Medical Equipment & Devices

Effective:  February 5, 2019

Medical equipment and devices include only the following types of items:

• canes
• crutches
• walkers
• manual and power wheelchairs
• wheelchair seating systems
• scooters
• toileting, transfers, and positioning aids
• hospital beds and related items
• pressure relief mattresses
• floor or ceiling lift devices
• non-conventional glucose meters

[For information on eligibility for breathing devices, hearing aids, and orthoses, see Related Links – Medical Equipment – Breathing Devices, Medical Equipment – Hearing Aids and Medical Equipment – Orthoses.]

Effective:  February 5, 2019

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;

and

• 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 or physical 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:

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.

Effective:  February 5, 2019

The ministry does not provide medical equipment and devices that do not meet the eligibility criteria above. For example:

• walking poles
• strollers
• high performance wheelchair for recreational or sports use
• scooters intended primarily for recreational or sports use
• automatic turning beds
• containment type beds
• lift chairs

Effective:  April 1, 2010

By regulation, the ministry 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 Need and Medical Services Only.

Effective:  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 they do 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 indicates 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.

Effective:  December 1, 2003

Recipients are responsible for providing required documentation. The ministry is not responsible for any fees associated with documentation.

Effective:  March 1, 2020

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 $630. [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.

Effective:  March 1, 2020

In order to ensure the least expensive medical equipment and devices are funded, the ministry has a contract with medical equipment service providers throughout the province.

Contracted service providers are the supplier of choice when purchasing medical equipment and devices. However, when an item is not available, non-contracted service providers may be considered.

The contracted medical equipment service providers provide the following service as part of their contract:
 

• Free assessment (fitting and trial of medical equipment). The ministry is not required to pay for the rental of equipment during the trial period, nor while a client’s application for funding is pending;
• Free delivery, in home set up, and training on the use of the equipment;
•  Two-year all inclusive service coverage on all parts and labour costs associated with repair, adjustments and fittings on eligible items (Power Wheelchairs, Manual Wheelchair, Scooters and Commercial Seating)
• Free preventative maintenance at 12 and 24 months
• 10-day new equipment delivery. Upon receipt of approval, the service provider will deliver all equipment to the client’s home or provide free suitable loaner equipment until such time as the ordered equipment can be supplied;
• Free suitable loaner mobility devices while the mobility devices are being repaired or serviced during the coverage period.
• A $630 maximum charge for replacement power wheelchair or scooter batteries. This includes the unit cost of 2 new batteries (minimum: G22 50 A/H) and all associated labour to complete the repair. Only new batteries will be accepted.
• The ministry pays up to a maximum labour rate of $100 per hour (including non-contracted service providers).

Effective:  March 27, 2015

If a recipient lives in a remote area of the province, which is not readily served by a contracted service provider, the ministry may use a non-contracted service provider to purchase low cost equipment (e.g., basic ambulatory or bathing/toileting aids) or complete basic repairs to existing equipment outside of the two year service agreement period.

Note: Requests that require extensive labour or installation costs (complex repairs) should be completed by a contracted medical equipment service provider.

Effective:  December 6, 2010

Wheelchairs (power and manual), scooters and attached seating purchased through a contracted equipment service provider by Health Assistance (HA) will include a two-year, all-inclusive warranty. Repair costs are not to be provided for equipment that is under warranty.

The warranty includes the following:

• All parts and labour costs associated with repair;
• Adjustments and fittings;
• Any costs associated with wear and tear or maintenance (e.g. covers flat tires, battery replacement for powered device);
• All freight and travel costs.

Clients receiving a new piece of warranted equipment from HA will be required to sign the Equipment Care and Responsibility Letter at the time of delivery. This letter outlines the client’s responsibilities for proper care and maintenance of the equipment. The medical equipment service provider will complete this task and submit the letter directly to HA.

Effective:  April 1, 2010

Clients requesting medical equipment must first be determined to be eligible for general health supplements. The following procedures must then be completed to assess eligibility for medical equipment and devices. [For procedures for other types of medical equipment, see Related Links – Medical Equipment – Breathing Devices, Medical Equipment – Hearing Aids and Medical Equipment – Orthoses.]

Persons who are not income assistance or disability assistance recipients but require medical equipment for a direct and imminent life-threatening health need must meet the eligibility criteria for Life-Threatening Health Needs before being assessed eligibility for medical equipment and devices [see Related Link – Life Threatening Health Needs].

The ministry requires that all other available resources must first be considered before funding any requests. 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 [see Policy – No Other Resources].

Effective:  September 1, 2024

All requests for medical equipment and devices are assessed by Health Assistance (HA).

To request medical equipment and devices, ministry staff will follow these steps:

• Provide the client with the Medical Equipment Request and Justification form (HR2138) and advise the client what information is required to complete the application.
  • Advise the client that occupational therapists and physical therapists employed at Regional Health Authority provide assessments for free and help clients with equipment trials and setup.
• Ensure all required documentation has been submitted and is ready for adjudication.

To assess eligibility for medical equipment and devices, Health Assistance will follow these steps:

• Assess application to ensure eligibility criteria are met. If a request for co-funding exceeds the amount the ministry would approve as the least expensive appropriate cost, the HA supervisor should submit a Policy Interpretation and Exception Request (PIER).
  • If approved, an approval letter will be issued to the client and a purchase authorization will be sent to the service provider.
  • If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration. The service provider will also be advised of the denial.

Note: If a diagnosis and prescription from a medical practitioner, or nurse practitioner and/or the assessment from the occupational therapist or physical therapist are received before the HR2138 is completed, Section 1 must still be completed and forwarded with the supplemental documentation to HA.

Effective:  September 1, 2024   

All repairs or replacement of medical equipment and devices are the sole responsibility of Health Assistance (HA).

When requesting repairs or replacement of medical equipment and devices, documentation outlining the repairs and the estimated cost are needed.

HA will assess all requests for repairs or replacement of medical equipment and devices. For replacement equipment, the invoice paid date for the original item generally indicates when the original item was provided. If there is reason to believe the item was provided on a different date discretion should be applied to ensure the replacement time period is determined fairly.

If approved, a letter will be issued to the client and a purchase authorization will be sent to the service provider. If denied, the client will be sent substantive reasons for the decision and be offered the right to reconsideration.

Effective:  April 1, 2010

All rentals for medical equipment and devices are the sole responsibility of Health Assistance (HA).

When equipment is rented, the service provider must be made aware that the recipient, not the ministry, is responsible for any damage to and for the return of the equipment. No deposits may be issued.

Effective:  October 1, 2012