Funding For Your Prosthetic Device in Ontario

**** Pathways Prosthetic Design Lab is a registered vendor with the Assistive Devices Program (ADP) in Ontario, Canada ****

The Assistive Devices Program (ADP) is a program run through the Ministry of Health and Long Term Care in Ontario.  ADP provides some coverage for eligible prosthetic devices.   ADP contributes 75% towards certain parts of a prosthetic device up to a maximum contribution. The remaining balance is the responsibility of the patient.  Often times, your private insurer will cover some, if not all, of the client balance.   

To qualify for funding through ADP, you must: 

• Be an Ontario resident 
• Have a valid Ontario health card 
• Have a long term disability  

Please note ADP does not fund:

• Prosthetic supplies (such as socks and shrinkers) 
• Repairs to your prosthetic device; these costs can sometimes be covered by private insurance
• Devices for recreation or devices that are purely cosmetic

Clients with ODSP coverage may be eligible for additional funding beyond the ADP contribution.  We will work closely with your case manager to determine eligibility for prosthetic care costs.

Clients with WSIB coverage are eligible for coverage for custom prosthetic devices pending approval from the WSIB.  Pathways Prosthetic Design Lab is a registered authorizer with the WSIB.

For more information about coverage for members of the Canadian Armed Forces and Veterans, please see the link below

Clients with NIHB coverage are eligible for coverage for prosthetic devices. Most items must be approved in advance by the NIHB regional office before they are distributed by an NIHB provider. You will need to show client identification in order for us to bill the program directly.  Medical supplies and equipment benefits are covered in accordance with program policies.

At Pathways Prosthetic Design Lab, we are a registered provider with the NIHB program and we invoice NIHB directly for services. This means that you do not have to pay any deductibles or co-payments for your medical equipment (i.e. prosthetic devices).

Ontario Works can help with some of the costs that the Assistive Devices Program does not cover.  We will work closely with your case manager to determine eligibility for prosthetic care costs.

After the ADP contribution, your private insurance policy may contribute towards some if not all of the client balance.   Check with your insurer to learn more about what they do and do not cover.  At the onset of your fitting, Pathways will provide you with a cost estimate so that you can submit this to your insurer for a prior authorization.  This prior authorization will clearly outline the amount they will cover.

The War Amps Adult Amputee Program offers financial assistance towards the cost of new or replacement artificial limbs.   This program is available to amputees 18 and older residing in Canada.  As The War Amps is a registered charity, it is important that amputees also access their own provincial or private medical plans, or group insurance. Please let your clinician know  if you would like to register for this program and an application can be started for you.

The War Amps Child Amputee (CHAMP) Program serves children in Canada (under 18) who are born missing a limb or have lost a limb due to an accident or medical causes.  The CHAMP program offers comprehensive services to child amputees and their families, including financial assistance, regional seminars and peer support.