How to get your custom knee brace fully covered?

Who will pay for your custom knee brace?

In Toronto and the Greater Toronto Area there are a few payment providers that will cover most or all of your custom knee brace cost. Each provider has specific requirements to pay for your custom knee brace.

1) Private Insurance Plans / Extended Health Care

2) WSIB (Work Related Injury)

3) ODSP (Ontario Disability Support Program)


1) Private Insurance Plans / Extended Health Care

  • examples include: Greenshield, Great-West Life, Sunlife, Manulife,  Desjardins, etc.
  • private insurance coverage can vary depending on your unique plan
  • they often cover between 80% – 100% of your custom knee brace
  • a physician, orthopaedic surgeon or sports medicine doctor will need to provide you with a referral that says:
    • 1) which knee the custom knee brace is for,
    • 2) recommend a custom knee brace for daily use (they will not cover custom knee braces for sports purposes only),
    • 3) a specific diagnosis, ie. ACL tear, meniscus tear, osteoarthritis, knee sprain/strain etc.
    • ProBracing’s sample referral form can be filled out by your doctor or used as a reference: CUSTOM KNEE BRACE DOCTOR REFERRAL FORM
  • Greenshield has a unique form that needs to be filled out instead of a doctors referral: GREENSHIELD AUTHORIZATION FORM FOR CUSTOM BRACES
  • an estimate letter can be sent to your private insurance to find out your exact coverage amount for a custom knee brace

Contact us for further questions or for your free estimate letter!

Contact ProBracing
Contact ProBracing

2) WSIB (Work Related Injury)

  • you must have injured your knee in a workplace accident and have an active claim made
  • an orthopaedic surgeon (it can’t be from just a physician) will need to provide you with a referral that says:
    • 1) which knee the custom knee brace is for,
    • 2) recommend a custom knee brace for daily use (they will not cover custom knee braces for sports purposes only),
    • 3) a specific diagnosis, ie. ACL tear, meniscus tear, osteoarthritis, knee sprain/strain etc.
    • ProBracing’s sample referral form can be filled out by your orthopaedic surgeon or used as a reference: CUSTOM KNEE BRACE DOCTOR REFERRAL FORM
  • an estimate letter along with the orthopaedic surgeon’s referral will need be sent to WSIB to approve payment for your custom knee brace

3) ODSP (Ontario Disability Support Program)

  • a physician, orthopaedic surgeon or sports medicine doctor will need to provide you with a referral that says:
    • 1) which knee the custom knee brace is for,
    • 2) recommend a custom knee brace for daily use (they will not cover custom knee braces for sports purposes only),
    • 3) a specific diagnosis, ie. ACL tear, meniscus tear, osteoarthritis, knee sprain/strain etc.
  • an estimate letter along with the physician’s referral will need be sent to ODSP to approve payment for your custom knee brace

How is payment made for my custom knee brace once the payment provider has given approval?

  • most private insurance companies will not pay your custom knee brace distributor directly
  • you will have to make payment directly to the custom knee brace provider which can be claimed for reimbursement by sending in your paid receipt
  • WSIB and ODSP can pay your custom knee brace distributor directly, provided they are registered for direct payment
  • ProBracing is registered with all payment providers and can accept direct payment if it’s an option
2018-02-20T11:53:24+00:00