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  1. Schedule of Benefits and fees. Get the latest Schedules of Benefits for OHIP covered services. This page is intended for health care providers. Learn more about services covered by OHIP.

    • Bulletin 220502

      For physicians interested in joining or becoming a Family...

    • Services Covered by OHIP
    • Doctors
    • Hospital Visits and Stays
    • Laboratory Testing
    • Abortion Services
    • Dental Surgery in Hospital
    • Optometry
    • Podiatry
    • Ambulance Services
    • Travel For Northern Ontario Residents

    OHIP covers part or allof the following services: 1. visits to doctors 2. hospital visits and stays 3. laboratory testingin community labs or hospitals 4. medical or surgical abortions 5. eligible dental surgery in hospital 6. eligible optometry(eye-health services) 7. podiatry(foot-health services) 8. ambulanceservices 9. travel for health service...

    Whether you visit your doctor, or if you see one in a walk-in clinic, OHIPcovers the full cost of your services – as long as they’re medically necessary. Learn about the services doctors provide. Find a doctor.

    If you need to go to the hospital, OHIPcovers: 1. doctor and nursing services 2. services to diagnose what’s wrong (such as blood tests and x-rays) 3. medications for in patients (once a patient is discharged, prescribed medications are not covered) 4. some medications for out patients (certain limited medications are provided to out-patients for h...

    OHIPcovers lab tests taken in hospitals that are medically necessary. Hospital patients should have their tests taken at the hospital to avoid any possible out-of-pocket charges. OHIP also covers medically necessary lab tests taken in non-hospital settings, such as community labs. Read the full list of covered tests in the community setting. Non-ho...

    OHIP covers the cost of: 1. surgical abortions that take place in a hospital or clinic 2. Mifegymiso(a pill that induces an abortion in early pregnancy), if you have a prescription from your doctor Contact an abortion clinic near youfor more information about ending a pregnancy.

    Some dental surgeries need to be performed in a hospital because they are complex and/or you have another medical condition that needs monitoring during the procedure. OHIPcovers in-hospital dental surgeries such as: 1. fracture repair 2. tumor removal 3. reconstructive surgeries 4. medically necessary tooth removal (prior approval by OHIPis requir...

    Children and youth 19 years old or younger are eligible for the following OHIPcovered services: 1. 1 major eye exam(for vision and general eye health) every 12 months 2. any minor assessments needed If you are 20 years old or older, and you have an eligible medical condition affecting your eyes, OHIPwill cover: 1. 1 major eye exam for you once ever...

    OHIP covers between $7-16 of each visit to a registered podiatrist up to $135 per patient per year, plus $30 for x-rays. You will need to pay for the remainder of the cost of each visit. Surgeries performed by podiatrists are not covered by OHIP. Find a registered podiatrist.

    If you need an ambulance for a medical emergency, OHIP covers part or all the costs depending on the circumstances.

    If you have to travel long distance for specialized medical care and live in one of the following areas, OHIPmight help pay for your travel and accommodation through the Northern Health Travel Grant: 1. Algoma 2. Cochrane 3. Kenora 4. Manitoulin 5. Nipissing 6. Parry Sound 7. Rainy River 8. Sudbury 9. Thunder Bay 10. Timiskaming Find out if you qua...

  2. Nov 17, 2022 · The average cost per service varied considerably across the different specialty groups. Costs ranged from $52.36 and $56.02 for dermatology and family medicine to $213.46 and $238.50 for thoracic/cardiovascular surgery and neurosurgery, respectively.

  3. Dec 1, 2022 · Most physicians can bill the government up to $80 per video visit with a patient under the Ontario Health Insurance Plan (OHIP). During the pandemic, the province allowed doctors to bill the...

  4. Jan 13, 2023 · Only 11 per cent of Ontario doctors charged no fees at all for uninsured services. The average annual block fee rate was $106 per individual and $194 per family.

  5. ensure that fees for individual uninsured services are commensurate with the nature of the services provided and the physicians professional costs, giving consideration to the recommended fees set out in the Ontario Medical Association’s Physicians Guide to Uninsured Services (“the OMA Guide”) and any recommended fees set out by professional spe...

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  7. Apr 1, 2022 · For physicians interested in joining or becoming a Family Health Organization (FHO), monthly registrations for entry into a FHO will be changed from the current 20 per month in areas of high physician need to the following: In fiscal 2022/23 60 physicians per month into two streams:

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