Who qualifies

To qualify, you must:

  • be an Ontario resident
  • have a valid Ontario health card
  • require a prosthetic limb or breast due to the partial or total absence of one or more limbs or breasts

We do not consider your income.

Who does not qualify

You do not qualify, if:

Breast prosthetics

Through the Assistive Devices Program (ADP), we help cover the cost of external silicone breast prosthetics for individuals who have 1 or more totally or partially absent breasts due to either:

  • a mastectomy (removal of an entire breast) or lumpectomy (removal of part of a breast) on 1 or both breasts
  • a failed reconstructive surgery of 1 or both breasts after a mastectomy or lumpectomy
  • a congenital deformity of 1 or both breasts

Replacing breast prosthetics

You can apply to replace breast prosthetics you originally purchased through the ADP.

Replacements will be funded where either:

  • your old prosthetic is worn out, 2 years have passed since you were approved for your old prosthetic, and your old prosthetic is no longer under warranty, or
  • a new prosthetic is required due to a change in your body size/shape, or to a change in your medical condition

We do not cover costs to replace a lost prosthetic or to repair prosthetics damaged through misuse or neglect.

Types of breast prosthetics not covered

The ADP does not cover the cost of:

  • non-silicone breast prosthetics
  • more than 1 breast prosthetic per side
  • temporary breast prosthetics
  • swim prosthetics and swimwear
  • silicone breast implants
  • breast prosthetics for failed breast reconstruction where you have not had a mastectomy or lumpectomy
  • breast prosthetics for acquired skeletal deformities (such as scoliosis)
  • breast prosthetics used to augment breast size
  • breast prosthetics for change in sexual identity
  • silicone nipples
  • bras
  • repair or maintenance costs for breast prosthetics

How much is covered for breast prosthetics

If you qualify, and your application is approved, you will receive a grant of:

  • $195 per side for full-breast prosthetics
  • $105 per side for partial-breast prosthetics

If you receive social assistance benefits through one of the programs listed below, you will be eligible for up to $260 per side for full-breast prosthetics, and $140 per side for partial-breast prosthetics:

Apply for breast prosthetics

Follow these 3 steps to apply for breast prosthetics:

  1. Find a business with staff trained/certified to fit people for breast prosthetics and complete a fitting.
  2. Buy the prosthetic(s) you need. You must pay the full cost to the retailer before submitting your application. (We advise you keep the receipt for 2 years.)

  3. Fill out the application form, and send it to the ADP by:

    Email: assistivedevicesprogram@opddp.ca

    Fax: 416-327-8192

    Mail: Assistive Devices Program
    5700 Yonge Street, 7th Floor  
    Toronto, Ontario M2M 4K5

After you apply

We aim to review your application within 8 weeks of receiving it.

If your application is approved, you will receive your funding within 30 days of our decision.

You can have payments directly deposited into your bank account. Fill out and submit this form to us to set up direct deposit

Otherwise, payments will be made by cheque mailed to you. Payment by direct deposit is faster, more secure, and less likely to be delayed by factors outside of ADP’s control.

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 ADP, we help you cover the cost of prosthetic limbs if you were born with a partially or totally absent arm or leg, or if you lost part or all of an arm or leg due to disease or injury (not work-related).

Two types of prosthetic limbs are covered:

  • conventional limb prosthetics for both upper and lower limbs
  • externally powered prosthetics for upper limbs only

Replacing prosthetic limbs

You can apply to replace prosthetic limb(s) originally purchased through the ADP.

The replacement must be needed because of either:

  • growth or 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 provide funding for:

  • a spare or back-up prosthetic for the same limb
  • prosthetics used only for cosmetic reasons
  • prosthetics that are only needed occasionally (for example, when playing a sport)
  • repairs
  • modifications to externally powered upper limb prosthetics
  • batteries and interface products

How much is covered for prosthetic limbs

If you qualify, and your application is approved:

  • The ADP will pay 75% of the ADP's set price for conventional limb prosthetics directly to the business selling you the prosthetic(s). You must pay the remaining 25% directly to the business.
  • The ADP will provide 100% coverage for externally powered upper limb prosthetics, up to a maximum funding limit. You must pay any amount above this limit directly to the business selling you the prosthetic(s).

Apply for prosthetic limbs

Follow these 6 steps to apply for help covering the costs of a prosthetic limb(s):

  1. Find an amputee team or externally powered upper limb prosthetics clinic that is registered with the ADP. You can email us for a list at assistivedevicesprogram@opddp.ca.
  2. Meet with the amputee team or clinic staff so that they can assess your needs and help you decide on the best prosthetic limb(s) for you.
  3. Fill out the application form with the help of your amputee team or the staff at your externally powered upper limb prosthetics clinic.
  4. Find a business that will make and sell you the prosthetic limb(s). The business must be registered with the ADP. Your medical team can help you to find a business. You can also use the tables below.

Conventional upper-limb or lower-limb prosthetics

 

Externally-powered upper-limb prosthetics

 

  1. Get a written estimate for the total cost of your prosthetic(s) from the business. Do not submit an application without receiving the estimate. It should show:

    • the amount the ADP will cover
    • the amount you must pay (if any)

    Your team will share the application form with the business, so that the business can fill out their part of the form.

  2. 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.

It is important to follow the steps above before purchasing your limb prosthetic. If you order or buy your device before the above steps have been completed and we have approved your application, you will be responsible for paying the full cost.

Receiving the prosthetic limbs

If your application is approved, we will notify the business that you are working with. They will contact you to let you know of our decision and arrange a time for delivery.

You must pay your share of the cost when you receive your prosthetic. We pay the business our share of the cost directly.

Getting up to 100% coverage

Through the Assistive Devices Program, we cover up to 100% of the cost (or up to 100% of the maximum amount) for prosthetic limbs, if you receive financial support from one of these programs: