Surgical Stockings / Brassieres
Surgical stockings and brassieres are specialized medical garments prescribed to assist in recovery or to manage health conditions such as poor circulation, lymphedema, or post-surgical healing. Health plans often reimburse a portion of the cost up to a defined annual or per-item limit.
How It Works
Compression stockings, also known as graduated pressure supports, help prevent swelling and improve blood flow, while surgical brassieres provide support after a mastectomy or other chest surgeries. Coverage under a Canadian health plan typically requires a physician's prescription and may specify a maximum number of garments per year, and a claim usually requires the garments to be supplied by an approved provider. The prescription must carry an eligible diagnosis from an approved prescriber such as a physician, nurse practitioner, occupational therapist, or podiatrist/chiropodist, and the itemized receipt must include the patient name, provider information, the date of service, and a detailed description of the item including the gradient, or compression, factor.
Example:
Picture an Ontario plan member with a physician-diagnosed circulation condition who buys a pair of graduated-compression surgical stockings from an approved supplier. To get reimbursed, they submit an Extended Health Care claim form with the diagnosis, the gradient (compression) factor, confirmation of whether the stockings are custom-made or off-the-shelf, and an itemized receipt. Because the provincial Assistive Devices Program may fund part of the cost for lymphedema, they first check provincial eligibility and attach that statement so the insurer can coordinate benefits on the remaining amount.
What to Watch For:
A medical referral on its own is not a diagnosis and is not enough on its own for a surgical stocking claim, so a separate diagnosis is required in addition to the referral. If a provincial program is helping to cover the cost, the insurer requires a statement confirming the amount paid so benefits can be coordinated. Tax treatment differs by garment type, as well. For CRA medical expense tax credit purposes, compression stockings with a therapeutic function for a limb condition are eligible under paragraph 118.2(2)(i) of the Income Tax Act and need no prescription or written certification, whereas the CRA has ruled that special undergarments worn to hold an external breast prosthesis in place after a mastectomy do not qualify, because no provision in the Regulations permits it.
