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what does ontario health insurance cover

Health Services

What's Covered by OHIP ?

OHIP covers a wide range of health services. A brief description of insured services follows below. For more details, please contact your nearest ministry office.

Services in Ontario

What services does my Ontario health coverage cover?

The ministry covers a wide range of health services; however, it does not pay for services that are not medically necessary, such as cosmetic surgery.

The ministry covers all insured medically necessary services provided by physicians. Physicians may bill you for uninsured services or if you miss an appointment or your health card is not valid. You may contact the ministry if you have questions about charges for uninsured services.

Other Health Care Providers :

Services provided by podiatrists are partially covered under OHIP. The ministry pays part while you must pay for the extra costs. You may need to pay the full or partial cost of services provided by other health care providers, such as physiotherapists. You may contact the ministry if you have questions about services provided by other health care providers.

Dental Services in Hospital :

The ministry pays for some dental surgery, when it is done in hospital. You must pay the cost of regular dental services in a dentist's office.

An eye examination is covered by OHIP once a year for persons under 20 and those 65 and over. OHIP also covers a major eye exam once every 12 months for persons aged 20 - 64

who have medical conditions requiring regular eye examinations (refer to OHIP Bulletin 8089 or to Changes to OHIP Coverage for Eye Care Services ).

Northern Health Travel Grant :

You may be eligible for a Northern Health Travel Grant to help pay transportation costs if you live in northern Ontario and must travel long distances for specialty medical care.

For more information on the Northern Health Travel Grant program, call 1 800 461-4006 (for service in English)

or 1 800 461-1149 (for service in French).

Services in Other Canadian Provinces and Territories

Most of your Ontario health coverage benefits can be used across Canada. The province or territory you are visiting will usually bill Ontario directly. If you have to pay for health services you receive in another part of Canada, you can submit your receipts to your local ministry office to be considered for reimbursement.

Prescription drugs from pharmacies, home care services, ambulance services and long-term care services provided in other provinces and territories are not covered.

Services Outside Canada

For people travelling outside Canada, the ministry pays a set rate for emergency health services. Emergency health services are those given in connection with an acute, unexpected condition, illness, disease or injury that arises outside Canada and requires immediate treatment. Ambulance services are not covered.

Ontario residents are encouraged to purchase supplementary insurance when traveling outside Canada as many emergency health services provided outside the country cost much more than OHIP may pay.

Category: Insurance

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