At the end of this chapter, you will be able to:
- understand costs of equipment and supplies
- understand funding for medical equipment and supplies in Ontario
How do I pay for my child's trach-vent needs?
With an Ontario Health Insurance Plan (OHIP) card, your child’s health-care team can apply to the Assistive Devices Program (ADP) from the Ministry of Health (MOH), which pays 75 per cent of the cost of your child's tracheostomy equipment (see list below) and other supplies. You must pay the remaining 25 per cent through private insurance, other government funding you/your child quality for or from other private sources. An exception is the oximeter which is funded through the Ontario Ventilator Equipment Pool (VEP) program. A list of required equipment and supplies will be provided throughout your tracheostomy training or by your child’s health-care team.
Equipment and supplies include:
- compressors: medication and/or high output (funded every five years)
- suction machines (one unit funded every three years, if broken)
- oxygen (annual renewal required)
- manual resuscitation bags
- tracheostomy supplies
- ventilator supplies (if applicable)
Quarterly ADP grants
- Under the respiratory section of ADP, your child can receive funding in the categories listed in the table below.
- The amounts provided in the table are an example of how much money per category, every three months, your child will receive with and without additional government assistance (see below for explanation).
ADP respiratory funding categories | ||||
---|---|---|---|---|
Category | Family qualifies for additional government funding ($) | Family does not qualify for additional government funding ($) | ||
Annual | Quarterly (every 3 months) | Annual | Quarterly | |
Tracheostomy tubes | 1200 | 300 | 900 | 225 |
Tracheostomy supplies | 2000 | 500 | 1500 | 375 |
Ventilator and supplies
(Both get the same single funding for this category whether your child has both these therapies or just one of the two) |
560 | 140 |
420 | 105 |
Suction device supplies | 240 | 60 | 180 | 45 |
Speaking valve
(Does not apply to infants as they cannot use a speaking valve) |
560 | 140 | 420 | 105 |
Total | 4560 | 1140 | 3420 | 855 |
How do I get funding from the ADP?
Your child’s health-care team will help you apply for funding. There are three main forms to apply for funding of equipment and supplies:
- Application for Funding Respiratory Equipment and Supplies (RE1 form).
- Application for Ventilator Equipment and Supplies (VE1 form), plus addendum form.
- Home Oxygen Program (HOP form).
It can take up to three months for you to receive your first payment by cheque.
What level of out-of-pocket costs should I expect for my child's equipment and supplies?
Monthly out of pocket average costs
- This amount varies patient to patient.
- The average monthly out of pocket cost is approximately $400 but can be more or less depending on the child’s needs.
- This amount can easily increase if your child gets sick and more supplies are used (for example suction catheters). It can also increase if your child requires a specialty product, for example, a custom tracheostomy tube.
How do I obtain my child's equipment and other supplies?
You can order supplies and some equipment through a respiratory medical vendor such as those listed below.
You must keep all receipts for supplies for at least two years in case you are audited for tax purposes.
ADP Equipment and Supplies Information: https://www.ontario.ca/page/respiratory-equipment-and-supplies
Purchasing a speaking valve
Your child's health-care provider must complete an ADP RE1 form and select a "speaking valve" for your child to receive a quarterly grant (a payment once every three months).
See chart above for funding amounts.
A speaking valve costs about $140. Purchase only one speaking valve at a time and make sure you keep your receipts for tax purposes.
Can I get government funding from other sources besides the ADP?
Additional government funding programs include:
- Assistance for Children with Severe Disabilities
- Ontario Works Program
- Ontario Disability Support Program.
To qualify for Assistance for Children with Severe Disabilities (ACSD), your family's total income must be less than approximately $64,000. Your social worker can help you apply for this funding (Assistance for Children with Severe Disabilities Program | ontario.ca)
Your eligibility and the amount of assistance you receive is based on a combination of factors:
- your household income
- size of your family
- severity of your child’s disability
- extraordinary costs related to your child’s disability
Please work with your child’s health-care team to explore funding if needed.
Example list of tracheostomy supplies to order from vendor before your child is discharged home from hospital.
Item | Monthly quantity (approximate) (Variable between patients) |
---|---|
Portable suction machines | 2 |
Connecting tubing for suctioning | 4 |
Suction catheters | 150-200 of the primary size (smaller catheters if needed to go into the smaller sized back up tracheostomy ) |
Suction tips, for oral or nasal tip suctioning | 6 |
Yankauers for oral suctioning | 6 |
Filters for suction machine – please order appropriate filter as per the suction unit ordered | 1 |
Suction canisters - please order appropriate canister as per the suction unit ordered | 1 |
Manual suction setup – feeding tube with syringe | 1 |
Oxygen mask | 1-2 |
Oxygen tubing | 2 |
Oxygen venturi setup (if your child requires it) | |
Oxygen nipple connector | 1 |
Tracheostomies (same size and one size down) | 2 (one for backup) |
Extra inner cannulas (if your child has an adult sized tube) | 2-4 |
Tracheostomy ties | 4 |
Heat and moisture exchanger (HME) | 30-40 |
Speaking valve (if prescribed) | 1 |
Tracheostomy cap (if prescribed) | 2 |
Gauze (2x2) - regular | 30-60 |
Tracheostomy drain sponges (e.g., pre-cut gauze or other specialty gauze) | 30-60 |
Cotton swap tips (medical grade) | 400-500 |
Distilled water | 4-liter bottle |
Saline nebules | 30 |
Nebulizer | 1-2 |
Heavy duty compressor | 1 |
Tabletop compressor (for inhaled medications) | 1 |
Syringe for cuffed tube | |
Sterile water nebules | 30 |
Water based lubricant | 3-6 packets |
Hydrogen Peroxide (for plastic tracheostomy tube cleaning) | 2 x 250 mL bottles |
Tracheostomy brush | 1-2 |
Blunt ended scissors | 1 pair |
Water-based lubricant | 4-8 |
Non-Latex Gloves | 1 box |
Other optional items (if needed) | Quantity |
---|---|
Stoma gel pads (e.g., Carestream Medical Sil.Flex TC Pad) | As needed |
Containers for sterile water and/or saline | 1-2 |
Containers for cleaning supplies | 1-2 |
Containers for emergency tracheostomy kits | 2 minimum |