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What it can cost when you need care out of province

In Canada we’re fortunate that when we need medical care we don’t have to worry about paying. However, that’s not always the case when you’re travelling out of your home province. Here’s what you should know about receiving care out of province and what it can cost you.

Tip:

You must show your valid Ontario health card prior to services being rendered. If you don't present your health card, the facility or the physician can bill you directly. 

For physicians’ services:

Physicians outside Ontario don't have to bill Ontario directly for their services, so you should ask the physician where their fees will be billed beforehand. 

  • If the physician bills OHIP directly, you shouldn't have to pay anything extra at the time of services.

  • If the physician doesn't bill OHIP directly, you will likely have to pay for the services at the time you receive them. To obtain reimbursement you will have to submit documents/invoices within 12 months of the treatment being rendered. (Click here for more information on getting reimbursed.) 

For public and private health facility services: 

All provinces and territories participate in reciprocal hospital billing agreements in publicly-funded hospitals, so a visit won't cost you a thing. OHIP does not cover payments to private hospitals or private health facilities outside Ontario.

  • Generally, any services you receive in a private clinic in Canada are not insured and OHIP will not reimburse you upon your return. (Except for the physician component of insured services.) 

  • If you're an inpatient in a public hospital while visiting another province or territory, you are eligible for OHIP coverage for the duration of your hospitalization up to a maximum of 12 months. 

Tip:

If you're studying, working or travelling outside the province, obtaining private health insurance is a good idea to cover unexpected ambulance rides or non-physician/non-hospital services you may need.

What services are NOT covered by OHIP out of province?

  • Treatment that is generally accepted, in Ontario, as experimental, for research or a study

  • Cosmetic surgery

  • Home care

  • Prescription drugs

  • Ambulance services

Tip:

If you have questions before you leave or while you are away contact your local ServiceOntario centre for answers.

Resource Center

Helpful links to the most useful lists and forms for health professionals.

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