Will a Provincial Program or Private Plan Pay for Crutches in Canada?

We will give you the part that affects your decision first, because it is the part that costs money if you find it out in the wrong order.

A pair of crutches bought from us cannot be funded by a Canadian provincial assistive-devices program. Those programs pay for equipment supplied through vendors registered or authorized within the province. Millennial Medical sells direct from the United States and holds no such registration anywhere in Canada. There is no form, no code and no workaround that changes that.

If provincial funding is the deciding factor for you, the useful next step is your province’s program, not this website. We would rather send you there than take an order you are going to regret.

What follows is what we understand about how the two routes work, so you can tell quickly which one you are in.

Route one: provincial programs

Every province runs some form of assistance for mobility equipment for residents with a long-term need. The names differ (Ontario’s Assistive Devices Program, Alberta Aids to Daily Living, and their equivalents elsewhere), and so do the details, but the shape is consistent enough to be worth describing:

• You have to be a resident of the province with valid provincial health coverage.
• The need has to be long-term. Ontario’s program, for example, is aimed at a physical disability expected to last six months or longer, and explicitly does not fund equipment for occasional or short-term use.
• An authorized assessor is usually involved. Frequently an occupational therapist or physiotherapist, who confirms the need and specifies the equipment.
• The equipment comes from a registered or authorized vendor. This is the requirement that matters here. Quebec’s program, for instance, requires devices to be obtained through facilities or laboratories it authorizes.
• The program pays a share, not the whole thing. Ontario’s contributes up to 75% of the cost of the basic equipment it defines as meeting the need, with full coverage for people on certain income support programs.
• The funded item is the basic one. These programs fund what meets the clinical need, not the model you would choose if you were paying.

That last point is the real trade-off and it is worth being clear-eyed about. Provincial funding substantially reduces what you pay, and in exchange you choose from what registered vendors carry in the category the program will fund. Some people care much more about the money. Some care much more about the specific equipment. Neither is wrong, but you cannot generally have both.

Route two: private extended health plans

This is the route that can work for a direct purchase, and it is the one worth a phone call before you order anything from anyone.

Many Canadian extended health plans, whether through an employer or bought individually, include mobility aids. The usual mechanic is reimbursement: you pay, you submit an itemised receipt, and the plan pays back some portion up to a limit.

Because the plan is a private contract rather than a public program, the rules are whatever your specific plan says. Some pay against a receipt alone. Some require a prescription from a physician. Some require you to get approval before purchasing, which is not something you can fix afterwards.

Ask these four questions before you order:

1. Are mobility aids covered under my plan, and up to what limit?
2. Do you need a prescription, and from whom?
3. Do you need to approve the purchase in advance?
4. Do you reimburse purchases from a supplier outside Canada?

Question four is the one people skip and the one most likely to end a claim, because a plan that happily reimburses a Canadian pharmacy receipt may treat an out-of-country purchase differently.

Workplace injuries are a separate system

If your need comes from an injury at work, it goes through your provincial workers compensation board rather than the general assistive-devices program. Those boards run their own approval processes and their own supplier arrangements.

The important practical point is the sequencing: buying equipment before the board has approved it generally means you have bought it yourself. Contact them first.

What we can and cannot give you

Plainly, so nothing is ambiguous:

We can give you an itemised receipt from the store, which is what most private plans want, and tell you exactly what the product is and what it costs.

We cannot act as a registered vendor for any Canadian program, provide Canadian programme paperwork or billing codes, bill a provincial program or a private insurer directly, or tell you whether your specific plan will reimburse you. Only your plan can answer the last one.

A note on how current this is

Programme names, eligibility rules, contribution rates and vendor requirements are set by provincial governments and change without consulting us. Everything above is an orientation to how these programs are generally structured, checked against the official pages listed below on the date shown. Where an official page disagrees with this one, it is right and we are out of date. Verify with the program before making a decision that depends on the detail.