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What kind of respiratory devices are covered by the Assistive Devices Program (ADP) ?
Except for apnea monitors, the above devices are covered for people of all ages. Apnea monitors are covered for infants who meet specific medical criteria. People needing compressors to administer medication must meet specific medical criteria. Who can apply ?
Any Ontario resident with a valid Health Card who has a long-term respiratory problem and does not live in an institution. Medical criteria are different for each product. Before buying a respiratory product you should discuss the criteria with your doctor or qualified health professional. 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 first get an Equipment/Supply Authorization form. You can get this form from your doctor or a vendor registered with ADP, or by calling ADP at one of these numbers :
Do I fill in the entire ADP form ?
No. Follow the instructions on the top page of the form. You, your doctor and an ADP registered vendor must each complete a section of the form. Do I need a medical check-up ?
Yes. You must be examined by an Ontario licensed medical doctor, preferably one who specializes in respiratory illness. For POSITIVE AIRWAY PRESSURS SYSTEMS, a doctor who works at a sleep clinic registered with ADP must assess you. In either case, the doctor will write your medical diagnosis and state the need for a respiratory product in the section # 2 of the ADP form. What happens next ?
Your doctor may refer you to a health professional such as a registered respiratory care practitioner, a registered nurse, or a registered physiotherapist. The health professional must be licensed to practise in Ontario. He or she may recommend the respiratory products that are best for you and complete section # 3 of your form. Or you may take the form directly to a registered respiratory vendor. Registered vendors have staff to assist you in selecting a product to meet your needs, and they may complete section # 3 of the form. If you need a POSITIVE AIRWAY PRESSURE SYSTEM, your sleep clinic doctor or another member of the sleep clinic will complete the third section of your form, describing the type of device you need. Where can I get my respiratory products ?
From any vendor registered with ADP. These vendors can bill ADP directly for a portion of the cost of your respiratory products. Ventilators are authorized by ADP and you must borrow from the Ventilator Equipment Pool (VEP). For further information, call VEP at 1-800-633-8977. Apnea/cardiorespiratory monitors for infants at risk of Sudden Infant Death Syndrome (SIDS) may be rented from registered vendors for up to a maximum of 6 months. There is no funding for rentals for more than 6 months. The criteria on who qualifies for apnea/ cardiorespiratory monitor funding are very specific. How much will ADP pay ?
For medication compressors, percussors, postural drainage boards, resuscitators and bi-level positive airway pressure systems, ADP funds 75 per cent of the vendor's selling price up to a set maximum amount. For apnea monitors, ADP funds 75 per cent of the vendor's monthly rental price up to a maximum monthly amount. The maximum amount varies with the type of equipment. The registered vendor will let you know what the maximum is for your product. For continuous positive airway pressure systems (CPAP and Auto-Titrating), suction and tracheostomy products, ADP will pay 75 per cent of the ADP approved price. You will be charged for the remaining 25 per cent. Will my health insurance company cover my share of the cost ?
Many will. If you have private medical coverage, check with your insurer or agent to see if they will pay your share of the cost. If I am receiving social assistance benefits, will ADP pay more ?
If you are receiving social assistance benefits under Ontario Works (OW), Ontario Disability Support Program (ODSP), or Assistance to Children with Severe Disabilities (ACSD), your vendor may be able to bill ADP for a higher amount. Does this mean that ADP will pay 100 per cent of my costs for equipment/supplies ?
Not always. For some devices, if the vendor's retail price is more than the maximum amount that ADP will pay on your behalf, you will be responsible for the difference. Be sure to ask your vendor how much of the total cost you will be responsible for. Who will show me how to use my respiratory device ?
Your doctor or a qualified health professional. Often this will be a registered respiratory care practitioner or a registered nurse working for the vendor. What if I need to replace my equipment ?
ADP will contribute towards the cost of replacement at the end of a certain period if your equipment is no longer working and cannot be repaired. Replacement periods are :
You must still meet the eligibility requirements and you will need a new ADP form signed by the doctor. What if I have more questions ?
For further information, please write : Ministry of Health and Long-Term Care Or call ADP : Toronto 416-327-8804 | ||||||||||||||||||||||||
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Ministry of Health and Long-Term Care Tel: Toronto 416-327-8804 |
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