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Enteral Feeding Supplies
What kinds of enteral feeding supplies are covered by the Assistive Devices Program (ADP)?
Feeding pumps, bags and containers, tubes and catheters and accessories are covered by ADP. ADP does not pay for the feeding formula.
Who can apply?
Any Ontario resident who has a valid Health Card and a long-term, physical disability requiring enteral feeding to maintain nutritional status.
ADP covers the cost of an enternal feeding pump only for people who require feeds to be delivered by a pump for six hours or more over a 24-hour period.
ADP does not cover enteral feeding pumps and supplies used in institutions, such as hospitals and long-term care facilities.
ADP does not pay for equipment available under the Workplace Safety & Insurance Board (WSIB), or to Group 'A' veterans for their pensioned conditions.
What do I do first?
You begin by getting an ADP Equipment/Supply Authorization form. You can get this form by calling one of these numbers:
| Toronto : | 416-327-8804 |
| Toll Free : | 1-800-268-6021 |
| TTD/TTY : | 416-327-4282 |
| TTD/TTY Toll Free : | 1-800-387-5559 |
You can also get this form by visiting a vendor who is registered with ADP. Call one of the above numbers for the names and telephone numbers of vendors in your area.
Do I fill in the entire form?
You will complete Section # 1, called Biographical Information. You will also be required to sign and date the application.
Do I need a medical check-up?
Yes. A doctor or nurse practitioner licensed in Ontario must examine you. He or she will provide information about your disability and your need for enteral feeding supplies in Section # 2 of the ADP form.
How will I know which enteral feeding supplies to choose?
Your doctor or nurse practitioner may refer you to a nurse, dietician or occupational therapist with a special interest in enteral nutrition to help answer your questions about enteral feeding and help you choose your supplies. He or she may complete Section # 3 of the ADP form.
Your doctor, nurse practitioner, or an ADP-registered vendor can also complete Section # 3 of the ADP form, listing the type of supplies you will need.
There are many different types of enteral feeding pumps and supplies, and they vary in cost. You should discuss your needs and what you consider affordable with health professionals and vendors that can help you.
Where can I get my enteral feeding supplies?
From any vendor in Ontario who is registered with ADP. The vendor will bill ADP directly for a portion of the cost of enteral feeding equipment and supplies.
How much will ADP pay?
The vendor will bill ADP for 75 per cent of the approved cost for your equipment and supplies. You will be charged for the remaining 25 per cent.
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 will be eligible to receive additional funding to 100 per cent of the ADP approved price.
Will my health insurance company cover my share of the cost?
Many private insurance plans will share your cost. If you have private medical coverage, check with your insurer or agent to see if they will help pay for your share of the cost.
Can I change the type of enteral feeding supplies I buy?
Yes, within reason. If your medical condition changes or the type of supplies you need are very different from the type on your original form, ADP will ask that you see your doctor or nurse practitioner again.
If you change from gravity enteral feeding to pump-assisted enteral feeding, a new application must be completed.
How long is my application good for? Do I have to be reassessed?
Yes. Your doctor or nurse practitioner must reassess you every three years. A new application is required and will not be accepted before the end of the three-year period.
What if I need a new enteral feeding pump?
Enteral feeding pumps are a long-term purchase. You should consider your lifestyle and abilities before choosing the type of pump you need.
After five years, if your pump is beyond economical repair, you are eligible for a replacement pump. You must send ADP a work order from your vendor or pump manufacturer describing the repairs the pump needs and their costs.
ADP does not pay for replacement during the five years if the original pump is lost, damaged through misuse, or under the manufacturer's warranty period.
Is there a maximum that ADP will pay for enteral feeding supplies?
Yes, there is a maximum that the ADP will pay for enteral feeding supplies. Not included in the maximum amount is the cost of the feeding pump. The feeding pump is funded separately from the supplies.
The maximum that the ADP will pay for enteral feeding supplies over the three-year claim period is $6,750.00.
If you are receiving social assistance (OW, ODSP, ACSD) the maximum amount that the ADP will pay for enteral feeding supplies over the three-year claim period is $9,000.00.
Since there is a maximum amount of funding assistance allowed, you should maintain a record of the funds you have used, as well as the amount of funds remaining available to you.
Is there anything else I need to know?
Although ADP requires that your doctor or nurse practitioner reassess you every 3 years, you should examine your access site for changes to your skin or leakage and seek medical attention if necessary. You should also examine your equipment and notify your vendor about any damages or problems in functioning.
What if I have more questions about this Program?
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 following telephone numbers:
| Toronto : | 416-327-8804 |
| Toll Free : | 1-800-268-6021 |
| TDD/TTY : | 416-327-4282 |
| Toll Free : | 1-800-387-5559 |
| Fax : | 416-327-8192 |
