Breast prostheses and artificial limbs
Get help paying for breast prostheses or artificial limbs when you qualify for the Assistive Devices Program.
Who qualifies
To qualify, you must:
- be an Ontario resident
- have a valid Ontario health card
- have a long-term disability requiring permanent use of prosthetic breast(s) or limb(s)
We do not consider your income.
Who does not qualify
You do not qualify, if:
- you already qualify for or are receiving financial support from the Workplace Safety and Insurance Board for the same prosthetic(s)
- you are a Group “A” veteran and already qualify for or are receiving financial support from Veterans Affairs Canada for the same prosthetic(s)
Breast Prostheses
Through the Assistive Devices Program (ADP), we help cover the cost of external silicone breast prostheses for individuals who:
- have had a mastectomy (removal of entire breast) or lumpectomy (removal of part of breast)
- were born with a deformity of one or both breasts
Replacing breast prostheses
You can apply to replace a breast prosthesis you originally purchased through the ADP.
The replacement must be needed because of:
- change in your body size/shape
- change in your medical condition
- normal wear to a prosthesis that is no longer under warranty
We do not cover costs to replace a lost prosthesis or to repair prostheses damaged through misuse or neglect.
Types of breast prostheses not covered
The ADP does not cover the cost of breast prostheses needed for:
- temporary use (such as fibrefill)
- increasing breast size (augmentation)
- skeletal deformities (such as scoliosis)
- transition in gender identity
Amount covered for breast prostheses
If you qualify, and your application is approved, you can get:
- $195 for a full-breast prosthesis
- $390 for two full-breast prostheses
- $105 for a partial-breast prosthesis
- $210 for two partial-breast prostheses
Apply for breast prostheses
Follow these 4 steps to apply for breast prostheses:
- Find a retailer with staff trained/certified to fit people for breast prostheses.
- Buy the prosthetic(s). You must pay the full cost before submitting your application. (We advise you keep the receipt for 2 years.)
- Fill out the application form.
Mail the completed form to:
Assistive Devices Program
7th Floor, 5700 Yonge Street
Toronto, Ontario M2M 4K5
If your application is approved
We aim to review your application within 8 weeks of receiving it.
If your application is approved, we’ll mail your cheque within 30 days of our decision.
If your application is declined, you will receive a letter from us with the reason for the denial and how you can follow up, including appealing our decision.
Prosthetic limbs
Through the Assistive Devices Program, we help you cover the cost of prosthetic limbs if you were born with a partial or totally absent arm, or if you lost part or all of a limb due to disease or injury (not work-related).
Two types of prosthetic limbs are covered:
- basic upper and lower-limb prosthetic(s)
- myoelectric upper-limb prosthetic(s)
- myoelectric prosthetics controlled by person’s own muscles
Replacing prosthetic limbs
You can apply to replace a prosthetic limb(s) originally purchased through the ADP.
The replacement must be needed because of:
- growth
- atrophy
- change in medical condition
- normal wear to prosthetic(s) no longer under warranty
We do not cover costs for repairs to prosthetics damaged through misuse or neglect.
Types of prosthetic limbs not covered
The ADP does not cover costs for a prosthetic limb(s) needed for:
- occasional use
- school
- an exercise program
- social or recreational use
Amount covered for prosthetic limbs
If you qualify, and your application is approved, you can get approximately 75% of the cost covered by the ADP.
You must pay any additional costs.
Find a vendor and apply for prosthetic limbs
Follow these 6 steps to apply for help covering the costs of a prosthetic limb(s):
Find an amputee team registered with the ADP. An amputee team consists of a physician, a physiotherapist or occupational therapist and a prosthetist.
Email us for a list of amputee teams.
- Meet with the amputee team so they can assess your needs and help you decide on the best prosthetic limb(s) for you.
- Fill out the application form with the help of your amputee team.
- Find a vendor that will make and sell you the prosthetic limb(s). The vendor must be registered with the ADP. Your team can help you find one that sells upper or lower-limb or myoelectric upper limb prosthetics using the tables below.
Upper or lower-limb prosthetics
Myoelectric upper limb prosthetics
Get a written estimate for the total cost of your prosthetic(s) from the vendor. Do not submit an application without receiving the estimate. It should show:
- the amount we will cover
- the amount you will pay (if total cost goes over maximum amount provided by ADP)
Your team will share the application form with the business to fill out their part.
- Your team submits the completed application form to us.
What happens next
We aim to review your application within 8 weeks of receiving it.
If your application has been denied, we will send you a letter explaining the reason for denial and how you can follow up, including appealing the decision.
Receiving the prosthetic limbs
If your application is approved, we will notify your vendor by mail. They will contact you to let you know of our decision and arrange a time for delivery.
You must pay your 25% share when you receive your prosthetic. We pay the business our 75% share directly.
Getting up to 100% coverage
Through the Assistive Devices Program, we cover up to 100% of the cost for prosthetic breasts and limbs, if you receive financial support from one of these programs: