Are orthotics covered by insurance in Ontario?

And how do you avoid paying $500 out of pocket?

You’ve been told you might need orthotics. Maybe your feet hurt, your knees ache, or your plantar fasciitis won’t quit.

Now you’re asking the real question:

“Is this going to be covered by insurance — or am I about to drop $500 out of pocket?”

At YFS (Your Form Sux), we don’t sell orthotics — but we do get asked this a lot. So here’s the no-BS breakdown of how orthotic coverage works in Ontario, and how to make sure you don’t get denied.

✅ Most Extended Health Plans in Ontario Cover Orthotics

The good news? Most private insurance plans in Ontario offer partial or full coverage for custom orthotics.

This typically includes plans from:

• Manulife
• Sun Life
• Green Shield
• Blue Cross
• Desjardins
• Canada Life (formerly Great-West Life)

Coverage usually ranges between $200–$500 per year, under categories like:

• “Medical equipment”
• “Orthopaedic devices”
• “Custom foot orthotics”

Some plans may also cover orthopaedic shoes — but that varies by provider.

⚠️ The Catch: You Need the Right Paperwork

This is where most people get denied. To qualify, most plans require:

• A prescription or referral from a recognized medical professional (MD, podiatrist, chiropodist — sometimes chiro or physio)
• A clinical biomechanical + gait assessment report — not just a foot scan
• An invoice from the provider that includes their credentials and the orthotic lab info
• Proof of customization — prefab or generic inserts won’t cut it

💡 Pro Tip: Ask for a pre-authorization form from your insurer before paying for orthotics. Saves you stress and surprises.

👟 What Counts as “Custom Orthotics”?

To get covered, your orthotics must be:

• Prescribed for your specific condition
• Custom-moulded using 3D scans, foam boxes, or casts
• Made by a certified orthotic lab
• Linked to a clinical assessment (not just “your arches are flat”)

Over-the-counter insoles, gel pads, or mall kiosk “fitters” don’t count. Insurance will not reimburse for generic devices — no matter how slick the sales pitch.

🩺 Who Can Prescribe Orthotics in Ontario?

Varies slightly, but most plans accept prescriptions from:

• Medical Doctor (MD)
• Podiatrist
• Chiropodist
• Chiropractor (some plans only)
• Physiotherapist (depending on policy)

At YFS: If we think you may benefit from orthotics, we’ll connect you with someone qualified — but only if it’s actually necessary.

💸 What Do Custom Orthotics Cost in Ontario?

Most run $400–$600, depending on:

• Materials used
• Whether you’re getting one or two pairs
• Clinical assessment or postural testing included
• Who makes and fits them

If your plan covers $500, it might cover the full cost — or only part if bundled with additional services.

🤔 Do You Even Need Orthotics?

Here’s where YFS takes a different path: We don’t assume foot pain = orthotics.

Instead, we:

• Assess how your feet, hips, and core actually move
• Rebuild arch control and ankle stability through training
• Refer for orthotics only if your foot pain truly needs outside support

Orthotics are a tool — not a default.

Bottom Line: Yes, Orthotics Are Often Covered — If You Do It Right

Before you drop hundreds on custom insoles, make sure you:

• ✅ Actually need them
• ✅ Get a proper movement and gait assessment
• ✅ Understand your policy coverage
• ✅ Have the right prescription + paperwork
• ✅ Use them as part of a bigger recovery plan — not just a crutch

Still not sure if orthotics are the right move?

Book a movement assessment at YFS — we’ll tell you what’s really going on, and help you make a smart call before you spend a dime on inserts.