Funding

Depending on your diagnosis and the intended use of the device, a portion of the cost of the custom orthotic or prosthetic device may qualify for Ministry of Health and Long-term Care Assistive Devices Program (ADP) funding.

• Other sources of funding may be available through Workplace Safety Insurance Board (WSIB), War Amps of Canada, Veterans Affairs Canada (DVA), Ontario Disability Support Program (ODSP), Ontario Works (OW), Assistance for Children with Severe Disabilities ACSD, Non-Insured Health Benefits for First Nations/Inuit Health (NIHB), Regional Social Services departments, private extended health benefits, and Federal Health Benefits (FHB)
• In some circumstances there can be multiple agencies funding a prosthetic or orthotic device.  Our staff will direct your funding requests to the appropriate sources.
• If there is a portion that is not covered by ADP or 3^rd party funding agency and self-payment is required to obtain our services.  The department accepts most forms of payment.

The Prosthetics and Orthotics department is staffed with Financial Assistants to help walk you through the funding of your prosthetics or orthotic device.  Financial Assistants are a resource for patients and family to:

• Provide you with a detailed cost of your prosthetic or orthotic device
• Guide you through your funding application process
• Provide you with information on possible funding sources
• Submit applications on your behalf to external funding agencies
• Coordinate funding with multiple payers towards your device
• Liaison with your personal insurance agency

• In most cases, funding for a prosthesis starts at an Outpatient Amputee Clinic.   At your clinic appointment you will be assessed by a physician and other members of your healthcare team to help determine your prosthetic needs.
• Following your clinic assessment, an estimate will be provided to you that outlines the total cost of the device and amount that qualifies for ADP funding.   
• If your device qualifies for ADP funding, your application is submitted to the Ministry of Health and Long-term Care by our office.
• ADP covers up to 75% of the cost to a maximum amount on approved components and procedures.   Some component costs are higher than the maximum contribution and this difference needs to be covered by your extended insurance or self-pay.   
  • If you are supported by provincial social assistance such as; Ontario Disability Support Program, Assistance for Children with Severe Disabilities, Ontario Works (ODSP, ACSD, OW), ADP offers an increased amount of funding assistance of 100% of the maximum contribution.
  • Regional social services that support individuals who have low income may assist you with the remaining cost not cover by ADP or other benefits.

• In order to receive our services you must be referred by your Physician or Nurse Practitioner.
• Following your assessment an estimate will be provided to you that outlines the total cost of the device and amount that qualifies for ADP funding.   
• For qualifying devices, ADP will assist with up to 75% of the cost of approved components and procedures.
  • If you are on provincial social assistance (ODSP, ACSD, OW) and your device qualifies for ADP there is an increased to 100% of the cost for your brace.
  • Regional social services that support individuals who have low income may assist you with the remaining cost not cover by ADP or other benefits.
  • If you have their own work benefits/insurance, our Financial Assistants will provide you with the estimate and supporting documentation you will need to submit to your insurance agency for predetermination of the amount of coverage.
  • Any remaining amount that is not covered must be paid prior to you receiving your device.

• Ministry of Health and Long-term Care Assistive Devices Program (ADP)
• Government of Ontario – Social assistance overview and how to apply

• War Amps of Canada

How do I know if my device qualifies for funding assistance?

• Your clinician will be able to inform you if the device you are being assessed for qualifies for provincial funding.  After you are assessed and provided a cost estimate our team will walk you through the funding process.

Does ADP fund sports or recreation devices?

• No, sports or recreation device do not qualify for ADP funding.

What do I do if I don’t have funds to pay the self-pay cost of my device?

• There can be multiple sources of funding for a single device.  Our Financial assistants will work with you to explore your funding and payment options.  Our clinical team will review the cost with you and explore alternatives that may meet your needs.    

Any further questions?

• Any questions regarding funding of any devices our department dispenses please contact our departmental Financial Assistant at 905-521-2607