Dealing with Ostomy Supply Costs in Canada

Dealing with Ostomy Supply Costs in

Unlike some other countries, where ostomy supplies are provided for free or at a very low-cost, Canadians usually have to pay out-of-pocket.  This can lead to financial stress and anxiety, but there are several strategies that I’ve found to help keep costs to a minimum.

Disclaimer: While I have done my best to make sure that the information provided is accurate and up-to-date, things change, so always check with specific programs to be certain of the eligibility criteria and coverage amounts.


Government Grants

Each province and territory have their own program to help ostomates recuperate some of their expenses (some don’t offer any assistance!).

Unfortunately, not all programs are straight forward, but it will benefit you to contact your provincial health office for details.

The following list has been compiled from various sources, and while I’ve done my best to ensure they are up-to-date, these things have a tendency to change over time.

LAST UPDATED July 3, 2019


Alberta:

Alberta Aids to Daily Living (AADL) Program

While this program can be a little tricky to navigate since it has a few restrictions, most patients pay for 25% of their supply costs up to a maximum $500 per year, then they are completely covered after that for the year.

This program has limits on how many of a particular product you can purchase at a time, but the limits seem reasonable.

Alberta Health
Alberta Aids to Daily Living
10th Floor, Milner Building
10040 – 104 Street NW
Edmonton, Alberta
T5J 0Z2
PHONE: 780-427-0731
WEBSITE


British Columbia

Pharmacare Program

PharmaCare covers ostomy supplies for patients who have undergone surgery on the bowel and/or bladder that results in a colostomy, ileostomy or urostomy. Actual coverage is subject to the rules of the patient’s PharmaCare plan, including any deductible requirements.

To be eligible you must be covered by one of the following PharmaCare plans:

Fair PharmaCare
Plan B (Residential Care)
Plan C (B.C. Income Assistance)
Plan F (At Home Program)

Fair PharmaCare plan inquiries:

Fair PharmaCare Administration
PO Box 9655 Stn Prov Govt
Victoria BC V8W 9P2

All other PharmaCare inquiries:

PharmaCare
PO Box 9655 Stn Prov Govt
Victoria BC V8W 9P2

PHONE: 1-800-663-7100
WEBSITE


Manitoba

Manitoba Ostomy Program (MOP)
Clients may purchase non-registered items outside of program with no financial assistance.

Manitoba Ostomy Program
845 Regent Ave. W
Winnipeg, Manitoba
R2C 3A9
WEBSITE


New Brunswick

No government coverage for the general public.

Private insurers typically provide 80-100% coverage.

There is a program called the Health Services Ostomy / Incontinence Program

This program is available to:
Clients of this department and their dependents
Individuals who have special health needs and who qualify for assisted health care under Section 4.4 of the Family Income Security Act and Regulations

WEBSITE

Newfoundland / Labrador

The Ostomy Subsidy Program

Those who qualify for a drug card under The 65Plus Plan also qualify for the Ostomy Subsidy Program. The program will reimburse for 75% of the retail cost of benefit ostomy items. The beneficiary is responsible for the remaining costs. The beneficiary is required to purchase the ostomy supplies and submit their original prescription receipts.

How to apply: No application is necessary. A Prescription Drug Program card is automatically issued when the Department of Health and Community Services is notified by Service Canada that an individual is in receipt of the Guaranteed Income Supplement (GIS) and Old Age Security benefits (OAS).

WEBSITE

Nova Scotia

100% – seniors (65+) with income below $16,000 per year.
Social assistance recipients
Cancer Society covers 100% of cost if diagnosis is cancer
80% – all other seniors (65+).

Nova Scotia Department of Health and Community Services
PO Box 696
Halifax, NS
B3J 2T7
902-424-5074


Ontario Assistive Devices Program

Any resident of Ontario with a valid Ontario Health card issued in their name, who has a colostomy, ileostomy, fecal continent reservoir, urostomy, ileal conduit or urinary continent reservoir. The ostomy must be permanent, or temporary if required for at least six months.

 As of July 2019:

  • You are eligible to receive $975 per ostomy each year.
  • If you are receiving social assistance benefits under Ontario Works (OW), Ontario Disability Support Program (OSDP), or Assistance to Children with Severe Disabilities (ACSD), you may be eligible to receive $1,300 annually per ostomy.
  • Residents of long-term care homes are eligible to receive $1,300 annually per ostomy.
  • For income tax purposes, you may be able to claim expenditures that exceed the amount of your grant.

Ontario Assistive Devices Program
5700 Younge St.
7th Floor
North York, ON
M2M 4K5
1-800-268-6021
WEBSITE


Prince Edward Island

100% coverage – social assistance recipients from Cancer Society for two years (if diagnosis is cancer and family income is below $35,000 per year)

Prince Edward Island Department of Health and Community Services
16 Garfield St.
PO Box 2000
Charlottetown, PE
C1A 8T5
902-368-6130


Quebec

Since October 1, 2018, persons having undergone a temporary colostomy, ileostomy or urostomy qualify for the program. And, for a permanent ostomy, the lump-sum amount paid out has also been increased.

For each ostomy, the program provides for an annual lump-sum payment of:

$1,228 for a permanent ostomy

$818 for a temporary ostomy

Regie de l’assurance maladie du Quebec
1125, chemin St. Louis
3ieme etage
Sillery, QC
G1S 1E7
418-646-4636
1-800-561-9749
WEBSITE


Saskatchewan

Saskatchewan Aids to Independent Living (SAIL)

Saskatchewan Aids Independent Living
3475 Albert
Regina, SK
S4S 6X6
306-787-7121
WEBSITE


Northwest Territories

Northwest Territories Health & Social Services
1-800-661-0830
WEBSITE


Yukon

Yukon Chronic Disease Programs
867-667-5403
WEBSITE


UPDATE: Ontario’s ADP grant will be increasing in 2015 and 2016!

These new increases will total 62% more than in previous years!

2015 Ontario Assistive Devices Program increase
Got my notice letter about the ADP increase!

Special Benefits

There are special benefits for First Nations people and Inuit, which can be obtained through the Non-Insured Health Benefits program (NIHB). Information about that program can be found HERE.

Additionally, Veterans can receive up to 100% reimbursement after completing the appropriate forms.  You can contact Veterans Affairs Canada for more information about medical supplies reimbursement HERE.


Tax Deductions

If you’ve paid out-of-pocket for any supplies, you could include them as a medical expense when filing for taxes. Please note that this doesn’t include products that have already been reimbursed by private insurance.

If you have private insurance, you can also claim the premiums when doing taxes.

Here’s information from the Canada Revenue Agency on how to submit medical expenses on your income tax forms:

Canadian Disability Tax Credit: Ostomy Tips

Lines 330 and 331 – Eligible medical expenses you can claim on your tax return

If you are caring for someone with an ostomy appliance, you may be able to receive a caregivers tax credit too:

Canada Revenue Agency: Family Caregiver Tax Credit


Disability Tax Credit

This one is tricky, but some ostomates may qualify for the disability tax credit, and it’s worth getting your doctor to sign the necessary forms to submit to Revenue Canada.  If you have IBD that been difficult to manage, despite having an ostomy, the chances of being approved are even better.

Information about the Disability Tax Credit can be found here:

Canada Revenue Agency: Disability Tax Credit

Note: I’ve also written about the Disability Tax Credit HERE.


Private Insurance

If you are lucky enough to have medical insurance through an employer, then you can take advantage of their services to help cover the cost of supplies.  If you don’t already have coverage, private insurance is something that I’d highly recommend looking into.

Unfortunately, not all private insurance companies will accept you after you’ve had your surgery since it falls under a “pre-existing condition”, but there are still companies which who can offer coverage.

I was with Green Shield Canada for several years and for under $70, they would cover $1500, $2500 and $5000 (1st, 2nd and 3rd+ year) worth of ostomy supplies and signed me up after my surgery.

They cover just about all ostomy supplies, including barrier rings, pouch liners, pouch deodorant, gelling products and obviously, wafers and pouches.


Patient Assistance Programs

Some charities offer temporary financial assistance to patients who are unable to afford supplies.

Colon Cancer Canada offers up to $1500 in assistance (up to $500 for ostomy supplies) to qualified patients who have a colon cancer diagnosis through their Wendy Bear Patient Assistance Program.


Request Product Samples

One thing that I always recommend to ostomates, especially new ones, is to ask for product samples from various suppliers.  In your first year as an ostomate, you’ll likely be trying new supplies until you find one that you love.  These freebies can help delay out-of-pocket expenses for a few months!

Consider this a great time to use supplies before your grants or insurance kicks in, and be sure not to settle for something unless it works best for you!

In my product reviews, I often mention whether you can get samples for a particular product and where.  My stoma nurse gave me a list of manufacturers to contact after leaving the hospital post-surgery.  All the major brands like Coloplast, Hollister and ConvaTec will send you samples upon request, but there are many other companies who offer free samples.

Tip: You can find a list of manufacturers who offer free samples HERE.


Ebay/Kijiji/Craigslist

You’d be surprised at the gems you can find through these websites.  I’ve been able to get free/low-cost supplies through Kijiji, but there are a few things to remember if you go this route:

  • Your insurance will likely not reimburse you for products purchased through these sites, so these will be out-of-pocket.
  • Sometimes the stuff you find are passed their expiry date; be sure to ask about the “freshness” of these products before you commit to anything.
  • Some of the stuff might be used. Liquids, powders, pastes, and sprays are often sold after being used a few times and are no longer needed; avoid these products unless it’s guaranteed that they haven’t been used.
  • Use caution when going to visit a stranger to pick up these supplies. If you can meet in a public place, that would be your safest bet.

Find Discount Suppliers

Your local medical supply store may not be the cheapest place to buy products from.  I get most of my supplies online because of the low prices and quick delivery.  You’d be surprised at how quickly $10-20 off a box of wafers or pouches can really add up!

Tip: Since most insurance companies won’t reimburse the cost of shipping, try to order enough to get free shipping when shopping online.

Here are a few discount suppliers you can find online:

Some medical supply stores offer discounts to the members of local Ostomy Canada chapter members.  You can usually find out which ones do through your local chapter’s newsletter.  It’s always a good idea to find or ask about discounts before you place an order.


Temporary Help

If you are part of a local ostomy group, you might be able to connect with other members who have unused supplies they can give you for free or at a low price.

This might not guarantee a steady flow of supplies, but it could help in situations where you might be in a pinch.


Practical Advice When Using Supplies.

While government assistance, being a savvy shopper and tax credits can help, there’s a lot of practical things you can do to help minimize your expenses.

  • Only use supplies that you need to.  Are barrier rings really necessary for your situation? Do you really need to use barrier wipes? Are you able to get an extra day out of your wafer without compromising your skin’s health?
  • Consider using a one-piece appliance instead of two-piece systems, which tend to be more expensive. There are differences between the two systems, so THIS guide will come in handy.
  • If you don’t need a convex wafer, don’t use one! They are far more expensive than flat wafers!
  • Use certain products, like pouch deodorant, only during certain circumstances, like when going out in public.
  • Consider using pouch liners if you have a colostomy.
  • Reuse your two-piece pouch. I’ve heard of many ostomates who rotate between two pouches, and they clean their soiled one, and let it dry before using it again on the next appliance change.  I’ve tried doing this a few times, but because I use filters on my pouches, this makes the filters useless, and I’ve had more leaks through the wafer coupling compared to when I use fresh pouches with each change.

Question: Do you have any money-saving tips?

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