Does OHIP cover hospital beds?
No, the Ontario Health Insurance Plan (OHIP) does not cover the cost of renting hospital beds for home use, specifically. However, there are other ways to get partial funding, such as going through the Assistive Devices Program (ADP) or private plans like our Freedom to Choose™ health and dental insurance.
Who is eligible for coverage?
Ontario residents with a valid OHIP card are eligible for partial coverage through ADP. You would need to be diagnosed with a long-term disability that requires a hospital bed for at least 6 months. The hospital bed or medical equipment must be prescribed by an authorized doctor or occupational therapist to be eligible.
What is included in OHIP or ADP coverage?
If you choose coverage with ADP, then you may get coverage for hospital beds, whether they’re manual or electric, and a variety of medical devices and equipment. That includes mobility, communication devices and more. This helps ensure that you receive partial coverage for the essentials, but special features or upgrades may not be covered.
It’s important to note that the program will only give funding for equipment that is approved by the ADP. They may cover up to 75% of the cost of a basic hospital bed or specialty hospital bed systems. ADP will help to subsidize the cost but does not provide full coverage for a hospital bed rental. There are additional funding programs available like, Ontario Works, but any outstanding cost must be covered by you or your family.
How do you access a hospital bed through ADP?
These are the steps you need to take in order to be eligible for funding for an ADP-approved hospital bed:
- Get assessed by an authorized doctor, occupational therapist or physiotherapist. They will determine your eligibility.
- If eligible, the doctor or therapist will complete and submit the ADP application for you.
- They will walk you through the process of choosing from an ADP-approved vendor and coordinate delivery.
- You or your caregiver will need pay the remaining portion of the cost not covered by ADP or the other alternative coverage options.
It’s important to note that ADP only covers a portion of the cost of hospital beds. To manage the remaining expenses, it may be helpful to look into private health insurance.
What is not covered by ADP?
The things that aren’t covered by ADP are:
- The full cost of the hospital bed.
- Temporary hospital beds or those for home-use without a medical condition where it’s required.
- The rental fees that come with a hospital bed if it’s acquired through a non-ADP approved vendor.
- Extra accessories like specialized mattresses, over-bed tables, and more.
What are the alternative coverage options?
Some good alternative insurance coverage options are:
- Private insurance like our Freedom to Choose health and dental.
- Local charitable organizations, like the Canadian Red Cross Health Equipment Loan Program (HELP), may provide hospital beds to those in need.
- Veterans Affairs Canada offers medical equipment support for eligible veterans.
- If you qualify, Ontario Works may provide additional assistance.
How do you handle common issues?
As with most funding that requires a medical assessment, you may experience a delay in paperwork processing. This may postpone your access to equipment, so you want to make sure that you start the process early. The more time you give yourself, the better. Something else to consider is that not all hospital bed vendors are ADP-approved, so you will want to verify with your doctor or physical therapist whether the equipment you need funding for is covered.