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Ontario: Provides 1 machine/5 years and no accessories?
#1
Anyone have a handle on those of us who have no health insurance in Ontario, Canada, asides from OHIP (government) coverage?

Spoke to ADP today and they tell me they will provide one APAP setup on Rx and that is it for FIVE YEARS. No filters, masks, hoses, nothing! Ditto sleep studies under OHIP?

And as a dualie (I am also a US Citizen) I have never had income generated in the USA and gather I am not eligible for ANY stateside benefits.

Ah well.
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Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.



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#2
US Medicare is dependent on the deductions from your paycheck. So if you've never worked in the US (and paid that deduction), you are not eligible. You would not be eligible for disability income either (SSDI). Medicaid is state funds for those with very low income. You're probably not eligible for that, either, as you'd have to establish residency in a US state.

I know nothing about Canadian health care so I can't help with that avenue. There are a lot of online dealers who sell for very low prices. The suppliers list has a Canadian supplier listed. #20.
http://www.apneaboard.com/forums/Thread-...plier-List

I poked around a little via Google and couldn't find much. Couldn't find any kind of schedule like there are for Medicare.
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#3
Hi there...I am from Ontario as well, and just purchased my machine today. My insurance coverage booklet from work says I have extra coverage there, but my predetermination was sent back as I am not eligable. I will need to contact my union rep to sort out whether or not I should be covered for the rest. So, at this point I bought mine as though I had no extra insurance coverage. Here is what I got and what I had to pay after Ontario paid their share......

The machine I purchased is a Resmed S9 Elite, and I purchased only what I had to have at this point...no extras.

Mask...(Mirage FX Nasal..they gave me 2 of these).........$275.00
Resmed S8 Elite CPAP machine, humififier included.........$1040.00

Sobtotal................................................................$1315.00
Tax.......................................................................$0.00
Patient pays............................................................$535.00

Also included all I needed...ie...machine, humidifier, mask, hose, nasal pillows, and case. Also OHIP paid for my sleep study, and the sleep study for titration. My nasal pillows are good for 6 to 12 months and cost about $40.00 each to replace. Not sure how much a new filter is...I need to buy a new one every 6 months. I did not buy extended warranty nor maintenance coverage. Any Drs appointments are covered by OHIP...and billed directly, as is the CPAP...ie...I did not need to pay first and then submit to receive their share. Hope this info helps. Also if I want to purchase a different mask, ie nasal it runs about $300.00. Also, I thought OHIP covered a new machine every 3 or 4 years, rather then every 5, but I might just be mistaken on that....I don't have the best memory..lol
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#4
Spare a thought for us here down under we have to pay for everything out pocket and no subsidy from government and insurance doesn't cover masks or supplies just one off rebate approx $500 for the machine which is cheaper to buy 0n-line and forfeit the rebate.

I've this link from "Ontario Ministry of Health and Long-Term Care" bookmark might be helpful for someone
http://www.health.gov.on.ca/english/publ.../cpap.html
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#5
My understanding is that the Assisted Devices Program (ADP) of OHIP will pay for one machine (limited in value) which will be a CPAP machine unless the doctor really believes that you need an Autoset (must be written specifically in prescription) a standard hose and a mask. The rest is up to you. Replacement hoses and masks are better off purchased from the US on-line. I have used supplier number one many times, and have been happy. You will save almost 50% on most things. The Ontario prices are horrible, and the only reason that I buy my stuff here is because of my insurance company, even though I could save the tax payers a ton of money.

ADP will no longer automatically replace your CPAP machine after 5 years unless it's defective. That was a change implemented last November.

Good luck!
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