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Is Ostenil covered by my medical insurance plan?
The majority of insurance companies cover viscosupplement injections like Ostenil under the Extended Health Benefit Plan. Benefits also vary according to the specific plan under which you're covered. You should note also, that not all insurers and plans reimburse the same way.
For example, some private plans provide unrestricted open coverage where you simply need to fill your Ostenil prescription at your pharmacy.
For other plans, you or your physician may need to file additional documentation to obtain a prior authorization for reimbursement of Ostenil costs.
When you call your insurance company, you may be asked for a DIN number (Drug Identification Number). Ostenil, like all viscosupplement products available in Canada, is classified as a medical device by Health Canada, and does not have a DIN number. Most insurance carriers will simply use the name Ostenil for identification, or they may generate their own product identification number sometimes referred to as pseudo-DIN's, or more often referred to as PIN's.
To help you obtain this information, when you call your insurance company, you should ask:
• For your insurance company's customer service or extended health department
• Whether your insurance plan covers viscosupplementation injection products like Synvisc
• Whether your insurance plan covers Ostenil
LIST OF INSURANCE COMPANIES AND SPECIFIC INFORMATION TO HELP YOU:
Claims Secure - Classified as a Fluid Supplementation
Great West Life - Classified as a drug, Identify by name of product OSTENIL
Green Shield - Classified as Viscosupplementation, OSTENIL is covered for knee injections only , you must be diagnosed by a Rheumatologist or Orthopaedic Surgeon. OSTENIL can be injected after your diagnosis by any medical doctor. Identify by name of product OSTENIL
Manulife Financial - Extended health department, Identify by name of product OSTENIL
Sun Life of Canada - Classified as an Injection, pseudo DIN number 00990211
Veterans Affairs Canada - Special authorization is required - Your pharmacist or physician needs to call 1-888-822-2884, pseudo DIN number 00068554
Workplace Safety & Insurance Board Ontario - OSTENIL Number 98002 5685
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