Doc wants me on 24 blood Pres. monitor not covered, is there a way around this?

[Liam T.]

Hello There,

 

I need to go on a 24 blood pressure monitor not covered by Ohip, the labs and hospitals want 50 dollars and up for this device. Will Odsp cover it? Fifty dollars ain't cheap in my situation.

Its strange because a 24 hour Holter monitor is covered (for the heart) but not the blood pressure one, a little weird.

Thank you kindly for any pointers.

Liam

[StarTears]

you can get a MSN health form filled out by your specialist as to why you need this special medical item and ODSP can say yes or no and either advise you to call assistive devices in toronto or ontario works for discretionary benefits depending on the length of time you need this item for liam.

if you need to have it for a couple months you'll likely be sent to OW, if it is a one time out of pocket cost but if it needs maintainence items it could be an ODSP item or ADP item that you get a 'grant' issued every term for the supplies like the insulin pumps. 

star

[L B]

It shouldn't cost you a cent. If it does then you need to ask your doctor to send you to another clinic. I have one about a year ago and I'm about to get a 48 hour monitoring device for my heart beat.

[Liam T.]

Thanks for the replies, Justice4odsp I tried a diffrent clinic and called the hospital- they don't provide this item for free. Its a one time 24 hour blood pressure monitor. (not a Holter)

 

Star what is a MSN form please?

 

Thank you

[StarTears]

Thanks for the replies, Justice4odsp I tried a diffrent clinic and called the hospital- they don't provide this item for free. Its a one time 24 hour blood pressure monitor. (not a Holter)

 

Star what is a MSN form please?

 

Thank you

MSN- mandatory special necessities form.  its the same form you get filled out for travel or other medical supplies.  again ask if its something that is covered by ODSP or ADP- assistive devices program or if its a discretionary benefit covered by ontario works in your muncipaility.  if your doctor says thats its necessary for you to wear this item just once then i imagine then ODSP would pick up the cost but if you have to keep wearing them at $50 a pop its going to be an ADP issue....similar to the sensors with the continuous glucose monitor that goes with my insulin pump.

however, if you can get your specialist to talk to your caseworker on your behalf for the necessity of the item, ODSP may direct pay the supplier for these monitors.  right now medtronic [who makes the insulin pump stuff i need] worked out a deal where ODSP pays them directly $575.50 monthly when i put in an order for supplies ABOVE my grant of $600 every 3 months for supplies due to the CGM sensors.

hope that makes sense.

star

[justice4odsp]

Try the Kingston Heart Clinic. I had a free one from there not long back.

The MSN form is the Mandatory Special Necessities form you can get
filled out for ODSP for extra medical expenses, medical transportation, etc.

On 20/05/2011 10:42 PM, Liam T. wrote:
> Thanks for the replies, Justice4odsp I tried a diffrent clinic and
> called the hospital- they don't provide this item for free. Its a one
> time 24 hour blood pressure monitor. (not a Holter)
>

--
justice4odsp

[justice4odsp]

Hi,

I just got thinking... Kingston is maybe too far away for you to go to the Kingston Heart Clinic.

I'll phone them on Tuesday and ask if they charge for you to get the 24-hour blood pressure monitor. 

I'll record the call and share the solid answer with you as an MP3 file. You can then take the sound file to your doctor and ask why one city doesn't charge and another city does. People on ODSP should not be denied health care just because they can't afford to pay.

I'll find out the answer soon enough and then I'll share the notes so we can compare the actions that are closing us out of health care in different cities. ODSP should cover if the health care system does not.

On 20/05/2011 11:11 PM, StarTears wrote:

Thanks for the replies, Justice4odsp I tried a diffrent clinic and called the hospital- they don't provide this item for free. Its a one time 24 hour blood pressure monitor. (not a Holter)

--

justice4odsp

[StarTears]

Hi,

I just got thinking... Kingston is maybe too far away for you to go to the Kingston Heart Clinic.

I'll phone them on Tuesday and ask if they charge for you to get the 24-hour blood pressure monitor. 

I'll record the call and share the solid answer with you as an MP3 file. You can then take the sound file to your doctor and ask why one city doesn't charge and another city does. People on ODSP should not be denied health care just because they can't afford to pay.

I'll find out the answer soon enough and then I'll share the notes so we can compare the actions that are closing us out of health care in different cities. ODSP should cover if the health care system does not.

because its all about how the municipality chooses to allocate funds for items.  we have been over this at great length several times on this forum justice.  what one can get covered at the ottawa or toronto division of ODSP is unlikely covered at the kingston or say belleville or cobourg branches because of the smaller funding basis of tax revenue to ODSP.  the province only gives -so- much then the muncipality kicks in a LOT more to the 'discretionary' benefits that we receive.  OW has a MUCH larger funding pool from the province for a variety of needs than ODSP does thus why we are sent there [which is insulting and obscene IMO] for things that fall off the radar in the directives of disability 'needs' in smaller towns.  bigger the city the larger the funds from the city itself to provide to each division.  politicians are also more likely to not want to raise themselves up the flagpole regarding WHY are the disabled going to over here for items related to disabilities when that is not what this is for [ie OW].

it doesn't seem to  matter how much of a stink we make about this in smaller communities because the money is just not there and you get shuffled around to where the money IS and we are to be thankful that there is someone to pay for what we need.

i say, start getting the flagpoles out this election and start making big farts about it.  enough IS enough.  we deserve dignity regardless for having issues we likely never asked for and we can't survive on policies.

star

[Liam T.]

Update on this case:

 

After talking to Odsp they will not pay for a 24 blood pressure monitor.

It also did not pay for an arm brace or sling that I needed after shoulder surgery, and it didn't pay for the initial consultation fee of physiotherapy.

 

FYI

 

[Cynthia Philip]

Since when do you have to pay for the 24h bp monitor? My son had it about a year or so ago and didn't pay for it. I have had it and didn't pay for it. what's with having to pay for it?

Did you have a doctor's letter of Rx for the brace? If yes, they should be paying for it.

I don't know about the physiotherapy part however.

I would look into this further.

 

Cynthia

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[Denny B.]

>FYI


** So once again, I find myself amazed at the audacity of our disability "support" program...
Obviously these costs were incurred at the time of your treatment; the decision to incur them
would have been made directly by a physician. It seems rather pompous for ODSP to refute
a medical services claim made specifically by a doctor, in real time! (not as in a form, passed
on, or mailed)

Another issue I have is the question of who ends up paying for those services or items which
ODSP deems unqualified? If they have been charged for, or billed for, then obviously that bill is going
to be sent to *someone* I wonder where the slack gets picked up....

Sorry to hear about your crappy two-bit medical treatment; I hope only that you're getting by despite it all!


denny -

[Bear Bear]

HI Liam. 

I went through something simmilar just recently. 

Get a Rx. and then get a good pharmacist. 

In this area the city, Ottawa, pays for things that ODSP won't cover. But you have to bug them. My pharmacy did the paperwork and got on to them. I had my BP Monitor within days. 

There are other discretionary funds but you really have to look.  Your MPP, after tomorrow, your city councillor, anyone you can think of. 

But start by talking to your pharmacist. If you are like many of us, they are making a lot of money off your Rx's. 

Bear

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[justice4odsp]

Hi,

I was wondering that too. This must be like it is for Physiotherapy and
Occupational Therapy. The services are no longer covered by OHIP but, by
law, there has to be at least one place you can go to get it.

In Kingston, the 24 hour blood pressure monitor was done for free
through the Heart Clinic. The 24 hour heart beat monitor was also covered.

I had a similar thing happen with a sleep apnea machine titration study.
I can't get into the sleep specialists office without being carried in
(they're not wheelchair accessible) so they arrange for home studies
through a medical supply company. The company I was with has not been
too friendly, and they've been far from accommodating, so I asked to
switch companies. The new company said it would cost $50 for the test
because I didn't buy my CPAP machine there.

I explained that I am ODSP, they're located near me, I bought my manual
wheelchair from them, and I wanted to do business with them on an
ongoing basis (instead of the other place) and they waived the $50 fee.

None of us should have to stoop down low like this to get medical care
that, by law, is supposed to be universal, but is not. However, I guess
we have to do what we must do. If you can, find out if there's a heart
clinic in your city and see if they'll fund the 24-hour Blood pressure
test. Better yet, go back to your doctor and make them do all the work.

As for the brace, the key words are recent surgery or disease. If the
doctor wrote recent surgery and ODSP still refused to pay, then it can
be appealed through an Internal Review and, if necessary, the Social
Benefits Tribunal.

Good luck.

justice4odsp

On 05/10/2011 10:32 AM, Cynthia Philip wrote:
> Since when do you have to pay for the 24h bp monitor?