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Need Orthotics? Make Sure They’re Covered. Rules Have Changed.

Canada’s major extended health benefits companies are moving to  protect Canadians from untrained individuals selling non medical grade orthotics. Make sure you are following the correct procedure and dealing with the right people to ensure you have insurance coverage for orthotics.

According to Greenshield Canada’s claim requirements, in order for them to be covered by insurance, orthotics can only be prescribed by :

• Physician • Podiatrist • Chiropodist • Nurse Practitioner

For the making and fitting of prescribed orthotics, only services by the following practitioners are covered:

• Podiatrist • Chiropodist • Pedorthist • Orthotist • Chiropractor

•What’s not covered under your benefits plan?

The following items are not considered custom-made and therefore are not eligible under your plan:

• Stock items, off-the-shelf orthotics, and prefabricated devices such as cushioned heel cups or insoles

Here’s what to avoid when buying your orthotics:

  • Your provider should be able to modify your orthotic. If they can’t, it may indicate they don’t have sufficient training to provide custom orthotics.
  • Orthotics sold at temporary locations, such as home exhibits, trade or sports shows, short term kiosks, health booths at malls, or department stores
  • Orthotics sold online
  • Providers who hold mass screenings for multiple people at homes or workplaces  Providers who offer to sell orthotics to your entire family without properly evaluating each family member individually
  • Special discounts, e.g., “two for the price of one” deals or “free items with the purchase of an orthotic.”
  • Legitimate orthotic providers are not permitted to make such offers according to their code of ethics.

Published on:December 19, 2013
Posted in Uncategorized by dm

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