B.C.'s Social Development and Innovation Program
Ministry Of Social Development & Innovation
Medical equipment and devices for medically essential needs are available to clients who are eligible for general health supplements. [For information on eligibility for general health supplements, see Related Links – Health Supplement Summary.]
Clients who are eligible for general health supplements may request medical equipment and devices. A requested item must meet the following:
- General Requirements for All Medical Equipment and Devices
- Specific Requirements for each Individual Type of Medical Equipment and Device.
General Requirements for All Medical Equipment and Devices
A client requesting medical equipment or devices must meet general requirements that apply to all medical equipment and devices:
- there are no resources available to the family unit to pay the cost of or obtain the medical equipment or device;
- the item is the least expensive, appropriate medical equipment or device;
- the item must be prescribed by a medical practitioner or nurse practitioner; and/or the medical need must be confirmed by the assessment of a relevant therapist (occupational, physical, or respiratory therapist)
Note: a medical need for a positive airway pressure device must be prescribed by a medical practitioner or nurse practitioner and the medical need must be confirmed by a respiratory therapist
- the request must be pre-approved by the ministry prior to purchase;
Note: the ministry will not accept payment responsibility, except in cases of a life-threatening emergency, for medical equipment purchased without prior approval.
Specific Requirements for each Individual Type of Medical Equipment and Device
In addition to meeting the general requirements for all medical equipment and devices, a client must also meet the specific requirements for the requested type of item:
|Type of item||Specific Requirements|
Canes, Crutches, Walkers
the ministry is satisfied that the cane, crutch, walker or related accessory is medically essential to achieve or maintain basic mobility
Manual and Power Wheelchairs
the ministry is satisfied that the wheelchair, upgraded component, or attached accessory is medically essential to achieve or maintain basic mobility
Wheelchair Seating Systems
the ministry is satisfied that the wheelchair seating system or accessory is medically essential to achieve or maintain a person’s positioning in a wheelchair
(conventional & bariatric)
Toileting, Transfers, and Positioning Aids
Hospital Beds and Related Items
Pressure Relief Mattresses
the ministry is satisfied that the pressure relief mattress is medically essential to prevent skin breakdown and maintain skin integrity
Floor or Ceiling Lift Devices
Positive Airway Pressure Devices
the ministry is satisfied that the positive airway pressure device or supply or accessory to operate the device is medically essential for the treatment of moderate to severe sleep apnea
the ministry is satisfied that the suction unit, accessory, or supply is medically essential for clearing respiratory airways
the ministry is satisfied that the percussor, accessory, or supply is medically essential for clearing respiratory airways
the ministry is satisfied that the medical humidifier, accessory, or supply is medically essential to moisturize air in order to allow a tracheostomy patient to breathe
Inhaler Accessory Device (e.g. spacer)
the ministry is satisfied that the inhaler accessory device, accessory, or supply is medically essential to deliver medication
Non-Conventional Glucose Meter
When clients no longer require the equipment and it cannot be exchanged or traded to meet a current need, they should be encouraged to donate the item to an agency that would benefit from that item.
Non-Eligible Items: October 1, 2012
The ministry does not provide medical equipment and devices that do not meet the eligibility criteria above. For example:
- walking poles
- high performance wheelchair for recreational or sports use
- scooters intended primarily for recreational or sports use
- automatic turning beds
- containment type beds
- lift chairs
No Other Resources: April 1, 2010
By regulation, the ministry is the payer of last resort and requires that all other available resources must first be considered before requesting funding. For income assistance and disability assistance clients, other resources include (but are not limited to) accessing medical equipment or funding through:
- Other government programs or funding sources (e.g., Fair PharmaCare, Health
- Authorities, ICBC, WorkSafeBC, Veterans Affairs Canada)
- Private insurance
- Publicly subsidized residential care facilities (when it is the client’s place of residence). Clients living in facilities funded by the Ministry of Health are not eligible for medical equipment from the ministry. These needs must be met through the facility. Facility staff should be contacted to determine the funding source.
If there are other resources available, the individual is not eligible for medical equipment from the ministry.
Co-funding may be considered when other resources cannot pay the entire cost. For example, if an insurance company will pay $500 for an item that costs $1000, the ministry may consider funding the remaining $500 if all other eligibility criteria are met.
Note: When assessing medical equipment eligibility for income or disability assistance clients, exempt assets are not considered. When assessing other resources for persons with a life-threatening health need or persons who are medical services only, see Related Links – Life-Threatening Health Needs and Medical Services Only.
Guidelines for Determining Medically Essential to Achieve or Maintain Basic Mobility: April 1, 2010
The following guidelines outline factors considered by the ministry when determining if medical equipment requests for canes, crutches, walkers, manual wheelchairs, power wheelchairs, or scooters are medically essential to achieve or maintain basic mobility. These guidelines assist ministry staff when reviewing the assessment provided by the client's Occupational Therapist (OT) or Physical Therapist (PT) and/or the prescription provided by the client's medical practitioner or nurse practitioner.
"Medically essential to achieve or maintain basic mobility" refers to a client's need for equipment due to a mobility impairment which is necessary to perform their day-to-day activities in their home and/or community.
Each equipment request is reviewed on an individual basis and the client's needs are taken into consideration. If the factors suggest that the equipment is medically essential to achieve or maintain basic mobility, and all other eligibility requirements have been met, the client is eligible for the requested equipment.
Note: the information to be considered under each factor is not all-inclusive as it is important to preserve the discretion of the ministry decision maker and allow for flexibility to assess uncommon or unexpected circumstances.
When assessing the information provided to determine if the equipment is medically essential to achieve or maintain basic mobility, the two factors to be considered are:
Factor 1: The client's mobility impairment
Information regarding the client's mobility impairment provides the medical basis for the equipment and the reason why it is being requested. The mobility impairment may result from a number of different medical conditions that restrict the client's functional ability.
When considering this factor, the following information is reviewed:
- The diagnosis provided by the medical practitioner or nurse practitioner to assist in determining if it is reasonable to expect that there are limitations to mobility and whether the medical condition presented is likely to need equipment.
- The assessment provided by the OT or PT to assist in determining the applicant's level of functioning. This includes information regarding:
- The cause of the equipment request.
- How the client mobilizes and performs day-to-day activities in their home and/or community.
- The client's ability to mobilize once reaching a destination point.
- Whether the medical condition would deteriorate without the equipment.
- Physical skills or limitations (e.g., head control, range of motion, vision, ambulation, endurance, coordination and strength) in relation to the equipment requested. Safety issues may also be identified such as a risk of falling without a walker or not having sufficient hand functional ability to operate a power wheelchair.
- Cognitive skills (e.g., visual spatial skills, judgement) in relation to the equipment request to identify if the client can safely use the equipment recommended.
Factor 2: The equipment requested
The type of equipment requested is reviewed to confirm that due to a mobility impairment, the product and components are required for the client's basic mobility.
When considering this factor, the following information is reviewed:
- Description of the recommended equipment that is being requested.
- The type and condition of the client's present equipment (if applicable) to determine its appropriateness and why it is no longer meeting the needs of the client. This may indicate if repairs or modifications can be done to the existing equipment or if a replacement is needed.
- The product specifications of each piece of equipment that has been trialed and the outcome of the trial to provide information regarding if the equipment recommended meets the client's needs and is the most cost effective.
- Details of the client's immediate environment if it contributes to the need for the equipment or the type of equipment requested (e.g., narrow door frames may necessitate a specific model of walker or wheelchair; hilly terrain may necessitate a walker with brakes.
- The adaptability of the equipment if the client's functional status is likely to change to determine if the equipment is sustainable in meeting their anticipated needs. For example, is the requested mobility equipment able to accommodate future modifications such as specialized seating or upgraded electronics for sip and puff control?
- Upgraded components may be considered if they are medically essential to achieve or maintain basic mobility.
- Examples where a request may be considered medically essential to achieve or maintain basic mobility:
- A client with multiple sclerosis experiences excessive fatigue, unsteadiness, and occasional falls. A walker is requested to prevent falls and provide stability.
- A client with cerebral palsy who experiences impaired motor control is requesting a scooter. The OT recommends a scooter instead of a power wheelchair as the client's impairment is not likely to deteriorate and require custom seating in the near future. The client's goal is to use the scooter for grocery shopping as she does not have sufficient mobility to walk to the store.
- A manual wheelchair with a lighter weight frame is requested for a client. The information from the OT indicates that the lighter weight frame is required as the client cannot propel a heavier wheelchair due to ongoing shoulder injuries and pain.
Examples where a request may not be considered medically essential for basic mobility:
- The client does not have a medical condition or mobility impairment requiring equipment but wants a scooter.
- A client with diabetes is requesting a scooter. Although the client has a medical condition, the information from the medical practitioner, nurse practitioner or OT indicate that the diabetes is controlled and there are no symptoms that impair the client's mobility.
- A manual wheelchair with a lighter weight frame is requested for a client. Although the medical practitioner, nurse practitioner or OT indicate that the client needs a manual wheelchair, there is no reason identified why a lighter weight frame is required or why a manual wheelchair with a standard frame would not be sufficient. The client would be eligible for a manual wheelchair, but not the lighter weight frame.
Guidelines for Determining Medically Essential for Treatment of Moderate to Severe Sleep Apnea: April 1, 2010
Sleep apnea occurs when a person regularly stops breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, based on the number of times an hour that the person stops breathing (apnea) or that airflow to the lungs is reduced.
The ministry will consider funding positive airway pressure devices when medically essential for treatment of moderate to severe sleep apnea based on information provided by the Respiratory Therapist.
To determine whether sleep apnea is moderate to severe, ministry staff use guidelines determined by Ministry of Health [see Contacts – Ministry of Health].
Recipients are responsible for providing required documentation. The ministry is not responsible for any fees associated with documentation.
Repairing or Replacing Medical Equipment and Devices: October 1, 2012
The ministry may consider repairing or replacing medical equipment due to the medical equipment being damaged, worn out, or not functioning.
Repairs may be considered if all of the following are met:
- It is more economical to repair, rather than replace, the medical equipment;
- The medical equipment has not been damaged by misuse;
- If the equipment was not previously provided by the ministry, all other eligibility requirements must be met (e.g., prescription, assessment).
Note: Repairs are not considered for wheelchairs, scooters, and attached seating that are under warranty. Upon the end of the warranty, the ministry may consider funding repairs. If power wheelchair or scooter batteries require replacement after the warranty expires, contracted service providers are not to charge over $450.00. [For more information, see below: Warranty on Wheelchairs, Scooters, and Attached Seating and Contracted Medical Equipment Service Providers].
Replacement may be considered if all of the following are met:
- It is more economical to replace, rather than repair, the medical equipment;
- The medical equipment has not been damaged by misuse;
- The time period, if any, set out in the table below has passed.
Note: The replacement time period does not apply when an item is required due to changes in a person's medical condition or growth.
|Medical Equipment||Replacement Time Period|
|Canes, crutches, walkers||As needed|
|Manual and Power Wheelchairs||5 years|
|Wheelchair Seating Systems||2 years|
|Scooters (conventional and bariatric)||5 years|
|Toileting, Transfers, and Positioning Aids||5 years|
|Hospital Beds||5 years|
|Pressure Relief Mattresses||5 years|
|Floor or Ceiling Lift Devices||5 years|
|Positive Airway Pressure Devices||5 years|
|Accessories or supplies required to operate a positive airway pressure device||1 year|
|Apnea monitors, suction units, percussors, nebulizers, medical humidifiers||5years|
|Inhaler Accessory Device (e.g. spacer)||1 years|
|Accessories or supplies required to operate an apnea monitor, suction unit, percussor, nebulizer, or medical humidifier||5 years|