Devices That Compensate for Physical Deficiencies – Procedure to Follow
If you need an orthotic, a prosthetic, an ambulation aid or a standing aid, you must:
- obtain a written medical prescription from an orthopedist, a physiatrist, a neurologist, a neurosurgeon, a rheumatologist or a geriatrician, or in some cases from a general practitioner or a pediatrician. Under certain conditions, general surgeons may write prescriptions for lower-limb prosthetics, while plastic surgeons may prescribe upper-limb or lower-limb orthotics;
- go to one of the facilities or laboratories authorized by the Régie, to obtain the insured device or service.
Please note that ambulation aids are insured only if they are made available as part of a rehabilitation process and are used every day for at least one year.
Descriptions of devices
An orthotic is designed to correct a deficient function, to compensate for a deficiency, or to increase the physiological performance of the trunk or of a limb that has lost its primary function, that has never fully developed or that is affected by a birth defect.
An example of an orthotic is a tibial orthotic.
A prosthetic is designed to fully or partially replace an amputated limb or a limb that is completely or partly missing, and to restore its primary function or original appearance.
An example of a prosthetic is an artificial leg.
An ambulation aid is a support that facilitates or permits walking. Ambulation aids include crutches, canes, walking frames and walkers.
A standing aid (a parapodium or an orthopodium) supports the trunk and lower limbs, thus enabling a person to assume an upright position.
Important
An orthotic is insured if a physician recommends that it be worn every day for a minimum period of:
- six months, for a lower-limb orthotic;
- three months, for a trunk orthotic;
- one month, for an upper-limb orthotic.
However, a person under age 19 whose orthotic is designed to correct a deformity does not have to wear the orthotic for the entire minimum period, but a physician must have recommended that it be worn on a daily basis. Orthotics worn only for the practice of a sport are not insured.
If you need a locomotor assist or a posture assist (a wheelchair or an adapted support), you must:
- obtain a written medical prescription from an orthopedist, a physiatrist, a neurologist, a neurosurgeon, a rheumatologist or a geriatrician, or in some cases from a general practitioner or a pediatrician. Certain devices and services provided to persons suffering from severe cardiovascular or cardiorespiratory problems must be prescribed by cardiologists or lung specialists;
- go to one of the facilities authorized by the Régie, where a multidisciplinary team will determine the technical specifications of the device you need and will provide you with the insured services you are entitled to receive.
Descriptions of devices
A locomotor assist is used for moving about. Locomotor assists include manual and powered wheelchairs, wheelbase systems, orthomobiles and children's strollers.
A posture assist is a device that supports one or more parts of the body (head, upper or lower limbs, spine) while a person is seated in a wheelchair or in a wheelbase system.
Important
You do not need a medical prescription to have a device adjusted or repaired. However, if your device has to be replaced because of a change in your physical condition, you must obtain a new prescription confirming the change and attesting to your need for another device.
Most devices are covered by the manufacturer's warranty. If your device requires adjustment or repair during the warranty period, contact the facility or laboratory that supplied it to you, which will ensure that the work is done under warranty. Once the warranty on your device has expired, adjustments or repairs must be carried out by authorized facilities or authorized laboratories.
The cost of replacing lost, stolen or damaged devices, and the cost of repairing devices used negligently, must be paid by the insured person or by private supplemental insurance.
The Régie pays only for the cost of services rendered by authorized facilities or laboratories.
The program does not cover such items as orthopedic shoes, cloth upright supports or elasticized socks.
For more information on the obligations related to the use of a wheelchair, consult the guide entitled Important Things to Know About Your Wheelchair.
