Need Advice and comments from Canadians

[Rupali]

Hi all,
We are in a dilemma right now due to an assignment at my husbands workplace.
We are currently based close to Boston. He has been asked to move and work from a place called Missisauga (suburb of Toronto) for one year for some assignment. During this time he wouldbe on Canadian payroll and as we already have a Permanent Residency from Canada so we would have the government insurance and some extra private insurance given by my husbands company.

Currently I am on Herceptin and have already done 1.5 years of Herceptin and my 2 years would be done in May 2007.

How good is the Canadian Medical system? Though we have a permanent residency from Canada, we have nevr lived there so we do not have medical cards from there. Does anyone know that if we move there, then could the Canadian government refus to give me medical benefits as they might say that I got breast cancer and now I am moving to Canada with a pre existing condition.
I am just confused and am scared what would happen to my treatment plan which was going fine in the US.
Also next year Tykerb would be launched, will it get launched in Canada at the same time?

Who is a good and open oncologist ion Toronto area?

Please provide your comments and help.

Regards,
Rupali

[dawn]

Hi Rupali,

Im from Newfoundland Canada and did live in Toronto for years. About minutes from Mississauga. Canada's medical care is second to none. I was dx in March.06. When I found my lump, I had a mammo the next day, the results the following day and saw the surgeon the next day. He scheduled my biopsy and I had that 1 week later. So this was all done within 10 days. It took three weeks to get my results. When it came back cancer, I got the call on Tuesday, In hopsital on Wednesday, Masectomy on Thursday, out of hospital 5 days later. I began 6 cycles of chemo three weeks later. When I finished chemo I began 25 rads 6 weeks later, tamoxifen 4 weeks later and began taking herceptin 3 weeks after finishing rads. No waiting, no fighting to get things done. The onc's, nurses, specialists, you name it have been very caring and helpful. I havent had any problems with insurance or medical care. But in Canada,you are covered under the provincial health plan. In Ontario its OHIP, they cover all hospital and doctor visits, xrays, specialists. The only thing it doesn't cover is drugs, glasses, prescriptions and your personal blue cross will cover that. When you go to the hospital for Herceptin infusions, they will give you the tylenol or other medication you require. If you need to see a doctor, you'll see one in Canada. Have your specialist refer you to one in Toronto, which is pretty much the same area you live in. AS you said, you will be living on the outskirts of Toronto. Princess Maragaret is a fantastic hospital, its in downtown Toronto, and has a great reputation for its canacer facilities as well as sunnybrook hospital. Canada is right on the tail of US when it comes to approving new drugs so I dont see Tykerb as being any type of problem. Get set up before you come with an onocologist in Ontario, maybe have a couple of telephone conversations to get familiar. You should be in great hands.

All the best, you'll love it in Mississauga,

Dawn

[Merridith]

Hi Rupali:

I am a Canadian living in British Columbia.

One of the benefits of the Canadian medical system is that it is universal. As long as you pay your monthly fee you are in. No exclusions. There is however a 3-month wait period before you can start dipping. You might be excluded from this wait period because your benefit is being covered by a company.

Since you will be covered under your husband’s work medical you don’t have to worry about paying the fee. It sounds like the company is going to offer you extended medical benefits. You should look at the offer very closely as you can often get quite a lot extra for a small fee. This is because the insurance companies only take up the slack AFTER OHIP (which I believe is the name of the medical insurance in Ontario) is expended. The offer of extended medical benefits will only be offered once at the commencement of employment. After that - it vanishes - so if you want it -take it.

Toronto has excellent oncology facilities. I believe that they are rated number two in Canada. You should be in good hands there. In terms of medical quality - the Canadian medical system is equal to the US system - within a similar quality range.

Herceptin is covered under OHIP. Tykerb is not. It is currently approved by the government for medical use, however with a $70,000+ annual price tag it has become part of a political debate. How much money can the taxpayer spend on these new very expensive treatments with limited life-prolonging benefit? There is only a certain amount of money in the pot - and it must be doled out for the maximum benefit of the country. $70,000 = 1 person with cancer or the same amount to vaccinate 100,000 school kids. That is the synopsis of the debate. - Just a suggestion - if you choose to pay for extended medical through your husband you might very well be covered for Tykerb use. But check for those nasty pre-existing clauses first.

One benefit that you will find is that you don’t have to keep track of all the various bills that the US pay-per-use system generates so that it is less stressful to deal with. Your bills are few and simple.

(ooops - there is a maximum post length - continued in the next message!)

[Merridith]

(continued from previous post.........)

As soon as you get to Canada, register with Pharmacare. This government agency will pick up the cost of your prescription medication above a certain maximum. It will also further subsidize you if your income is below a certain amount. Pharmacare only covers generic medications in each class unless the doctor writes a compelling reason as to why you need a name brand of something. But the coverage is pretty extensive.

Canadian doctors work as teams. At the oncology hospital they will have designated days where they will meet with each other to discuss their cases. This is advantageous because the different types of doctors that are involved with you will actually be coordinating and talking with each other. Another plus is that you will get the benefit of the combined knowlege and experience of several doctors (including not your own) with the same and different specialties focussing on your case at once for added feedback and synergy. Everything is centrally electronically filed so that it will save on duplication of tests and all the medical people have seamless communication. I believe that if you have privacy concerns - you can forbid this medical interaction - I however thought that it was a great concept - no one knows everything. You will be able to access your medical files free of charge.

For further information, I suggest that you contact the Canadian Cancer Society. They are extremely user friendly and will give one-on-one help by phone or email.

I hope you enjoy your stay here.

Regards,
Merridith

[heblaj01]

Rupali,
As far as I know permanent residency status gives you all the privileges & duties of a Canadian citizen except voting rights. Normally a person allowed in Canada as emigrant has passed a medical examination before being permitted to enter the country. So you must have done that?
There are probably limits on how long you can stay out of Canada without loosing your status of permanent resident & must reaply for renewal of the card of permanent resident (which I am almost sure does not require a new medical examination).
If your employer is not giving you enough info on this subject you should contact any Canadian consulate.
You can also search into this web site: www.cic.gc.ca (http://www.cic.gc.ca/).
The toll free number (probably valid in Canada only) is: 1-800-255-4541
or FAX: 1-888-576-8502

[sherri]

As all the other sisters said, you are in good hand in Canada, just call and find outn about waiting period. In BC is about 3 month I'm not sure about Ontario. But if you have private insurance they cover it for you for waiting period. We have the best medical system and we are hoping to keep it that way.

Take care,

[mke]

I live in Toronto and am familiar with Mississauga (which is near Toronto but is also the 6th largest city in Canada - they can get testy about the suburb thing). Generally speaking the health care in Canada and access to services is excellent, especially in the urban areas. In Mississauga you could use the Trillium health centre or you could do a short drive into Toronto to either Princess Margaret (part of the U of Toronto health services system) or Sunnybrook hospital, also a highly regarded treatment centre. I have been treated at Princess Margaret and have been quite satisfied.

However you are right to be concerned. There is a waiting period of 3 months before you would be covered by OHIP (Ontario Health Insurance Program). You would also have the possible problem of finding an oncologist and treatment centre that would follow another's treatment plan. It is not likely that tykerb will be approved in Ontario at the same time it happens in the US (it will by a province by province approval) and often Canada waits longer for drugs to prove their worth. Fewer drug lobbyers I suspect.

I don't know that Ontario has Pharmacare, it has something called the Trillium fund which, after application is approved, will pay for drug costs over some percent (4 percent??) of the family income that are not covered by other plans.

There is another possibility. You will be a couple hours from Buffalo. Would it be easier to approve the continuation of your treatment there? Could you stay in Boston and finish your herceptin treatment and then join your husband in Ontario?

Google OHIP for the answer to some of your questions.

Good luck and let me know if I can provide other info.

[heblaj01]

Rupali,
Make sure that you have the Permanent Resident Card which since dec. 2003 is the required document to re-enter Canada. Previously the IMM 1000 Record of Landing attached to a passport was all that was necessary:
http://www.cic.gc.ca/english/pr-card/index.html

[Rupali]

Hi everyone,

I really appreciate the replies and information. We have the Permanent Resident cards as we became landed immigrants in Jan 2005 and then were told that it is valid for 5 years. So we came to Toronto for 2 days and did the landed immigrant formalities and drove back to Boston.
I must say that when we entered Canada then we were given a very good welcome to become landed immigrants.

Now at that point we could not get a medical coverage as we told them that we were going to go back to US and then come back after probably a year.

We plan to finish my herceptin in May 2007 (2 years of Herceptin) and then we plan to move to Toronto. My husbands company told us that apart from the government baseed insurance in Canada we can also avail a Group insurance plan of the company. I will ask him to confimr that we will have that plan activated on day 1.

Regarding Tykerb, I guess our plan would be to see how things work out till March for the FDA approval. My husband told me that if by end of April we come to know that we can get Tykerb paid by our insurance in US then he could say no to his assignment which would be a career boost for him and we could continue to live in US.

Otherwise its a matter of going to Toronto to live there for 1 year.

We had once gone to Health office in Tornto in end of 2005 and asked them if we could apply for medical coverage as my husband had a latter from his employer stating that he was doing projects in Canada, but they wrote on our application that the health coverage is subject to us proving them that he was on Canadian payroll. SO I am guessing this might mean that we might not have to wiat for 3 months as now he would be on Canadian payroll.

Keep your thoughts pouring in.

Do you know if supplements from US can easily be shipped from US to Canada. Also I saw there is a WHoleFood in Toronto. Do you know if there are similar Organic food markets in Missisauga and Brampton.


Regards,
Rupali