What OHIP covers
Find out what services you can get through OHIP.
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Services covered by OHIP
OHIP covers part or all of the following services:
- visits to doctors
- hospital visits and stays
- medical or surgical abortions
- eligible dental surgery in hospital
- eligible optometry (eye-health services)
- podiatry (foot-health services)
- ambulance services
- travel for health services if you live in northern Ontario
Whether you visit your doctor, or if you see one in a walk-in clinic, OHIP covers the full cost of your services – as long as they’re medically necessary.
Learn about the services doctors provide.
If you need to go to the hospital, OHIP covers:
- doctor and nursing services
- services to diagnose what’s wrong (such as blood tests and x-rays)
- medications for in patients (once a patient is discharged, prescribed medications are not covered)
- some medications for out patients (certain limited medications are provided to out-patients for home use)
- accommodation and meals if you have to stay
- if you want a private or semi-private room, you or your private insurance will have to pay some or all of those hospital fees
OHIP covers the cost of:
- surgical abortions that take place in a hospital or clinic
- Mifegymiso (a pill that induces an abortion in early pregnancy), if you have a prescription from your doctor
Contact an abortion clinic near you for 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.
OHIP covers in-hospital dental surgeries such as:
- fracture repair
- tumor removal
- reconstructive surgeries
- medically necessary tooth removal (prior approval by OHIP is required)
OHIP covers the cost of one major eye exam (for vision and general eye health) every 12 months, plus any minor assessments you need, but only if you are:
- 19 years and younger
- 65 years and older
If you are 20 to 64 years old, and you have a specific medical condition affecting your eyes that requires regular monitoring, OHIP will cover a major eye exam for you once every 12 months and any follow-up appointments related to the condition. Covered conditions are:
- diabetes mellitus
- retinal disease
- visual field defects
- corneal disease
- recurrent uveitis
- optic pathway disease
OHIP may also cover a major eye exam if it has been requested for a specific reason by your doctor (they will need to give you a referral form).
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.
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, OHIP might help pay for your travel and accommodation through the Northern Health Travel Grant:
- Parry Sound
- Rainy River
- Thunder Bay
Find out if you qualify and how to apply to the Northern Health Travel Grant.
Services not covered by OHIP
OHIP does not cover:
- prescription drugs provided in non-hospital settings (e.g. antibiotics prescribed by your family doctor)
- dental services provided in a dentist’s office
- eyeglasses, contact lenses
- laser eye surgery
- cosmetic surgery
Protect your health card number
Only share your health card number with health care professionals who are entitled to have it, such as:
- nurse practitioners
You can use your health card as a form of identification for other reasons, but no one else can record or copy your health card number. If your health card number falls into the wrong hands, it could be used to access to your personal health information or for OHIP fraud.
Help prevent OHIP fraud
You can help stop someone who:
- knowingly uses an Ontario health card that is not theirs
- receives health services covered by OHIP but is not an Ontario resident
- knowingly gives false information to get OHIP when they know they are not eligible
To report suspected cases of OHIP abuse or fraud:
- call us anonymously at 1-888-781-5556
- send us an e-mail
We investigate every report and will cancel OHIP coverage if someone cannot prove they qualify for OHIP. We also refer suspected fraud to the Ontario Provincial Police for investigation and possible prosecution.