WSIB Health Care Benefit Calculator
Understanding your medical coverage and benefits after a workplace injury or illness
The WSIB Health Care Benefit Estimator helps Ontario workers understand the comprehensive medical coverage available through the Workplace Safety and Insurance Board (WSIB) following a work-related injury or illness. WSIB pays for all approved health care costs related to your claim, even if you have not missed time at work and even if you have other insurance coverage .
Your primary health care provider will guide you to appropriate treatment that WSIB covers. If you need additional help finding a specialized provider, you can search WSIB's programs of care directory or community mental health network psychologist directory for registered providers in your region .
WSIB Health Care Benefits Overview
WSIB provides comprehensive health care benefits to support your recovery. Each claim is treated separately, and the amount of financial assistance varies depending on the specific benefit you are approved for . The following health care benefits are available:
Medical Treatment
- Doctor's visits and specialist appointments
- Surgery and surgical procedures
- Hospitalization and emergency care
- Physiotherapy and rehabilitation
Prescription Drugs
- Claim-related medications
- Direct billing to WSIB at most pharmacies
- Reimbursement for out-of-pocket costs
Medical Devices & Equipment
- Assistive devices (walkers, crutches)
- Braces and supports
- Orthotics and prostheses
- Adjustable bed frames and mattresses
- Wound care supplies
Additional Benefits
- Reasonable travel and accommodation expenses
- Special clothing or footwear costs
- Transportation to health care appointments
Prescription Drug Benefits
WSIB's drug benefit program covers medications prescribed for work-related injuries or illnesses . The WSIB drug benefit program covers prescription and over-the-counter products that are classified as life-sustaining products (such as insulin, iron) and/or support the patient's return to work and improvement in function. All products paid by the WSIB drug benefit program require prescriptions, including over-the-counter products .
How Prescription Coverage Works
- Most pharmacies can bill WSIB directly online for claim-related medications
- Pharmacies use TELUS Health as the electronic drug adjudication provider
- If a pharmacy cannot bill directly, you can be reimbursed by completing the Medication Reimbursement Form (PDF 0806A) and submitting your receipts through the WSIB website
- A maximum 100-day supply for maintenance medication can be dispensed per prescription
- Vacation supply up to 200 days may be granted for out-of-province travel
Pharmacy Billing Information
Pharmacies should note the following to complete prescription transactions :
- Insurer: TELUS (formerly Assure Health)
- Carrier ID: 49
- Group ID: 2000
- Client ID: WSIB claim number + 01
Health Care Equipment and Supplies
WSIB may authorize the purchase of health care equipment and supplies when an injured worker requires these products as a result of a work-related injury or disease . Health care equipment and supplies are products used as a treatment or functional aid during recovery, or to improve or maintain the worker's independent living .
Eligible Equipment Includes
- Crutches and tips
- Back rests (e.g., Obus formes/seats)
- Wrist supports and splints
- Genito-urinary supplies
- Toilet seats and commodes
- Tub stools and grab bars
- Walkers and accessories
Important: Before purchasing new or replacement health care equipment, workers should get approval from WSIB for the equipment, the cost, and the supplier. If WSIB does not authorize the purchase, they are not responsible for the cost .
Preferred Suppliers
Workers are expected to purchase health care equipment and supplies from preferred suppliers that have entered into an agreement with WSIB. Using preferred suppliers ensures the worker will not have to pay out-of-pocket, as WSIB pays the supplier directly .
Clothing Allowance Benefits
If you wear or use a medical device (such as a brace, wheelchair, or prosthesis) because of your work-related injury, you may be eligible for an annual clothing allowance to repair or replace clothing damaged by your device .
Clothing Allowance Eligibility Criteria
- You have reached maximum medical recovery (MMR) and have a permanent impairment/disability that results in either a non-economic loss (NEL) benefit or a permanent disability (PD) benefit
- WSIB has authorized and/or supplied the device
- You have worn the device for one full year after receiving the permanent impairment/disability benefit
- You apply annually for a clothing allowance by submitting a written application
Clothing Allowance Calculation
Clothing allowances are calculated based on the number of hours per week the worker uses the device :
| Hours Used Per Week |
Percentage of Benefit |
| Less than 15 hours | 0% |
| 15 - 19 hours | 50% |
| 20 - 24 hours | 75% |
| More than 25 hours | 100% |
Devices Causing Major Damage
The following devices qualify for major damage clothing allowance :
- Back brace (Harris-type rigid frame, rigid plastic with steel stays)
- Back support or corset (canvas belt/corset with steel stays)
- Leg prostheses worn at or above the ankle
- Custom-made knee brace
- Permanent leg brace
- Manual wheelchair
Devices Causing Minor Damage
The following devices qualify for minor damage clothing allowance :
- Cervical brace
- Arm prosthesis worn at or above the wrist
- Arm brace
- Wrist gauntlet(s)/brace(s)
- Forearm-supported crutches
- Off-the-shelf knee brace
- Power wheelchair
- Under-arm crutches
Functional Abilities Form (FAF)
The Functional Abilities Form is a tool used by WSIB to assess an individual's functional abilities following a workplace injury or illness. A qualified healthcare professional (doctor, physiotherapist) completes the form, identifying the worker's ability to walk, stand, sit, lift, and perform other work-related tasks . The form helps inform decisions about return-to-work plans and disability benefits.
Frequently Asked Questions
Because assuming can leave you paying out of pocket. This WSIB health benefits calculator shows you what medical costs are covered — prescriptions, equipment, transportation, even clothing damaged by braces or wheelchairs. No surprises when you need treatment.
This WSIB medical expense estimator is for workers with an approved WSIB claim. Whether you missed work or not, if you need prescriptions, physiotherapy, medical equipment, or travel to appointments, this tool helps you understand what WSIB will cover.
100% free. No sign up, no credit card, no hidden fees. This WSIB prescription coverage calculator works for any worker with an active claim. It costs nothing to estimate your medication coverage, clothing allowance, or transportation reimbursements.
No way. This WSIB medical equipment approval tool does not save or share anything. No name, no claim number, no medical details. Your answers stay in your browser. We never see them and we never sell your data. Completely private.
Yes. This Ontario WSIB health benefit tool follows official WSIB rules. That means prescription coverage through direct pharmacy billing, the clothing allowance for device users, transportation to medical appointments, and the requirement to get approval before buying equipment. It won't approve your expenses, but it tells you what you can claim before you pay out of pocket.
