Assistive Devices Program
1. What kind of breast prostheses are covered by the Assistive Devices
The ADP will provide a grant to help pay for a portion of the cost of external silicone breast prostheses.
2. Who can apply?
Any permanent resident of Ontario who has a valid Health Card Number and:
3. What is not covered under the ADP?
The ADP does not fund brassieres, temporary breast prostheses, silicone
nipples or breast implants.ADP does not help pay for prostheses available
under the Workplace and Safety Insurance Board (WSIB) or for Group A veterans
4. How do I get my breast prosthesis(es)?
Select any vendor in Ontario that sells breast prostheses and has staff trained
to fit you properly. Once you are fitted with your prosthesis(es) you will
pay the vendor and obtain a receipt of payment.
5. How do I apply for the ADP grant?
You may print the application form off of our website at www.health.gov.on.ca
or obtain an application form by contacting the ADP directly (see # 14 below
for contact numbers). Complete the application form in full, attach the original
receipt from the vendor and mail to: Ministry of Health and Long-Term CareAssistive
5700 Yonge Street 7th floor
Toronto ON M2M 4K5
6. How much money will I receive?
If you require one full breast prosthesis, you will receive $195. If you
require two full prostheses, you will receive $390.If you require one partial
breast prosthesis, you will receive $105. If you require two partial prostheses,
you will receive $210.If you are receiving social assistance benefits under
Ontario Works, Ontario Disability Support Program or Assistance to Children
with Severe Disabilities, you are eligible to receive $260 for each full prosthesis
and $140 for each partial prosthesis. Check all of the applicable boxes in
the section entitled “Confirmation of Eligibility” on the application
7. How will payment be made?
You will receive a cheque within six to eight weeks after the ADP receives
your application form.
8. Does this mean that the full cost of my breast prosthesis(es) will
Not always. If the vendor’s retail price is more than the grant
amount, you will be responsible to pay the difference. Be sure to ask your
vendor how much of the total cost you are responsible for.
9. Will my private insurance cover any additional costs?
Certain insurance companies may cover additional costs. The ADP recommends
that you check with your insurer.
10. How often can I apply?
You can apply every two years if the prosthesis is worn out or is no longer
usable.If, during the two years, you require a new breast prosthesis because
your body size or shape changes or because of a change in your medical condition,
you may apply once for a replacement.The ADP does not provide the grant for
a replacement during the two years if the original prosthesis is lost, stolen
or damaged due to misuse. You are encouraged to buy insurance for coverage
in these situations.
11. What documents must legal agents provide if signing on behalf
of the applicant?
Legal agents must attach applicable documents, such as:
12. Should I keep my receipts?
You are required to send your original receipt to the
ADP with the application form.You should keep a copy of your receipt for
two years.Note that for income tax purposes, you can only claim receipts for
that exceed the amount of the ADP grant.
13. Is there a warranty?
Manufacturers of breast prostheses provide a two-year
warranty. You are encouraged to speak to the fitter of your breast prosthesis(es)
for more information.
14. What if I have more questions?
Call the ADP at one of the numbers listed below:
TDD (for the deaf) 1 800 387-5559
Fact Sheet Page 1
Health Number (10 digits)
Date of Birth (dd/mm/yyyy)
Home Telephone (include area code)
Business Telephone (include area code)
The Ministry of Health and Long-Term Care’s (the Ministry) collection of the personal
health information on or attached to this form is necessary for the purpose of assessing
and verifying eligibility for the Assistive Devices Program, and for all other purposes
related to the proper administration of that Program.
This information may be used or disclosed
in accordance with the Personal Health Information Protection Act, 2004, as set out in the
Ministry’s “Statement of Information Practices” which is accessible
Applicants may withhold their consent to the collection of this information; however, doing so
will interfere with their coverage under the Assistive Devices Program.
For more information on the Ministry’s Information Practices, or the collection of the personal health information on this
call 1 800 268-6021 or 416 327-8804 or write to the Program Manager, 5700 Yonge
Street, 7th floor,
Toronto ON M2M 4K5.
I certify that the information I have provided on this form is true, correct and complete to the best of
my knowledge. I understand that this information is subject to audit.
Signature of Applicant or Agent (Spouse, Parent, Legal Guardian, Public Trustee, Power of Attorney)
Power of Attorney
Please mail completed application and original receipt to:
Ministry of Health and Long-Term CareAssistive Devices Program
5700 Yonge Street 7th Floor
Toronto ON M2M 4K5
4392–67E (06/05) © Queen’s Printer for Ontario, 2006