What the 3203 is for
ODSP’s Hearing Aid Benefit helps recipients, their spouses and dependent children, and some others, pay for hearing aids and related items and services. The standard benefit runs through the Hearing Aid Benefit Authorization Form. The 3203 is for requests outside it, which ODSP’s directive allows where a medical indication exists.
The directive gives examples such as advanced hearing aids, and tinnitus alongside hearing impairment where the prescriber indicates the need. The Director and managers in the ministry make the decision.
Who completes it
Only a registered ADP hearing aid authorizer may complete Sections A to C. The applicant, or someone lawfully authorized to sign for them, signs the declaration and consent in Section D. Without that signature the request isn’t processed. A family physician doesn’t complete the form.
How to fill in Sections A to C
Section A, Applicant Information
Enter the applicant’s name, date of birth and ODSP member ID, and the invoice number from the Hearing Aid Benefit Authorization Form.
Section B, Authorizer and Vendor Information
Give your ADP registration number, your CASLPO or AHIP member number, and the vendor’s name, ADP registration number and contact details.
Section C, Request
Describe each service, device or item requested and its cost. In the clinical determination and rationale, explain why the standard benefit doesn’t meet the applicant’s need, citing the assessment and audiogram, and any condition such as tinnitus. Sign and date it.
Common reasons it’s delayed or refused
- No copy of the Hearing Aid Benefit Authorization Form attached.
- A rationale that names the device without explaining the medical indication.
- Section D unsigned.
- Items dispensed before approval, which the form doesn’t permit.
Submitting and who pays
The authorizer mails the form and the authorization form copy to the ODSP Hearing Aid Benefit Program (Exceptional Circumstances) at the Toronto address printed on it. The ministry sends a decision letter to both the authorizer and the applicant.