AADL – Benefits covered

What is covered

Benefits provided through Alberta Aids to Daily Living (AADL) include:

• back and abdominal supports
• bathing and toileting equipment*
• burn garments
• compression stockings and garments
• custom-made footwear
• custom-made ocular prostheses**
• hearing aids and FM systems
• homecare beds and accessories*
• incontinence supplies (diapers and catheters)
• injection supplies (not provided for insulin injections)
• laryngectomy equipment and supplies
• breast prostheses**
• orthotic braces (not foot orthotics)**
• ostomy supplies
• oxygen
• patient lifters*
• pressure reduction overlays
• prosthetic devices**
• respiratory equipment and supplies*
• shoe elevations
• specialized pediatric equipment*
• specialized seating devices
• speech generating communication devices
• therapeutic shoes with custom modifications
• transfer aids
• walkers and walking aids
• wheelchair cushions and accessories
• wheelchairs – manual and power*
• vision aids – administered by the Canadian National Institute for the Blind

To be eligible, a clinical assessment by a health care professional is required. The health professional determine what equipment and supplies you can get through the AADL program.

• Lean about AADL eligibility and how to apply for benefits

AADL is a cost-share program. Albertans pay 25% of the benefit cost to a maximum of $500 per individual or family per year. Low-income Albertans and those receiving income assistance do not pay the cost-sharing portion.

• Learn more about AADL cost-sharing

What is not covered

AADL does not provide coverage for:

• foot orthotics
• eyeglasses
• prescription drugs
• dental care or dentures

Seniors may be eligible for financial assistance with these items through other programs.

• For more information on AADL benefits, read the AADL Program Manual and product lists

Equipment and supplies

Once assessed by an AADL authorizer, clients will be provided with a list of up to 3 AADL approved vendors from which to obtain medical equipment or supplies.

• Find an approved vendor

If clients are assessed by a specialty supplier, the specialty supplier will supply the benefit.

Ownership of recycle equipment: Beds, lifts, pediatric equipment and wheelchairs

The AADL program retains full ownership of recycled equipment provided to clients from the recycle vendor, Eco Medical. This includes beds, lifts, pediatric equipment and wheelchairs. The equipment is not for resale and must be returned to the vendor if:

• the equipment is no longer required, for whatever reason
• the equipment needs to be replaced by AADL
• the person using the equipment moves out of Alberta
• for any reason, the person becomes ineligible for the benefit

Once the equipment is no longer required, contact the recycle vendor to arrange pick up.

• Call Eco Medical Equipment toll-free within Alberta at 1-800-232-9450 or in Edmonton at 780-483-6232.

Client responsibility

The client (their family, trustee, guardian) is responsible to ensure reasonable care and maintenance of AADL-supplied equipment. The client is responsible for replacing equipment that is lost, stolen or damaged due to misuse.

Refusing ordered equipment

If the equipment is refused, AADL will not resupply for at least six months. If the client and/or the family require the equipment be re-ordered, they must submit a request letter. The letter must outline why the equipment was initially refused and what circumstances have changed that now allow them to accept the equipment.

If there is a second refusal of the equipment, AADL will not provide the benefit again.

If there is an unexpected change and the equipment is no longer required, contact the vendor immediately to prevent being charged for the cost-share.

Benefit limits

A maximum number of benefits are available each year. AADL will review requests for more than the maximum number through an appeal.

Some benefits may be upgraded to a more expensive item, but you are responsible for paying the additional amount. If you have any questions or concerns about this, please speak to your authorizer or specialty supplier.

Benefit limits can be found in the benefit's approved products list, or in the benefit's specific policy and procedures manual.

Hearing aids benefits

Eligibility

Albertans are eligible for funding towards the purchase, replacement and repair of hearing aids, if you are:

• under the age of 18 and have a documented hearing loss – you may be eligible for 2 hearing aids once every 5 years
• 18 to 24 years old, have a documented hearing loss and are pursuing full-time post-secondary studies – you may be eligible for 2 hearing aids once every 5 years
• 18 to 64 year old, have a documented hearing loss and have a low income – you may be eligible for funding towards 2 hearing aids or a personal listening device once every 5 years
• 65 years or older, you or your spouse/adult dependent have a documented hearing loss and have a low income – you may be eligible for funding towards 2 hearing aids or a personal listening device once every 5 years
• 65 years or older, you or your spouse/adult dependent have a documented hearing loss but have a higher income – you may be eligible for funding towards 1 hearing aid or a personal listening device once every 5 years.

Read more about AADL benefit eligibility

Hearing aids purchase process

Assessment

Before you can request hearing aids, you must have a complete hearing assessment. This assessment may be done by an AADL vendor or by an audiologist working for Alberta Health Services. Once a diagnosis is made and any possibility of medical intervention ruled out, you may proceed to discuss your hearing aid options.

Counselling

The hearing professional will use the information from the assessment to make recommendations regarding your hearing aids.

• Find an approved AADL hearing aid vendor

Fitting

When the hearing aids are ready, an appointment is made to fit the devices. The devices are checked for proper fit and comfort, and the aids are programmed to meet your specific hearing needs.

You will also receive instruction on the proper care, use and maintenance of your hearing aids. At the fitting, the vendor will ask you to pay your cost-share portion and any upgrade costs, if applicable.

• Read more about AADL cost sharing

Trial period

You will be given a minimum 28-day trial period with the hearing aids. Should you have any questions or concerns, please discuss them with your vendor.

Validation Certificate

After your trial period, you will sign an AADL Validation Certificate if you are satisfied with your hearing aids. If you are not satisfied, do not sign the Validation Certificate. You may continue your trial with further adjustments, or you may return the hearing aids.

AADL billing by the vendor

Once you have signed the Validation Certificate or returned the hearing aids, your vendor will submit a claim for the equipment and/or services they have provided through the Alberta Blue Cross online health portal.

Ensure you do not sign the Validation Certificate until you are completely satisfied with your hearing aids.

Hearing aid replacement

AADL will replace a hearing aid if:

• your degree of hearing loss or physical condition has changed so much that the device is ineffective
• your ability to operate the controls has diminished to the point where it is impossible for you to use the device
• after 5 years of use, the benefit of repair is not cost effective

Hearing aid repairs

AADL will provide funding towards the cost of repairs once per year for each device registered with AADL. All repairs come with a 1-year manufacturer’s warranty.

Funding for earmolds

AADL will provide funding towards the cost of replacement earmolds for those individuals who are fit with behind-the-ear style hearing aids.

For replacement quantities and frequencies, ask your vendor.

Returns within trial period

If you return your hearing aids at the end of the trial period, there will be no charge to cost-share exempt clients – AADL pays the vendor for services rendered.

Non-exempt clients will have to pay for earmolds and custom accessories that cannot be returned to the manufacturer.

Homecare bed benefits

Eligibility

To get a bed or bed equipment through AADL, you must first be assessed by an AADL authorizer and then eligibility for equipment is decided.

The person who needs the equipment:

• must be an Alberta resident with a valid Alberta Health Care Insurance Plan card
• requires equipment due to a long-term disability, chronic illness or terminal illness
• spends 80% of their time in bed and/or are end-stage palliative

The authorizer identifies the needed equipment, the client signs the Client Consent form and is made aware of the cost-share portion, if required. Then the equipment is ordered and delivered.

Beds and accessories are provided as a package or individual items. A bed package includes a homecare bed (power), a pressure reduction mattress, and bed rails.

Bed equipment is not provided to people in acute care facilities or continuing care centres, and may be new or recycled.

Ownership of equipment

The AADL program retains full ownership of the equipment. The equipment is not for resale and must be returned to the vendor if:

• no longer required
• if itneeds to be replaced
• if the person using the equipment moves out of Alberta, or
• the client becomes ineligible for the benefit.

Once the equipment is no longer required, contact the vendor to arrange pick up.

• Call Eco Medical Equipment toll-free within Alberta at 1-800-232-9450 or in Edmonton at 780-483-6232.