What is Not Covered by Ohip?

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The Ontario Health Insurance Plan (OHIP) is a foundational part of health care for residents in Ontario, providing coverage for many essential medical services. However, not everything is covered under OHIP. Understanding the limitations ensures residents can plan ahead for medical expenses that they might incur. This article delves into services and instances where OHIP coverage does not apply.

Services Not Covered by OHIP

As of the knowledge cutoff in 2024, here are several common services that are not covered by OHIP, which you may need to pay for out of pocket or obtain supplementary insurance to cover:

Service Type Description Reason for Non-Coverage
Cosmetic Surgery Procedures that are not medically necessary, such as face-lifts, liposuction, or breast augmentation. Considered elective and for aesthetic purposes only.
Vision Care Routine eye exams for adults aged 20-64, eyeglasses, and contact lenses. Limited coverage; only provided under specific circumstances or for certain age groups.
Dental Care Routine dental services such as cleanings, fillings, extractions, and braces. Typically not covered unless surgery must be done in a hospital.
Prescription Drugs Medications prescribed outside of hospitals. Coverage is available through separate drug programs but is not part of basic OHIP.
Podiatry Certain foot care services by podiatrists or chiropodists. Limited coverage, with some restrictions on the number of visits.

This table does not encompass every uninsured service, but these categories represent areas where individuals typically seek supplemental insurance coverage.

Extended Health Care Services

Many Ontarians choose to purchase extended health care insurance to cover services that are not covered by OHIP. Here’s what is often included:

  • Prescription medications
  • Dental care
  • Private or semi-private hospital room accommodation
  • Physiotherapy
  • Chiropractic services
  • Massage therapy
  • Alternative therapies such as naturopathy and acupuncture
  • Travel insurance for health care services outside Ontario

If these services matter to you or if you frequently use them, extended health care insurance can provide peace of mind and protect against high out-of-pocket costs.

Understanding Your Coverage and Options

It’s important to understand the exact details of your insurance coverage. You can check the OHIP website or contact their helpdesk for the most accurate and up-to-date information.

For any services not covered by OHIP, you should consider looking into private or employer-provided health insurance plans to ensure you are appropriately protected.

In some cases, there may be community programs or charity organizations that can help subsidize the cost of medical services not covered by OHIP. It’s always worth researching local resources and discussing with your healthcare provider for any leads on such assistance.

Frequently Asked Questions Of What Is Not Covered By Ohip?

Does Ohip Cover Prescription Medications?

No, OHIP generally does not cover the cost of prescription medications outside of hospitals.

Can Ohip Pay For Dental Services?

OHIP does not cover dental services, except for some dental surgeries done in hospital.

Is Vision Care Part Of Ohip Benefits?

Routine eye exams for adults 20-64 are not covered by OHIP.

Are Cosmetic Surgeries Covered By Ohip?

Cosmetic surgeries not medically necessary are not covered by OHIP.

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