ADP : Limb Prostheses

ADP covers conventional upper and lower limb prostheses and powered upper limb prostheses. It does not cover limbs designed for only one type of use, such as recreation, and does not cover repairs.

ADP does not pay for equipment available under the Workplace Safety & Insurance Board or to Group ‘A’ veterans for their pensioned conditions.

Any resident of Ontario who has a valid Health Card issued in his/her name and is missing part or all of an arm or leg may apply.

You make an appointment with an Amputee Team registered with ADP. To get the name of a registered team, call one of these ADP numbers :

You can also ask ADP to send you the form that has to be filled out by you and the team members. Be sure to tell the staff what type of prosthesis you are being assessed for.

No. You fill in the applicant information, and sign and date the applicant/agent section of the form.

Every team has a physician, a prosthetist and a physiotherapist or occupational therapist. Together, this group assesses your needs and helps you decide which type of prosthesis is best for you.

The physician will indicate your diagnosis and need for a prosthesis in the second part of the form.

The prosthetist will list the prosthetic procedures and components you need in the third part of the form.

The team’s occupational therapist or physiotherapist will assess your rehabilitation needs and sign the form.

Before the prosthetist starts to make the prosthesis you should receive a written estimate of the total cost. The estimate should include the amount that can be billed to ADP and the portion that you will be responsible for.

It is important that you discuss the choice of components and associated costs with your prosthetist.

Many private insurance plans will help cover your share of the cost. If you have private medical coverage, check with the insurance company to see if it will pay some or all of your portion.

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

Not always. If the vendor’s retail price is more than the maximum amount that the ADP will pay on your behalf, you will be responsible for the difference. Be sure to ask your vendor how much of the total cost you will be responsible for.

The prosthetist builds a limb prosthesis to the team's specifications, and completes parts 3 and 5 of the form.

Arrangements will be made with rehabilitation services for you to be trained in how to use your prosthesis safely and effectively.

Under certain conditions, the socket can be replaced or adjustments made if the team agrees that it no longer fits your residual limb.

ADP will pay a portion of the approved amount if your prosthetic device is worn out due to regular use.

ADP does not pay for replacement where the original equipment is lost, stolen, or damaged due to misuse. You are encouraged to buy insurance for coverage in these situations.

Yes, it should be given to you in writing by the prosthetist. It is for six months against breakage and three months for satisfactory fit of the prosthesis, provided that your size or medical condition does not change significantly. You should also ask the prosthetist about any manufacturer’s warranties for component parts.

Yes, you must sign and date the invoice or proof of delivery slip when the prosthetist has completed the prosthesis to your satisfaction. Please make sure you have received your copy of the completed application form.

If you have any concerns or questions about your treatment, consult your prosthetist. Specific concerns about fees charged will be reviewed by the Ontario Association for Prosthetists and Orthotists (OAPO) if you cannot resolve them with the vendor first and the association will render an opinion. The association’s address is :

Ontario Association of Prosthetists and Orthotists (OAPO)
c/o CBCPO Head Office
303-267 Edmonton Street
Winnipeg, Manitoba
R3C 1S2
Canada

Tel  :  204-949-4972
Fax :  204-947-3627

For more information, write :

Ministry of Health and Long-Term Care
Assistive Devices Program
7th Floor, 5700 Yonge Street
Toronto, ON M2M 4K5

Or call one of the telephone numbers listed below :

Toronto : 416-327-8804
Toll-free : 1-800-268-6021
TDD/TTY : 416-327-4282
TDD/TTY : 1-800-387-5559
Fax : 416-327-8192

June 2006 Cat. No. 2104082