ADP : Ocular Prostheses

You can apply for artificial eyes if you are a resident of Ontario with a valid Health Card issued in your name.

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

You start by getting an Equipment and Supply Authorization form. You can get this form by calling ADP at one of these numbers :

You can also pick up an application from an ocular prosthesis authorizer or vendor registered with the Assistive Devices Program. ADP has a list of their names and numbers.

No. You complete, sign, and date the first part called Biographical Information. Then you sign and date Section 4 of the form.

Yes. You must be examined by an ophthalmologist (a medical doctor who specializes in eye care), a family doctor, or optometrist.

The doctor will verify your need for an artificial eye. He or she will then fill in Section 2 of your application.

Your doctor will refer you to a certified ocularist. This person works for a vendor of artificial eyes who is registered with ADP.

The ocularist will determine which type of artificial eye you need, then make it. He or she will fill in Section 3 or your application.

ADP pays 75 percent of a fixed price for each approved device and/or procedure. The ADP vendor you purchase your prosthesis from will charge you the remaining 25 per cent. You pay the retail price to the vendor for any items you buy that are not covered by ADP.

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.

You should receive an estimate of the total cost for your prosthesis. The estimate should include the amount that can be billed to ADP and the portion you will need to pay for.

Many private insurance plans will help cover your share of the cost. If you have private medical coverage, check with your insurance company to find out if it will pay your share of the cost.

When the eye prosthesis is provided and you are satisfied with its fit and appearance, you will be given an invoice to sign and date and asked to pay for your share. ADP will be billed for its contribution.

Please make sure you receive a copy of the invoice and the Equipment/Supply Authorization form.

Yes, the vendor must provide a three-month warranty for proper fit of the ocular prosthesis. In addition, under normal use, a one-year warranty guarantees against discoloration and separation of the materials. Contact the ocularist with any concerns about your prosthesis.

ADP will pay part of the cost of a build-up or replacement if your artificial eye is no longer usable. Your doctor must verify this is due to a change in your medical condition or the size of the affected eye socket.

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.

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

August 2005 Cat. No. 2104107