Friday, October 18, 2013

Acoustic ShockWave Therapy and OHIP



I have had 2 responses, one from a friend in New Brunswick and another by a local. She wants to know if it is covered by OHIP?








SHERRY RIOUX,

BROKER, SRES
Home Office 705-444-2470
www.sellingcollingwood.com


Good Morning Sherry,

I will double check with Wayne, although from my general understanding, some private plans do cover treatments or a percentage, however, OHIP on other Rehab programs cover a very limited amount and many health professionals seemed to have opted to not participate with OHIP.

A similar situation evolved in Europe and many other countries where private insurance often covered but state insurance so little that it was not economic to participate.

The cost of the equipment for treatments in ESWT can range from $20,000 to $60,000 depending on the models and therefore treatment costs are pricy to justify clinics ownership, and thus the opportunity for my company to assist clinics to have access without having to purchase, and we do a form of lease agreement.  A treatment program is $390. (over three weeks/3 treatments) with some injury areas taking more time at additional cost.

What patients all over Canada have come to realize though, is that SWT works, as opposed to eight to ten times per month over many months of alternate more traditional forms of rehab which OHIP covers only a small portion , with the final cost being much higher that SWT in many cases.  Patients have come to be happy to pay the somewhat expensive treatment costs because it works and becoming pain free is the priority.

My sister in law in Toronto just embarked on an SWT program for frozen shoulder, that she has endured in a worsening state for 18 months, attending physio one or two times per week for the last four months, to no avail-zero improvement and a cost of well over one thousand dollars.  Donna’s shoulder has mobilized remarkably even after her first couple of sessions and she is elated to say the least.  Toronto has many SWT treatment facilities and has had for years.  I discovered one clinic in Barrie that has been practicing busily for the past six years, but none in this area until now!

The Canadian SWT distributor mentioned to me that there are an estimated over 600 SWT machines now in clinics across Canada, although mostly in major cities.

Wishing you a super day, and thanks again for your support Sherry.

Best,

Ken
www.swtorthopedics.com

Sherry, Ken:
OHIP does not cover chiropractic therapy.
Many private extended health plans do provide benefits for chiropractic, however there is a wide range of how they do so. Typically a plan will cover all or a portion of the treatment cost up to a specified number of treatments per year.  Some plans are more generous than others.
I have had no experience with any plan that may cover the $390 for a three visit ASWT program.
As for OHIP within the medical system.... As OHIP has become progressively more restrictive on the therapies it will cover, I would be very surprised that it would cover ASWT. Much research would be needed to establish unequivocally  that ASWT is superior in efficacy and and more cost effective than established treatments for the same conditions. ASWT is not there ... yet.
It is possible that private extended health care plans may provide benefits for ASWT within the medical system. The current protocols are the physician provides a prescription to a hospital or private physiotherapy clinic.  Benefits are usually not extended to chiropractic clinics even though the treatment may be at least identical to physiotherapy.

...So... at this time... it really depends on the individual's private insurance plan.

Does that clear things up?
Best regards, Dr. Wayne Coghlan

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