cpap in Ontario

garyland · Post by **garyland** » Sat Feb 04, 2006 6:58 pm

Hey Darth Vader,

What's it like to live in a civilized country where they provide health care for all of their citizens? ....I wouldn't know!

Gary

Gerri · Post by **Gerri** » Sun Feb 05, 2006 7:49 am

I am glad to see so many people from Ontario. I moved from the Kitchener-Waterloo area in 2003, to Port Franks, Ontario, cottage country.

I also found out I have severe sleep apnea. It was hard finding a new doctor, after the move, but a lot easier than most people have at finding a new doctor. When I did, she had heard of my symptoms, she was convinced I had sleep apnea and sent me to be tested. I really didn't think I had a problem, and was to a point of cancelling. My GP convinced me to keep my appointment, and I was glad when I had an answer to my health problems.

Gerri

Goodburn · Post by **Goodburn** » Sun Feb 05, 2006 6:01 pm

Hey everyone, Scott, here in Hamilton.
I have very severe sleep apnea and have had CPAP for about 3 years now!
I am much better than I used to be.
Any questions, just ask me

Bella · Post by **Bella** » Mon Feb 06, 2006 10:19 am

Just found out this morning that the ADP approved my application and the VEP is couriering (sp) my bilevel machine to me this week, all set up and ready to go! Because it's bilevel, it's free - not brand new - but free. I already have two masks because I've been renting a machine since November. My insurance company is very tight and will only pay once every ten years!

Darth Vader Look · Post by **Darth Vader Look** » Mon Feb 06, 2006 5:49 pm

Garyml, when you talk about free health care for all their citizens you forget one very important factor. Both the provincial and federal Liberal parties are determined that in order to get to the American version of health care (benchmark for them ) you have to start eliminating things from the system that were once covered. The only medical things that you can bet are covered are a trip to your family doctor (unless s/he has moved to the states) and an emergency room visit. Even then the politicians have their hands in your pocket.

WillSucceed · Post by **WillSucceed** » Tue Feb 07, 2006 8:04 am

At risk of starting a political discussion -which I'd rather avoid, I'm more worried about the Conservatives trashing public health care in Canada. It is going to be interesting to see what our new PM does with the country.

danw · Post by **danw** » Fri Feb 17, 2006 5:42 pm

Hi, everyone. I am just wondering if any one has problem obtaining a prescription for a CPAP machine in Ontario? I am trying to order a CPAP machine online for my mom who lives in Ontario but we are having difficulty getting a prescription from the respiratory therapist. We have been getting all kinds of execuses for the past two weeks. Anyone else in Ontario has had similar experience? The therapist has a title of "MD FRCPC". Is it possible that he actually can't give prescription?!?!

Thanks in advance.

Daniel

Bella · Post by **Bella** » Mon Feb 20, 2006 10:52 am

Did your mother go for a sleep study at one of the hospitals/clinics? I did and it took me a while to get the px because the doctor had to interpret the study first. I gather that he is so busy it takes a while. Even though I got in for my study two weeks after I was referred, I'm having to wait 4 months to see the actual respirologists. Something else the respirologist may have done is already referred your mother's results to a registered vendor. (You do not have to stick with that vendor.) In Ontario you can apply to a program, the Assistive Devices Program, that covers 75% of a set cost of the machine. The registered vendor may likely do all of that paper work for you and only charge the difference. If you buy from a company that is not a registered vendor, you cannot apply to the ADP.

PS - if you know of a Canadian, especially, Ontario, online source I'd be interested in knowing about it.

danw · Post by **danw** » Tue Feb 21, 2006 8:37 pm

Hi, Bella. Thanks for you reply. My mom has been to a study a month ago and since then been using a loaner CPAP with a mask she bought for herself. She is scheduled to go back for a follow up study about 3 weeks later.
Actually I live in California myself and my mom lives in Ontario. She is awared of the ADP but her out-of-pocket cost over there is still twice as much comparing to what the exact same machine costs from a US online store. Just got a call from the respirologist and he actually said he "cannot" give a prescription! He referred my mom's case to a vendor and also said if we were planning to buy to machine, they will not let us borrow the machine any longer! Something doesn't feel right here. Was it that difficult for you? He could have told me it would take time but he actually said he "cannot" give us a prescription. I am considering calling the College of Respiratory Therapists of Ontario tomorrow to get some opinion. I thought all we are asking is to get a statement of what kind of treatment my mom is receiving. Thanks again for your help.

Daniel

Guest · Post by **Guest** » Tue Feb 21, 2006 9:16 pm

danw wrote:Hi, Bella. Thanks for you reply. My mom has been to a study a month ago and since then been using a loaner CPAP with a mask she bought for herself. She is scheduled to go back for a follow up study about 3 weeks later.

I wander how can she loan a CPAP machine without prescription. I think there must a deal between the doctor and the vendor. My sleeping doctor first refuses to give me the prescription directly, but would fax to the vendor that he suggested. I visited the vendor and got the copy of the prescription and then went to different vendor. Remember to let your mother know that the doctor cannot force her to go to a particular vendor.

For the ADP in Ontario, you have to be careful since some vendors will charge extra for the service. If she does not have any insurance to cover the cost, it may be cheaper to get the machine online in US.

Guest · Post by **Guest** » Tue Feb 21, 2006 10:36 pm

Danw:

Danw posts - The therapist has a title of "MD FRCPC". Is it possible that he actually can't give prescription?!?!

Those letters stand for Medical Doctor (or Doctorate) Fellow of the Royal College of Physicians Canada and yes he can give a prescription. Here is a link to check to see if he is indeed registered with them and still active. Here are some numbers including a toll free one to contact this college:

Telephone: 613-730-8177 Toll free 1-800-668-3740 Fax: 613-730-8830

Guest posted - For the ADP in Ontario, you have to be careful since some vendors will charge extra for the service.

This is so true especially when it comes to APAP's. The maximum amount that can be charged for an APAP or a CPAP for that matter is $1040 by ADP guidelines/rules. The ADP will cover up to 75% or up to $780 of that cost. The supplier must supply a machine warranted by them for 3 years, heated humidifier, basic mask and a carrying case for that amount. If you have an insurance company, they may cover some or all of the remainder (up to $260). Suppliers up the price by saying you have to purchase the upgrade or compliance package which includes a years worth of filters, upgraded mask of your choice if they carry it, free loaner, all the free adjustments to pressure settings that are needed and some cleaner or wipes. This cost is usually at least the same or more than the basic package. If a supplier is trying to pull a fast one on you, you can lodge a complain with the ADP.

DanW, here are 2 toll free numbers and if one of them doesn't work I have included the regular number to the ADP.

Toll free 1-800-268-6021 Toll free 1-800-387-5559 1-416-327-8804

An agent may be able to help you out with the doctor not giving a prescription as well. The agent will also give a list of participating suppliers in your mother's area if you want. I used Medigas who followed the guidelines.

Finally, a doctor can not refuse to give you your prescription. They don't have to mail it but they must provide it to you at their office.

Good luck Dan .

Darth Vader Look · Post by **Darth Vader Look** » Tue Feb 21, 2006 10:40 pm

That last guest post was by me. I was automatically logged out I guess. .

Bella · Post by **Bella** » Wed Feb 22, 2006 6:26 am

Dan - I used MediGas too. At the sleep clinic they told me I could choose the vendor and they had literature for the registered ones in the area. Next thing you know, I get a call from MediGas. Seems the doctor referred my px there. Kind of "irked" me that he sent my personal information around like that. They filled out all of the ADP forms for me even though they aren't getting much money from me. I qualified for the VEP and so only need to buy masks.

But I did get a copy of a prescription from the sleep clinic after my second study. In between the first and second study I had no machine, but then again it was only a matter of two weeks. I did not get a loaner while waiting for ADP approval - I guess because I wasn't buying a machine. Daniel, I'm guessing that they loaned your mother a machine because they expect her to buy one through them. If they think she's not going to shop with them, there is no future in a free loan. Perhaps your mum could rent still? I don't know what a normal price is but I paid $250.00 a month and my insurance will pay back 80% of it.

Good luck, and I would suggest calling the ADP too as someone else suggested.

Ontario RT · Post by **Ontario RT** » Fri Mar 03, 2006 1:37 pm

The Ventilator Equipment Pool (VEP) is based in Kingston but serves all of Ontario. They provide Life Support respiratory equipment like ventilators and BiPAP S/T machines. A BiPAP S/T machine has a respiratory rate, aka a back-up rate to guarantee a certain delivered breathing rate (you can breathe higher than that, of course).

If you have been given a prescription for a CPAP or APAP or BiPAP machine, you purchase it from a vendor who will apply to the ADP for your $780 to help pay for it. Only if you require a BiPAP S/T or a home-ventilator (usually only for very complex respiratory syndromes or diseases) you will be LOANED a machine from the VEP. The machine still belongs to the province but you will have the use of it for your lifetime.

Why are VEP machines free? That's just how our healthcare system works. Many of the VEP clients are people who's diseases are so severe that they can't work, so they receive 100% assistance with the machine. They do, however have to cough up a little money for the accessories.

I am a Respiratory Therapist working for a CPAP vendor in Ontario and know 'the system' quite well, so ask if you have any questions.

Bella · Post by **Bella** » Mon Mar 06, 2006 6:30 am

Having sleep apnea came at me out of the blue. I have epilepsy, and I'd been telling my neurologist, for some time, how tired I was. I was "passing out" all over the place, and didn't know if it was seizures or exhaustion. He referred me for the sleep study, and I found out that it was CSA, with an AHI of 124 (I think I posted 128 earlier by mistake). There's not much info. out there about CSA, but what I read was enough to concern me. And then to find out that because of it I qualify for the loaner, kind of scared me. As you say, it's for the serious cases. I still haven't seen the specialist - my appointment is next week.

I guess what I'm trying to say is, my questions about who pays what has been a lot more out of fear of this disease (?), than trying to save money. (On the other hand, I'm irked that my insurance company will only cover any related costs once every 10 years, and I read about others getting masks every 6 months. I don't know that I would need a new one that often, but I pay enough in mandatory insurance every month, I'd think it could do better than every ten years - and that's at 80%)

I'm very glad that we have the VEP in Ontario, given the costs of the BiPap S/T. With so many OHIP cut-backs, it's wonderful that this exists.

cpap in Ontario

Anyone in Ontario

I'm new here, in Hamilton

Difficulty with obtaining prescription in Ontario?

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Thanks OntarioRT