Health Services Prosthetic Program
Social Development
Overview
This program assists clients of this department with coverage for specific prosthetic services that are not covered by other agencies or private health insurance plans.
Eligibility
This program is available to:
• Clients of this department 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, SD 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.
Description
This program covers:
• Limb prostheses (arm, leg, foot)
• Artificial larynx (Servox device, voice prostheses)
• Ocular prostheses (artificial eye)
• Breast prostheses and 1 bra
• Modifications and repairs
This program does not cover:
• Myo-electric prostheses
Prosthetic limbs are payable once every 5 years.
Artificial larynxes and artificial eyes are eligible every 3 years.
Breast prostheses and bras are eligible once every 2 years.
Modifications and repairs are considered as required.
There is no cost to eligible clients for entitled prosthetic services.
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