PharmaCare’s Prosthetic Program provides funding to help supply all current residents of BC with prosthetic treatment which allows them to maintain basic mobility. In order to be covered under this program, individuals must first register with PharmaCare. Once registered, each individual will be assigned a deductible and a family maximum based on their household income 2 years ago. Until the deductible is reached, the individual is responsible for paying 100% of the eligible costs**. Once the deductible is reached, PharmaCare pays 70% until the individual has paid the maximum, at which point PharmaCare pays 100% of eligible costs. Certified will invoice PharmaCare directly for their portion of the payment. Additional information on this can be found at PharmaCare for BC Residents.
**It is very important to note that not all prosthetic costs are considered to be eligible by PharmaCare and individuals will need to pay for these ineligible costs themselves. For more information on what is covered, please talk to your Prosthetist.
The Ministry of Housing and Social Development provides funding of orthoses for eligible clients (over the age of 19) to meet a medically essential need. There must be no other resources available to the client to provide the item requested. To find out if you are eligible to receive funding from The Ministry, you may need to contact your local ministry representative. As of April 1, 2011, the procedure to obtain funding from the Ministry for orthotics is as follows:
Once Approval is received, we will set up an appointment for you to come in to our office for a casting, fitting and follow-up. Please know that approval from the Ministry can take anywhere from 30-90 days. To find the office closest to you, please visit the Ministry Website
PharmaCare’s Orthotic Program provides funding for orthoses for children under the age of 18 who are residents of BC. They cover 100% of orthotic treatments and any necessary adjustments and repairs, as long as the appropriate forms have been completed. Prior approval is required before starting a treatment, and after the final device is dispensed, Certified will invoice PharmaCare directly. Funding from Fair PharmaCare is based on the family deductible unless the child is on the At Home Program with PharmaCare.
WorkSafe BC provides 100% coverage for people needing prosthetic and orthotic treatments due to workplace injuries. In order to ensure funding for prostheses and orthoses for all levels, it is necessary that injured workers see a Certified Prosthetist or Orthotist. After doing an initial assessment, the Prosthetist or Orthotist will submit a request to WorkSafe BC which must be authorized before a treatment can be started. Upon completion of the treatment, clinics will invoice WorkSafe directly.
ICBC provides funding for prosthetic and orthotic treatments required for injuries resulting from a motor vehicle accident. $150,000 is available for medical and rehabilitation expenses prior to a settlement. In order to access this funding the injured individual needs to have a valid ICBC claim number, as well as the name and contact number of their adjuster. Prior approval is required before treatment can begin, and Certified will invoice ICBC directly upon completion of the treatment.
NIHB provides funding for prostheses and orthoses for First Nations and Inuit individuals. In order to apply for funding for all treatment, services or supplies, prescriptions from a doctor are first required. A request for prior approval will be sent to NIHB before treatment begins and Certified will invoice NIHB directly after the treatment is completed.
DVA provides funding for prostheses and orthoses for veterans who are eligible for benefits from service. A prescription from a doctor is required for all treatments and services provided. A request for prior approval will be sent to DVA before treatment begins and Certified will invoice DVA directly upon completion of the treatment.
Extended Health Plans, such as those offered by Pacific Blue Cross, Great West Life and others, can either be provided by employers or purchased privately. These plans are all unique and the funding they provide is based on the specific natures of each plan. To determine what is eligible for coverage under a specific plan, the plan provider must be contacted and asked what is covered and what paperwork is required. In all cases, the individual must pay Certified directly and submit the receipt to the Insurance Company for reimbursement.
The War Amps CHAMPS program aims to encourage amputees 18 years old or younger to develop a positive approach to challenges. It does this in a variety of ways, including offering financial assistance, mentoring, seminars and other programs. To receive financial assistance, all other paying agencies must first be contacted and prior authorization must be attained. After the treatment is provided, Certified will invoice CHAMPS directly. They also assist with funding for Adult Amputees.
There are several other funding sources available to help cover the costs of some prosthetic and orthotic treatments. These include the Challenged Athletes Foundation, Variety Children’s Charity, President’s Choice Children’s Charity and the PLAY Foundation. For more information on whether these organizations may be able to help you, please contact our office or your prosthetist.
There are several types of funding available to make prosthetics accessible. They are:
Funding availability for prostheses is different in every province. The provincial governments set out varied fee schedules and residents of each province, with a valid heath card, are eligible for coverage, if available in their provinces.
Most provinces that provide public funding for prosthetics require that:
The following Provinces have healthcare funding programs for prosthetic treatments through the indicated departments:
Each province has a Worker Compensation Program that covers those who are injured on the job. These departments go by different names across the provinces but provide orthotic and prosthetic funding when injuries occur at work.