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Bunion Surgery coverage in Canada?


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Old 03-31-2008, 09:13 PM   #1
lifwynn
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Bunion Surgery coverage in Canada?

Hello everyone,

I've inherited my mother's bunions, and I've known for a long time that one day I would need to have the surgery. In the last few years the bunion on my left foot has gotten much worse. I've been finding it difficult to find shoes that won't hurt (especially summer shoes), and I'm in pain most days, no matter how comfortable my shoes are supposed to be. So I decided to pick up the phone and try to take the first step...

Last week, I called the office of a podiatrist who specializes in minimally-invasive bunion surgery - the website explicitly stated there was no need for a referral - only to find out that the surgery would cost 4500$ per foot, and that if I wanted the surgery to be covered by Ohip, I would need my doctor to refer me to a podiatric surgeon. The receptionist also added that unlike other podiatrists, the minimally-invasive procedure would spare me the screws and crutches, and would also cause less pain and lead to an easier recovery...
I'm not sure I believe that Ohip coverage necessarily means that you don't get the cutting edge minimally invasive techniques, no?

I really don't know what to expect concerning a number of things.

Most importantly, I am a graduate student from France, and am covered under Uhip - which is the same coverage as Ohip and presumably covers surgery as well. Also, my spouse has great insurance through his work for fees having to do with hospitalization.
I just worry that I would be denied the surgery on the grounds that I am not a Canadian citizen. I wonder whether anyone can let me know whether they've had to pay for a portion of their bunion surgery or if it was all covered by the insurance.
I've lived in Canada for almost 7 years now, and have no coverage in France anymore since I am no longer considered a resident there (I only go to visit my family once a year, and have no working / student status there anymore). Stupidly, I've been putting off applying to become a permanent resident, although my spouse and I have been in a committed relationship for 5 years and have been common-law partners for 4 years. I just knew I would apply, but there was no urgent reason for me to do so. Now I wonder if this will hold me back for having this surgery.

Anyhow, I will stop the rambling now...I would really appreciate it if anyone would be able to share any information they have on Ohip coverage and bunion surgery. Is there a scale whereby this surgery can be considered not absolutely necessary yet - ie, depending on how big the toe joint has gotten, etc?

Thank you very much for reading this post, and I hope to hear from some of you out there!

All the best,

Lifwynn (Old English word meaning 'enjoyment of life')

 
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Old 04-02-2008, 11:42 AM   #2
tootsie:)
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Re: Bunion Surgery coverage in Canada?

Hi Lifwynn-I don't know how much help I can be as I live in British Columbia, so medical coverage here may be a bit different from Ontario. But I had bunion surgery last year and I dealt with a podiatric surgeon. I did not need a referral from my doctor to see a podiatrist and only a small portion of the cost was covered by our extended medical. The total cost was around $2300 of which I paid $1800. If I had been referred to an orthopedic surgeon, only then would the surgery be covered by medical. But typically, the waiting list for this type of surgery is very long. It sounds as if things are structured roughly the same way there. I would think that if you are covered under your spouse's medical plan (OHIP), that there wouldn't be a problem with you having surgery in Canada. You might want to check with your health plan.

In regards to the "minimally-invasive procedure", I see a red flag there. I would like to know what exactly they mean by that. I did not have screws, nor did I use crutches. I had 2 pins that were removed after 2 weeks, but I had the bone cut and realigned which is the normal procedure. This was by no means an easy surgery, for me at least, and because of it I am having even more issues to this day. I have been back to my surgeon numerous times since and I have finally given up with him and am now scheduled to see an orthopedic surgeon in hopes that he can figure out why I still have so much discomfort. So just please, please be careful when selecting someone to do the surgery. Maybe you should talk to your GP about a referral. You are right when you say you don't believe that with OHIP coverage you wouldn't get the latest techniques, on the contrary, you may even be safer to go that route. It sounds like you have a legitimate reason, meaning a lot of discomfort with your feet, so I don't see why you couldn't at least get a referral to see a specialist. Hope this helps. Good luck.

 
Old 04-03-2008, 11:56 PM   #3
lifwynn
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Smile Re: Bunion Surgery coverage in Canada?

Dear Tootsie,

Thank you so much for your response, I really appreciate it. I'm seeing my GP tomorrow with the intention of asking for a referral to a podiatric surgeon.
I am not covered under Ohip, but the equivalent coverage for international students, which means that for a number of services I have to pay in advance and then submit a claim form. Since my first post, I found out that for surgeries that are not emergency surgeries, I would need to have the surgeon fill out a detailed form explaining the rationale for the surgery, and wouldn't be surprised if this type of surgery is easily denied to non-Canadian residents despite their theoretical eligibility.
This website is really an amazing resource and I could not believe the number of posts on the topic of bunion surgery. It seems that a not-so-easy recovery is quite common, which I really was not aware of. The lady at the private podiatry office made it sound like it was a breeze...Today I walked a fair bit and my feet were burning, my left bunion hurt a lot, and felt like I was walking on extra bone. Hardly a day goes by without thinking of finally getting this surgery done.
I wish you all the best with your follow-up and truly hope that someone can find the source of your discomfort and alleviate it.

Thank you again and best wishes for your recovery,

lifwynn.

Last edited by moderator2; 04-04-2008 at 08:15 AM. Reason: please delete the quote - or, instead, use the quick reply button

 
Old 10-01-2008, 03:54 PM   #4
lovelybones
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Re: Bunion Surgery coverage in Canada?

Hi tootsie - im also a BC'er in need to bunion surgery. While I know the deal with coverge here (and it sux) I am looking for a good podiatrist to perform bunion surgery. I have seen one guy in Burnaby but was not impressed with him/the office/staff. On my second appointment I was to see the x-rays I had done and they where nowhere to be seen - major mess. Now Im in search of another podiatrist - hopefully with the help of word by mouth. Who performed your surgery and can you recomment anyone else whom you have heard of who has a good track record? Thanks a bunch!

 
Old 10-01-2008, 09:03 PM   #5
tootsie:)
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Re: Bunion Surgery coverage in Canada?

Hi Lovelybones - I'd be happy to give you some names. Lord knows I have researched this topic to death! As far as podiatrists go, I would check out the two that work out of St. Paul's Hospital in Vancouver. Dr. Chalmers and Dr. Kalla, I believe are their names. I don't have any personal experience with either one of them, but when I went to see my foot and ankle orthopedic specialist for a second opinion after my unsuccessful surgery, he mentioned that he is a collegue of theirs and that as far as podiatrists go, (there seems to be a rivalry between the 2 professions) they are decent. I have also seen a Dr. Laakmann DPM, (for another second opinion), he is also downtown on Hornby St. I found him to be very, very thorough, treats you with respect and really listens - your initial appt. is booked for 60-90 minutes automatically.

I am approaching the 2 year mark since my surgery and I am still having problems unfortunately. I've told myself that if by the end of January things have not resolved, then I will go ahead and have a revision surgery. I keep praying that it won't come to that, but I know that if things aren't better by now, they probably never will be. It scares me to death to have to do this because there are of course no guarantees and who knows I could end up in even worse shape. But I can't keep on living this way. I will choose to have the orthopedic specialist do this as he is one of the best in the province. And I will pay the big bucks and jump the queue because otherwise I would be waiting 2-3 years to get in to see him and I just can't wait that long.

Please excuse my rambling on, it's been a long time since I've vented on this board! I wish you good luck in your search. You are wise to be doing your homework, because I know all to well that it can be life altering if you put your trust in the wrong hands. And I think it's important to mention that no matter what, you are always taking a risk with any surgery no matter who does it. Sorry, I just had to say that...If you have any other questions, please feel free to ask me. Take care.
Tootsie

 
Old 10-02-2008, 08:10 AM   #6
lovelybones
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Re: Bunion Surgery coverage in Canada?

HI tootsie, thank you so much for your reply and wise words. I do have a few more questions (since you are the only person I am now corresponding with who has had this surgery). Is it better do you think from the research you have done to go to a podiatrist or an orthopedic surgeon - it seems to me each has his pros and cons. Also - Im not sure you if are willing to give me the name of your surgeon (whom you are not all too impressed with?) so that I can avoid a similar experience. I will check out the guy on Hornby - he sounds promising. Also - my husband seems concerned with the surgeries beiing mostly consucted in a private setting and rarely in a hospital where things are overseen - it seems to be very common practice here to perform these in the private office, right? I am fairly young (28) and I have had my bunion ever since I can remember (around 8 is when I noticed it first) - it is causing me pain but it's not unbearable yet - however - I feel that it's getting worse and I want to do preventative action - I don't want it getting worse and I feel that doing it early in life might save me from a much more elaborate surgery later when my foot is totally messed up (so far I have no crooked toes - my big toes is still fairly straight only with a fair sized bunion on the side that is red and throbbing at the end of the day or when I come home from walks). What was the severity of your bunion and did you have a simple surgery done with realighnment of the joint and removal of the bump and pins etc or did you have a more elaborate surgery performed. Sorry for all the questions......take your time in responding - Im looking to have the surgery hopefully performed by the end of next year - in the mean time I want to do all the research I can. Thanks again for all your help!

Lovelybones

 
Old 10-02-2008, 10:50 AM   #7
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Re: Bunion Surgery coverage in Canada?

Oh one more question - which orthopedic surgeon do you have experience with at St. Pauls? How do you get in with them - do you just call for an appointment? Is there a consultation fee with orthopedic surgeons or is this payd by Medicare?

I hope that you foot ailements get better by the new year - are you considering an orthopedic surgeon for the second surgery because you think they are better than podiatrists? Best of luck with you foot tootsie!

Cheers

 
Old 10-27-2008, 02:07 PM   #8
tootsie:)
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Re: Bunion Surgery coverage in Canada?

Hi lovelybones - I've been meaning to get back to you for awhile now, but anyways, here I am. As far as choosing between a podiatrist and orthopedic surgeon, I would say an ortho and one who specializes in the foot and ankle. That is just my opinion. I'm sure there are good podiatrists out there, I think that the trick is to choose carefully no matter who you decide to go with. I don't really feel comfortable to name who did my surgery, lets just say I would avoid anyone in the Surrey/Delta area. I had a modified Austin procedure where the bone is cut and realigned. I also had 2 pins that were removed after only 2 weeks (from what I've learned, they should have never come out that soon.) When I had an MRI done earlier this year, it was noted on the results that I also had a cheilectomy. My doctor didn't even mention that he also did this. You are right about these surgeries being performed in private offices, it seems to be the common practice amongst podiatrists. That was my experience and I was fully awake during the procedure and just had an ankle block. I was given a laptop to watch a movie like it was no big deal and I have to say when I look back on that experience, I am horrified that I actually went throught that because it was very uncomfortable and my anxiety was over the top. He didn't even give me the option of light sedation which I would have gladly taken. This to me is a barbaric practice. As far as seeing an orthopedic surgeon at St. Paul's or anywhere for that matter that would be covered by your MSP you must first be referred to that specific doctor by your primary care dr. There would be a waiting period to see any specialist but as far as an ortho at St. Paul's, the waiting list is in all likelyhood probably pretty long. But in your case as you are in no hurry, this would be an ideal way for you to go. If you wanted to see one of the podiatrists at St. Paul's that I mentioned before, I know for a fact that it wouldn't take long to get in as I called to enquire last summer and was suprised that I could have gotten in pretty quickly. As you know, pods are not covered by basic MSP, but if you have extended medical such as Blue Cross for example, you can claim your visits/surgery and you are partially reimbursed according to your coverage. As for me, I went back to see the specialist recently and he has referred me to a pain management specialist to assess me for RSD. He doesn't think I have this condition, but he just wants to make sure beyond a shadow of a doubt that this isn't the case because if I choose to have a revision this would make things worse for me. I am again jumping the queue in order to see him right away and have to pay $750 in order to do so. But after 2 years of this, I have lost track of what this has cost am beyond the point of caring. If however this other specialist is of the opinion that I do have this condition, then I will have to live with my foot the way it is. However I would hope he'd be able to offer me some kind of pain management. Anyways, sorry, I have been long-winded, but I hope I've helped to answer your questions. If there is anything else I may be able to help you with, please just let me know.
tootsie

 
Old 10-27-2008, 02:18 PM   #9
tootsie:)
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Re: Bunion Surgery coverage in Canada?

P.S.

After all that and I forgot the mention the name of the ortho dr. that I've been seeing who's public practice is at St. Paul's. He is a foot and ankle specialist and his name is Dr. Murray Penner. He has an excellent reputation and he is who the Vancouver Canucks go to see when they have problems. Good luck and let me know what you decide.
tootsie

 
Old 12-06-2008, 10:05 AM   #10
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Re: Bunion Surgery coverage in Canada?

Hi Lovelybones, I had bunion surgery (Chevron) at the end of August by an excellent orthopaedic surgeon in Burnaby. Please keep in mind both Podiatrists and Orthapaedic surgeons are qualified for the procedure. With Podiatrists the wait isn't as long but you have to pay. The orthopaedic surgeon I went to currently has a three month waiting list, which isn't bad. I was put right under with general anesthesia, and the surgery was performed in Burnaby General Hospital. I was able to go home a couple hours after waking up, and could get around easily on crutches. After one week, I went back for a bandage change, and two weeks later went back for another bandage change and to get the pin removed. After another three weeks, I went back and the bandages were finally removed for good. The pain was certainly manageable with the medication I was given, and the whole experience was much easier than I had expected. I'm going back for my second foot in January, and have full confidence in the surgeon I'm going back to.

 
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