Ostomy Supply Reimbursement In Alberta

Alberta Aids to Daily Living (AADL) helps Albertans with a long-term disability chronic or terminal illness pay for essential medical equipment and supplies, including ostomy products.

Am I Eligible?

AADL may provide funding for ostomy supplies for clients:

With a chronic functioning colostomy, urostomy or ileostomy; and
Who have a permanent ostomy and are not expected to have a reversal within six months of the initial ostomy surgery.
who are pediatric clients and clients with an esophagectomy, cecostomy or fistula. (Must be assessed by NSWOC).
Be an Alberta resident with a valid Alberta Personal Health Care Number;
Be evaluated by a healthcare professional who is also an AADL approved Authorizer or Specialty Assessor (i.e. NSWOC); and
Meet specific eligibility criteria for the recommended benefit.

Individuals who are not eligible may include:

How to Apply

Before applying for AADL benefits, you need to be assessed by a health care professional, typically an NSWOC. They will determine your basic medical needs and whether you are eligible for the program and provide authorization for your ostomy supplies. AADL will not reimburse clients who purchase ostomy supplies before assessment and authorization.

Coverage

AADL provides coverage for ostomy supplies through their cost-share program, where Albertans pay 25% of the benefit-cost to a maximum of $500 per individual or family per year (July 1 to June 30). Coverage is raised to 100% at that point.

Clients may choose an upgraded ostomy supply item and pay the additional cost of this item. These additional costs are not included in the $500 cost-share maximum. Low-income Albertans and people receiving income assistance do not pay the cost-sharing portion. Read more…

Taxable Family Income

AADL Cost-Share

Client Cost-Share

Cost-Share Max, then 100% covered

Clients who do not qualify for the low-income exemption

75%

25%

$500

Low-Income Single, taxable income below $20,970

100%

Low-Income Couple with no children, taxable income below $33,240

100%

Low-Income Parents with children, taxable income below $39,250

100%

What Products Are Covered

AADL covers a comprehensive list of ostomy supplies:

One and two-piece ostomy appliances
Ostomy Pouches, drainable, closed, high output & urostomy
Skin Barrier Wafers / Flanges, flat, convex, extended wear
Pediatric ostomy supplies
Ostomy accessories include convex inserts, stoma collars, flange extenders, powder, skin barrier rings/sheets/seals, skin barrier paste/strips, ostomy tape,
Odour control (note: limited to 1 bottle/4 month)
Ostomy irrigation kits, sleeves
Continent ostomy dressing
Ostomy belt and hernia belt
Manufacturers covered include Hollister, Convatec, Coloplast, Salts, Safe & Simple, Marlen, B.Braun Medical, CUI/Fulcionel.
For a detailed product list, please see AADL Approved Product List.

What Products Are Covered

AADL covers a comprehensive list of ostomy supplies:

One and two-piece ostomy appliances
Ostomy Pouches, drainable, closed, high output & urostomy
Skin Barrier Wafers / Flanges, flat, convex, extended wear

Taxable Family Income

Clients who do not qualify for the low-income exemption

AADL Cost-Share

75%

Client Cost-Share

25%

Cost-Share Max, then 100% covered

$500

Taxable Family Income

Low-Income Single, taxable income below $20,970

AADL Cost-Share

100%

Client Cost-Share

Cost-Share Max, then 100% covered

Taxable Family Income

Low-Income Couple with no children, taxable income below $33,240

AADL Cost-Share

100%

Client Cost-Share

Cost-Share Max, then 100% covered

Taxable Family Income

Low-Income Parents with children, taxable income below $39,250

AADL Cost-Share

100%

Client Cost-Share

Cost-Share Max, then 100% covered

Pediatric ostomy supplies
Ostomy accessories include convex inserts, stoma collars, flange extenders, powder, skin barrier rings/sheets/seals, skin barrier paste/strips, ostomy tape,
Odour control (note: limited to 1 bottle/4 month)
Ostomy irrigation kits, sleeves
Continent ostomy dressing
Ostomy belt and hernia belt

Manufacturers covered include Hollister, Convatec, Coloplast, Salts, Safe & Simple, Marlen, B.Braun Medical, CUI/Fulcionel.

For a detailed product list, please see AADL Approved Product List.

Quantity & Frequency

You can only order a certain quantity of ostomy supplies every two months through AADL. (For example, 30 Skin Barrier Wafers every two months). However, an NSWOC can authorize amounts higher than the listed maximums.

Purchasing Ostomy Supplies

You are required to purchase your ostomy supplies from an approved AADL vendor. Approved vendors include home health care stores and pharmacies that sell ostomy supplies. AADL does not support online-only shops. Your authorizer will provide you with a list of at least three vendors, or you may choose from the approved vendor list.

Reimbursement Procedure

Your ostomy vendor will bill (via Blue Cross) the covered amount directly to AADL. At the same time, you will pay the remaining balance. You can claim the remaining balance on your income tax as a Medical Expense.

Contact Information:

ALBERTA HEALTH
ALBERTA AIDS TO DAILY LIVING (AADL)

Telus House
13th Floor, 10020-100 Street NW
Edmonton AB T5J 0N3

Phone: 780-427-0731
Toll-free: 310-0000 before the phone number (in Alberta)
Fax: 780-422-0968 or 780-424-0432

Disclaimer: The information contained in this page have been researched and sourced from a variety of provincial and federal sites. However information may change and we encourage individuals to check for updates of policies, plans and forms.

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