Tag: medical bed coverage Ontario

For families whose loved ones require a medical bed at home, one of the first questions they ask is whether insurance will help defray the cost. In Ontario it varies based on insurance plan, medical condition, and whether the bed is purchased or rented. Knowing your options can save you money and accelerate the approval process.

Does OHIP Cover Medical Beds?

Medical beds at home are not directly funded by the Ontario Health Insurance Plan (OHIP). But coverage may be possible via other federally funded programs.

Important points to know:

• OHIP inverted that emphasis to concentrate on the services of hospitals and physicians.
• Home med products are all managed by other programs.
• Funding is often contingent upon a doctor’s prescription.

Assistive Devices Program (ADP) Coverage

The Ontario Assistive Devices Program (ADP) is the biggest provider of government support for medical beds.

What ADP may cover:

• 75% of the cost of a simple hospital bed
• Long-term care for people with medical needs
• Funds can exclusively be used for purchase, not rental, in most instances.

Eligibility requirements include:

• A medical condition requiring a hospital bed in the home
• An ADP-approved vendor
• An application signed by a doctor or OT.

Private and group employer insurance plans

Partial funding may be limited to private plans in Ontario.

Coverage is dependent on the individual provider and might be

• Reimbursement for full or partial steps after purchase
• Rental coverage for short-term recovery
• Maximums for DME (Durable Medical Equipment) on an annual or lifetime basis

Before purchasing or renting, inquire of your insurer:

• What is “durable medical equipment”? Is a hospital bed considered as such?
• Do you need pre-approval?
• Do I need a prescription or letter of medical necessity?

Medical Bed Rentals and Insurance

Short-term rentals are generally advised after surgery or during recovery, although insurance coverage is not as reliable.

Typical rental coverage scenarios:

• Some private insurers reimburse a certain period of rentals.
• ADP is generally not available for rental; it emits, however
• Families may prepay and submit for reimbursement.

Tips to Maximize Your Coverage

Here are best practices to avoid a surprise bill:

• Prior to purchasing a bed, have them prescribe it in writing.
• If you have ADP insurance, ensure it is approved, or if you are non-insured, obtain approval from the vendor with the insurer.
• Save all medical and payment records.
• Inquire about used or refurbished beds for savings.

Final Thoughts

Medical Beds Ontario’s OHIP Coverage Although they are not covered directly by the OHIP, medical beds may be partially or fully covered by payment through programs such as the ADP program and some private insurance plans. When you learn eligibility, documentation, and limits of coverage, your families will be more informed when it comes to locking down that medical bed without suffering financially.