ACADEMY FOOT AND ORTHOTIC CLINICS SHARES MANULIFE FINANCIAL INSURANCE GUIDLINES FOR ORTHOTICS

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

orthotic.

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.

Who’s authorized?

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

and pattern).

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

abnormalities.

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

laser scanning.

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.

Group Benefits

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

your orthotic.

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

answers.

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.