OHIP does not cover custom foot orthotics. Many extended health plans do, usually up to a set amount every one to three years, and most require a prescription plus specific paperwork. Check your plan’s rules before you order, because a claim can be refused if a step is missed.
Do I need a prescription?
You do not need one to be assessed. For insurance, most plans do ask for one, and each plan names which professionals it accepts: commonly a physician, nurse practitioner, podiatrist or chiropodist, and sometimes a chiropractor or physiotherapist. Your plan booklet is the only reliable answer.
What insurers commonly ask for
- A prescription or referral that includes a diagnosis
- A biomechanical assessment or gait analysis report
- A description of how the orthotics were cast or scanned and made
- A receipt showing they were paid in full, with the date they were dispensed
- The name and credentials of the provider
Questions to ask your insurer before you order
- Does my plan cover custom foot orthotics, and how much?
- How often can I claim: every year, two years or three?
- Who must write the prescription?
- Which providers can dispense them for the claim to be accepted?
- Which casting or scanning methods are accepted?
- Is there separate coverage for knee braces?
Is there any Ontario government funding?
Ontario’s Assistive Devices Program helps with some custom arm, leg and spinal braces for people with a long-term physical disability, but it does not cover foot orthoses that support under the foot, or devices needed only for sport. Most people rely on a workplace plan or pay out of pocket.
What we do
We assess your feet with the Footmaxx Metascan system and tell you whether orthotics are likely to help. Call us to ask what documents we provide with your order so you can match them to your plan’s requirements.
Not sure you need custom? Read custom orthotics or store-bought insoles? More detail is on the custom orthotics and bracing page.
Checked your plan and ready for an assessment?