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Insurance covers care at Mayo Clinic

Canadians are being offered a new health insurance plan that will provide a second opinion on diagnosis and treatment at the Mayo Clinic south of the border.

Canadians are being offered a new health insurance plan that will provide a second opinion on diagnosis and treatment at the Mayo Clinic south of the border.

The MyCare program, announced Monday by Assured Diagnosis Inc. of Calgary, will initially will be available to Canadians outside of Quebec, up to the age of 75.

MyCare policyholders will have access to diagnostic expertise delivered remotely via an electronic second-opinion consultation as well as on-site care at the Mayo Clinic’s three sites in Rochester, Minn., Jacksonville, Fla., and Scottsdale-Phoenix, Ariz.

The program is aimed at serious illnesses such as cancer and heart disease, with policies available for singles, couples and families, said Jim Viccars, president and CEO of Assured Diagnosis, who has long been involved in the insurance industry.

“I had wanted to bring forward a program that involved Mayo Clinic because I’d been exposed to how Mayo Clinic does health care,” said Viccars, who first approached the world-renowned, not-for-profit institution more than three years ago about setting up an insurance program for Canadians.

“There were so many people in Canada when it came to serious illness having a difficult time getting a confirmed diagnosis and therefore getting their treatment started. And they may want to access Mayo Clinic, but because of financial constraints may not be able to. So an insurance program would work to their benefit.”

The insurance program, underwritten by Lloyds of London, does not include deductibles or co-payments, but there are coverage exclusions for pre-existing medical conditions. In other words, a person with existing heart disease would not be covered for that condition, but would be eligible for electronic consultations and treatment for cancer and joint replacements, for instance. The insurance plan also pays travel and accommodation costs for the patient and in some cases for a companion, Viccars said.

However, it is not cheap: a non-smoking couple under age 40, for example, would pay CDN$60.90 per month in premiums; a similar couple who smokes would pay $102.90 a month. The premium for a single person over age 50 would be $87.50 per month if a non-smoker, $149.33 a month if a tobacco user.

Dr. David Hayes, a cardiologist at the Mayo in Rochester, Minn., said tens of thousands of Canadians have sought testing and treatment at the clinic’s three locations over the years.

For some time, said Hayes, its physicians and other staff have been providing diagnosis and second opinions through remote electronic consultations and Mayo is now looking to make that expertise available outside the United States.

Canada, which shares a common language and is geographically close, “seemed like an excellent opportunity for such an initiative,” he said.

Depending on the success of MyCare, the Mayo Clinic may entertain hooking up with insurers from other countries, said Hayes. “So if we can reach out to more international patients, we’d love to do so.

“We can offer a timely second opinion, so this will be up to the people offering the product when they reach out to us for the electronic second-opinion consultation,” he said, adding that if a patient and their Canadian health provider feel that treatment might be better done at the Mayo, then those arrangements would be made.

Viccars said the insurance program was designed to be complementary and not to compete with Canada’s publicly funded, universal health-care system.

But David Eggen, executive director of Friends of Medicare in Alberta, said the introduction of the private health insurance program is disturbing and “goes against the spirit if not the letter of the law of the Canada Health Act.”

“We see insurance companies trying to expand their markets all the time in Canada. It’s very lucrative to sell private insurance, as we see in the United States,” he said. “It’s part of a disturbing trend that I think we should protect Canadians from, quite frankly.”

Eggen said such companies profit by spreading the false idea that Canada’s universally accessible system is irrevocably broken and that the care provided is somehow inferior to American private-sector health services.

“That’s not helpful and simply not true as well.”

“But that will be decided on the Canadian end of things. I do want to make the point that ... it’s not our goal to see these Canadian patients and then keep them as Mayo Clinic patients to deliver all of their care here. This is being done collaboratively, so we can work with the local health-care provider through MyCare to help get the best for the patient.”