Government & Insurance Guide

Assistive Devices Program

The Ontario Ministry of Health and Long-term Care runs the Assistive Devices Program (ADP) to help people who have long-term physical disabilities and a valid Ontario Health Card get needed equipment. There is no income limits for eligibility.

In most cases the ADP pays 75% of the cost of items like walkers, wheelchairs, and breathing aids. In other cases, the ADP assists with funding for breast prostheses but sends the reimbursement for a grant directly to the individual.

If you are receiving social assistance benefits under Ontario Works (OW), Ontario Disability Program (ODSP) or Assistance to Children with Severe Disabilities (ACSD) you may be eligible to receive more funding.

ADP does not pay for equipment available for clients under the Workplace Safety and Insurance Board or to Group “A” veterans through the Department of Veterans Affairs when it directly relates to their pension conditions.

In regards to mobility equipment such as walkers, wheelchairs, scooters, power wheelchair and seating and positioning, a medical assessment must be completed by a registered authorized therapist (OT/PT). The authorizer will assess your needs to determine whether you meet the ADP funding criteria. After the authorizer determines your needs, you may take the completed application to the registered vendor of your choice to purchase the necessary equipment.

In regards to CPAP, you must be referred to a sleep clinic by your physician where you will undergo diagnostic tests to determine the underlying cause of your disruptive sleep by a physician that specializes in sleep medicine. If you meet the medical criteria and your sleep physician confirms that you have obstructive sleep apnea, an ADP application will be completed. The sleep clinic staff will decide what type of equipment you should use.

Home Oxygen Program pays for long term oxygen therapy for individuals who have a chronic illness or dysfunction that requires oxygen therapy. Your physician must complete a Home Oxygen Application and you must meet the medical criteria set by them Ministry of Health. You will receive 100% coverage if over the age of 65, reside in a long term care facility, receiving benefits thru OW, ODSP, ACSD or receiving services through a Community Care Access Centre. If you do not qualify under these categories then you will receive 75% coverage. If you have a private medical coverage then you have the option to submit the 25% balance to them or if you do not meet the criteria your insurance may be able to assist.

Registered vendors bill ADP directly for the ministry portion and the clients’ portion is made payable directly to the vendor of choice.

Homestead Oxygen is a registered vendor for following devices:

• Enteral Feeding Supplies
• Home Oxygen
• Respiratory Supplies and Equipment
• Continuous Positive Pressure Systems (CPAP)
• Wheelchairs, Ambulation Aids, Scooters and Power Wheehchairs
• Seating and Positioning

Veterans Affairs Canada (VAC)

Veterans Affairs Canada (VAC) works in partnership with other government health care authorities, health care providers and research professionals to ensure that eligible clients receive appropriate health care benefits and services.

Homestead Oxygen and Medical Equipment is a registered provider through VAC for various categories within the 14 programs of Choice made available through VAC.

There are 2 groups of clients that are eligible to receive benefits or services through VAC:

Group “A” clients have the letter “A” under the Program of Choice. These clients may be eligible to receive benefits that are directly related to their pensioned disability. Some benefits may require pre-authorization by the District Office in their area.

Group “B” clients have the letter “B’ under the Program of Choice. These clients maybe eligible to receive benefits proving they have clearly demonstrated health need and the benefits are not covered by a Provincial heath care plan. Some benefits may require pre-authorization by the department.

All service and products must be outlined in the benefit grid provided by VAC or if not listed in the benefit grid be pre-authorized by District Office. All products or services supplied by Homestead Oxygen and Medical Equipment but be prescribed or recommend by the corresponding individual outlines in the benefit grid.

Homestead Oxygen and Medical Equipment is a provider of the following Programs of Choice (POC):

POC 1 – Aids for Daily Living

Devices and accessories designed to assist with the activities of a client’s daily living. These items may include walking aids, self help aids for feeding or dressing, bedroom aids and bathroom and bathing aids.

POC 7 – Medical supplies

Medical and surgical equipment such as bandages, medical stockings and incontinence supplies. All these benefits must be prescribed by a physician or other approved medical health professional.

POC 9 – Oxygen therapy

Rental oxygen and required accessories such as concentrators, compressors and breathing pumps as well as rental or purchase of other respiratory supplies and equipment. These benefits must be prescribed by a physician and eligible criteria must be meet through pre-authorization.

POC 11 – Prosthetics and Orthotics

Prosthetic and Orthotic appliances such as braces for back, knee, wrist, ankle etc. These benefits must be prescribed by a physician or other approved medical health professional.

POC 13 – Special Equipment

Special equipment for the care and treatment of client with disabilities or handicaps. This may include such items such as hospital beds, lifts, home adaptions, wheelchair etc. These benefits must be prescribed by a physician and, in many cases they must also be supported by the recommendation of another health professional such as an Occupational or Physio Therapist. In most instances, pre-authorization from District Office is required.

Other Third Party Extended Health Insurances

Green Shield, Manulife, Great West Life, Johnson Insurance are just some of the numerous examples of extended health benefit coverage supplements the coverage of medical service and supplies. Your plan sponsor/employer specifies plan design options such as co-payments, frequency limits and annual dollar amount maximums. Please check your booklet for a list of products and services and explanations. In most cases all products and services require a prescription from you physician even if the Ministry of Health does not.