Looking to get surgical stockings or compression stockings?

May 3, 2018

Did you know under the OSSTF Benefits Plan, your coverage for surgical stockings is: up to a maximum of six (6) pairs per plan year on a reasonable and customary basis? The plan year is September to August.

To avoid delays in processing your surgical stocking claims, please complete and sign the Extended Health Care Claim form and attach the following information:

From the physician/podiatrist:

1. Diagnosis necessitating the surgical stockings (A medical referral is not a diagnosis and will be insufficient. A separate diagnosis in addition to the medical referral is required.)
2. Description of what activities the surgical stockings will be primarily worn for (daily living, sports, etc.)
3. Anticipated duration the surgical stockings will be required
4. Verification if this is an initial purchase or reason for replacement

From the supplier:

1. Itemized receipt including patient name, date of service and total amount of purchase
2. Confirmation whether or not the surgical stockings are eligible for funding through a provincial plan (if “yes” and applicable, a copy of the provincial plan’s statement of payment is required)
3. Make, model and style of the stockings (style: knee-high or full-length)
4. Confirmation if the stockings are custom-made or off-the-shelf
5. Gradient factor

Ensure all applicable sections of the claim form are completed and include copies of primary payment if coordination of benefits (COB) is required. Please send this information as instructed on the form.

NOTES:

• It is strongly recommended a pre-determination be submitted prior to incurring expenses to ensure eligibility.
• Any costs associated in obtaining the above information will be the responsibility of the patient. In some situations, we may request further information in order to confirm eligibility.

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DID YOU KNOW?

If you have either lymphedema or a hypertrophic scar, you can apply for coverage with the Assistive Devices Program (ADP).

ADP’s allowance is 75% of the cost of:

• Lymphedema compression stockings: 3 pairs over a 2-year period
• Hypertrophic scar pressure stockings: 5 pairs over a 2-year period

NOTE: Varicose veins, diabetes, thromboses are not eligible under the ADP.

To apply to the ADP, please work with your service provider. If the ADP does not cover the full cost of your expense, you can submit the remainder to OSSTF Benefits Plan via My Claims or completing the Extended Health Benefit Claim form (776kB PDF).

Questions about the ADP? You can learn more at: Garments, pumps and braces.

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The information in this document is provided by OSSTF Benefits for general information only. OSSTF Benefits endeavours to have all information current and accurate. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, or suitability of the information included. All information is subject to change without notice.

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