tell you that they don’t care how small they are after the surgery — they just want to be comfortable and pain free.
Thanks, guys! I’m looking forward to getting rid of my back pain! 🙂
PK: I admire your courage and determination to have breast reduction surgery done to be pain free. Because I can tell you that NO guy would have penis reduction surgery, no matter how bad his back hurt! 😉
I’m not sure about this because I was still a student and had an NB medicare card… but when I had my wisdom teeth out at the hospital here 3 years ago, I had to pay out of pocket (on my Visa, because I didn’t find out until I got there that they wouldn’t take a cheque from my dad) and get reimbursed by my dad’s blue cross. Also Murder Junkie, some dental surgeons will do wisdom teeth removal in their office – there’s a dentist who took my friend’s out, he has an office in Dartmouth. Now that I think of it, she’s from NS and MSI didn’t cover hers either…
wow pk. hope it goes well… lots of titty talk around the town
i had my wisdom teeth out in ontario, i was covered work-wise to 75%
my son had free checkups at the dentist til 12 but we have nothing but msi so all the other stuff was out of pocket…wisdoms and braces youch but it was worth it
I hear ya, OP. My partner had a similar discovery last week. She was having a simple procedure done, but the clinic conducted a ‘mandatory’ swab test to determine if the procedure can be conducted without inflaming any possible pre-existing conditions.
When she submitted the claim to MSI, they covered the procedure, but not the mandatory test. She called MSI and explained that the test is part of the procedure, and should therefore be covered along with it. They said they understand that, but that the test won’t be covered because it “happened on the same day”.
MSI said that if clinic had conducted the test that day, then asked her to come back for the procedure the next day, both would have been covered by MSI!!
The clinic claimed they had no idea about this “same day” rule. Whether it’s a cash grab by the clinic or a weird loop hole at MSI, it is quite ridiculous.