Description

The program assists eligible clients with the coverage of prosthetic services which are not covered by other agencies or private health insurance plans.

Benefit Amount

The program covers:

• limb prostheses (arm, leg, foot)
• artificial larynx (Servox device, voice prostheses)
• ocular prostheses (artificial eye)
• breast prostheses and one bra
• modifications and repairs

Prosthetic limbs are payable once every five years.

Artificial larynxes and artificial eyes are eligible every three years.

Breast prostheses and bras are eligible once every two years.

Modifications and repairs are considered as required.

Eligibility Criteria

The program is available to:

• clients of the Department of Social Development and their dependents
• individuals who have special health needs and who qualify for assisted health care under Section 4.4 of the Family Income Security Act and Regulations

Clients must have one of the following:

• a valid white Health Services Card showing “SUPPLEMENTARY” in the BASIC HEALTH ELIGIBILITY section, or “PR” in the ADDITIONAL HEALTH ELIGIBILITY section

OR

• a valid yellow Health Services Card with a “Y” under the OTH in the VALID ONLY FOR box a “X” under SUPP in the VALID ONLY FOR box

Additional benefit specific criteria may apply.

In situations where an applicant/client has existing coverage for a prosthetic device but would be in financial hardship to pay their co-pay, the program may assist them with the difference.

The prosthetic device must be a benefit of the program and not cost more than the maximum amount the department has determined for that benefit.

Application Process

Contact Health Services Program.