Ostomy Subsidy Information Needed

Hi, I am currently putting together some information on Ostomy Appliance Subsidies around the world and am seeking info on what countries have a government subsidy to help cover the cost of their appliances. I would like to know how much is covered (%) and if there is a financial or quantity limit on appliances and how much, plus anything else which could be of value.

Any information about any country would be very much appreciated. Thanks.

Hi Charlie - The UK covers 100% of the cost and as far as I am aware, there are no limitations as to how many pouches, etc., you can request.

Good luck with gathering your information,

Rach xx

Hey. Australia has a stoma scheme, we have limits on how much you're able to get. Most of this is done via month to month but some things like hernia supports are done as a yearly amount. I have attached our list below.

http://www.health.gov.au/internet/main/publishing.nsf/Content/989AA2889CB492B9CA256F180049215D/$File/01072010Complete.pdf

In Indonesia, there is no subsidy from the government.

Thanks everyone. This is great feedback. Does anyone know what happens in the European and other Asian countries? Darwin_Liong has advised that there is no subsidy in Indonesia but what about everywhere else? Is there any government assistance or are supplies covered by private health insurance? Do some countries have a compulsory social health insurance and at what cost? I am starting to get a good picture of what happens in Aust, USA, UK, and Canada but not much else!

I have private insurance in the US. It covers about 90% of my expenses. The government will kick in when I am on Medicare (over age 65 or disabled).

I'm in the US and have Medicare (primary insurance) and Tri-care (secondary insurance), so I'm 100% covered.

Hi - Medicare (and insurances that follow Medicare's lead) cover medical equipment (ostomy supplies) at 80% of the Medicare approved rate - that's if you have Medicare Part B which currently costs about $98 a month. The 20% not covered either comes out of pocket or can be paid by a supplement purchased by the patient - mine is currently $250 a month. There are quite strict restrictions on the number of pouches allowed per month and so I irrigate to cut down on the number of pouches I need to use - other people use liners they buy.

Still other people are on managed care systems like Kaiser which REALLY limit what they can get. One friend has to get a new prescription from his doctor to change the product, and even the SIZE of his appliance when needed. Virtually no freedom of choice and the idea that it's the doctor, not the ostomate, in charge of his/her body.

Hi Pinky, I am disabled so I have Medicare and Medical (for the state of California) called Medicaid in other states....I have found that with the Hollister disposable bags they send me many more than I need. I get 3 months at a time and I get almost 3 times more than I need. I tried irrigating and it didn't work for me. I go through 2 or 3 bags a day. You might ask for a box of free samples to try. Hope you are doing well today....Faith

Hi Faith - Glad things are working out well for you! I don't qualify for Medi-Cal, but that's OK - I feel that I get more than my money's worth from my Medicare supplement.

I notice too that I get a lot more supplies than I need if I order by the 3-month plan. I'm glad about that because then when someone in the ostomy group needs extra or I meet someone without insurance I can "share"!

Your ostomy is working really well if you only need to use 2-3 pouches a day without irrigating. Sometimes I use that much WITH irrigating! I have so little of my colon left so it is very unruly. I remember with my temp back in 2003 I could count on it working at 6 am, 12 noon, and 6 pm! Very easy to plan life around it. Now I think things would be very difficult for me if I didn't irrigate. But I don't think I'll ever get to use just a cap like my surgeon thought! Take care. Pam

I am from Canada and you are only given a certain amount of money. If it does not cover the cost, too bad. If you are on disability, you are given a little bit more. I have had my colostomy for 6 years and with a lot of samples and good management, I do all right.

Charlie

Across the water here in New Zealand, all ostomy supplies are supplied at no cost to the patient by the local District Health Boards, who are funded by the NZ Ministry of Health. The Stomal Nurse allocates the type and amount based on your needs. There are preferred suppliers whose appliances are tried first for new ostomates, but in practice, you can get whichever brand suits you best.

Regards
Tony

Thanks Tony.

Is there any cost associated with a visit to the nurse? Do you have access to a wide range of ancillary products such as creams, seals, barriers, belts, support garments? Do you know where I might be able to access a listing of those ostomy products approved by the Ministry for Health?

Regards

CharlieB

Thanks Lin. It is very sad that there can be such an inequity of financial support dependent on geographical location. Still, I guess something is better than nothing. I believe that in third world countries there is very little, if any, access to supplies and most ostomates use makeshift appliances made from plastic bags and string.

CharlieB

In Canada, it depends on which province you live in. Health care is a provincial matter. In Saskatchewan, half the cost is covered. Private insurance covers 80% of the remaining cost for us, so it costs us very little.

Thanks, Christopher. Very helpful.

Cheers

CharlieB

Here in the UK, we get them free on prescription. I was given a prescription exemption card so I don't have to pay the nominal charge, but oddly, the exemption doesn't differentiate between prescriptions. So if I was given one for antibiotics or whatever from the dentist, I wouldn't have to pay for them either.