ACADEMY FOOT AND ORTHOTIC CLINICS SHARES MANULIFE FINANCIAL INSURANCE GUIDLINES FOR ORTHOTICS
posted: Feb 10, 2014.
Buying custom-made orthotics – what you
need to know
If you’ve been prescribed orthotics this information will
help guide you through your purchase. It’s important to
ask questions and keep yourself informed throughout
the process, to ensure you get a suitable custom-made
Please note that some of the examples listed on the
following pages may not pertain to your benefit plan.
Consult your benefit plan for details.
Custom-made orthotics are prescribed by specific
healthcare professionals, which include physicians,
podiatrists and chiropodists. They will diagnose whether
or not an orthotic would be beneficial to your situation.
Many suppliers offer orthotics, but podiatrists,
chiropodists, pedorthists and certified orthotists are
recognized as foot care specialists. These particular
professionals are trained specifically to assess, design,
manufacture and fit foot orthotics.
The prescribers and providers listed above are licensed
and governed by either a provincial or national body,
and are subject to standards of practice. This, along
with each body’s Code of Ethics, helps ensure their
accountability and your protection.
What to expect for your assessment
After being prescribed an orthotic, you’ll need to visit
one of the providers listed above for an assessment.
A provider will guide you through an extensive
evaluation to ensure an orthotic is the best option
and that it’s properly designed. You should expect the
orthotic provider to perform the following:
Medical History Review: a complete investigation
and documentation of your medical history, symptoms
and previous injuries. He or she will also take into
consideration your lifestyle (occupation and activities) as
well as your current and past footwear (fit, style, wear
Examination: a hands-on evaluation of the lower limbs
including foot structure, alignment, strength, range of
motion, soft-tissue damage as well as identifying any
Gait Analysis: The provider will observe you walking to
identify accommodations or abnormalities. For instance
whether you favour one leg or the other.
Orthotic Evaluation: The provider will determine
treatment options and explain how the treatments will
address your specific needs.
Casting: Taking a mould ensures that your orthotic is
made with all of the contours and structure of your foot.
A proper cast is essential to create a truly custom-made
orthotic. Casting techniques include: foam box casting,
plaster of paris slipper casting, contact digitizing and
Having your footprint taken on an inkpad or using your
shoe size to provide a prefabricated insole is not
considered casting and does not qualify as custom-made.
Manufacturing: For an orthotic to be claimed under
your benefit plan, it must be constructed from scratch
and fabricated directly from your mould. You can expect
at least one-week between your initial assessment and
your fitting appointments.
Some providers will supply what’s called a “best fit”
footbed. These are prefabricated inserts that are
matched to your cast, however the cast is never used in
the actual manufacturing of the orthotic. These are not
considered custom-made and would not qualify under
your benefit plan.
Orthotics that aren’t manufactured specifically to your
needs can result in pain by overstressing your muscles,
bones and joints.
Dispensing: Custom-made orthotics should be fitted
specifically for you and your footwear. The provider
should evaluate how you walk while wearing the
orthotics. You should also be offered a follow up
appointment within 2-6 weeks of receiving your orthotic.
Education: The provider should educate you on things like
breaking in your new orthotics, lifespan, as well as how
they should fit. You should also be made aware of any
warning signs that the orthotics are not working properly
and instructed to return if you experience any problems.
Be cautious – things to be aware of when
buying an orthotic
A provider should have the capacity to modify
Exercise caution when considering the purchase of
orthotics from exhibits at trade shows, home shows
or sportsman shows. If there’s a problem with the
orthotic, returning it could be a problem, not to
mention they probably aren’t custom-made.
Exercise caution when considering the purchase from
kiosks or booths in malls, department stores or over
the internet for the same reasons.
Be wary of people who come to your home, or
conduct group screenings of employees or family
members without a proper evaluation.
“Two for the price of one” deals or “free giveaways”
with your purchase are not allowed under the code
of ethics that regulated providers and dispensers are
bound by. Some providers will use these “freebies” to
inflate the price of an orthotic.
Be suspicious of any provider that can’t answer your
questions clearly or gives vague and ambiguous
Question a provider who strongly recommends you
see a doctor of his or her choosing for a referral
instead of your family physician.
Question a provider who recommends your whole
family could benefit from orthotics without having
seen or assessed them individually.
Custom-made orthotics for children under 5 are
highly uncommon. Skeletal or soft tissue injuries
that require orthotic treatment don’t usually present
themselves until a person is older. If for some reason
they do need an orthotic, a medical doctor or
pediatric specialist must prescribe it.
Prescribers and providers should have the following
designations in their titles.
Physician – M.D.
Podiatrist – D.P.M.
Chiropodist – D.Ch. or D Pod M
Pedorthist – C.Ped. (C). or C Ped (MC)
Orthotist – C.O. (c) or CPO (c)
Check your benefits booklet to see which prescribers
your plan specifies.
If you feel pressured to purchase additional products
or are uncomfortable with the business practices of
the provider, consider another provider.
Don’t ever give the provider a signed claim form.
You are responsible for that claim submission and
the only way to be sure of what is submitted is to
complete it and mail it yourself.