What is covered or not covered by OHIP?
What are insured services?
Services that are listed in the Health Insurance Act and the Schedule of Benefits are publicly funded under OHIP, so long as the service is being provided to an insured person. The OHIP insured services are billed to OHIP at 38% of the of the uninsured rates.
What are uninsured services?
These are services provided by physicians that are not funded by OHIP (e.g. prescription refills over the phone, copy or transfer of medical records, etc.). This also includes services provided individuals who are not insured under OHIP.
Where can I find more information?
Please see the CPSO article on uninsured services.
How are uninsured fees determined?
We use the OMA fee schedule for uninsured services. The fees in the schedule are calculated by adjusting for inflation.
We will inform you of the fee before the procedure.
Your Health - Votre Santé 