Third Party and Uninsured Services

The Ontario Health Insurance Plan (OHIP) provides coverage for a vast majority of physician services; however, there are some services that are not covered. Physicians are pleased to offer these valuable services; however, the responsibility for payment lies with the patient or the third party requesting the service. Quality health care, medical advice and timely access are priorities that Ontario’s physicians intend to honour. Speak with your physician for more information about other health care services that are not covered by OHIP.

EXAMPLES OF SERVICES NOT COVERED BY OHIP

Medical Services

  • Routine eye examinations for patients 20 – 64 yrs of age
  • Examinations/diagnostic tests necessary to satisfy requirements requested by employers, insurance companies, government agencies, etc.
  • Pre-adoption examinations
  • Prescription renewals without a visit
  • Travel medicine advice and services for travelling outside of Canada
  • Telephone advice if initiated by the patient
  • Cosmetic procedures and related examinations and diagnostic tests

Completion of Forms and Medical Records

  • Medical/legal reports
  • Federal government forms
  • Certificates for the purpose of travel, immigration, employment, etc.
  • Driver’s/aviation medical exam and other licensing forms/certificates
  • Insurance forms, reports and certificates, such as:
    • Disability certificate
    • Treatment plan
    • Insurance medical examination reports
  • Completion of work and school related forms/notes, such as:
    • Sick or back-to-work notes
    • Admission to day care/schools/ recreational
    • Employer requested reports/forms (e.g., form physicals)

Administrative Services

    • Copying medical records, reports and letters at the patient’s request
    • Transfer or summary of medical records at the patient’s request
    • Missed appointments without sufficient notice

Block Fees

A block fee is defined as an optional flat fee charged by a physician for a predetermined set of services not covered by OHIP for a specific period of time. Not all physicians offer a block fee due to the nature of their practice and charge for each uninsured service when rendered. Speak to your physician for more information on block fees.