UNINSURED SERVICES

Uninsured services are those OHIP does not cover for Ontario residents. Therefore, patients must cover the cost. 

The Ontario Health Insurance Plan (OHIP) covers most aspects of your care; however, some medical and administrative services are not covered by OHIP and require separate payment. The typical cost of such services are enumerated below and are set in line with the guidelines set by the Ontario Medical Association (OMA) and the College of Physicians and Surgeons of Ontario (CPSO).

 

Payment can be made by electronic money transfer, cash or credit card (user fee applies). Invoice will be provided. The following list provides the cost of commonly uninsured services as determined by the Ontario Medical Association.

 

Payment will be required for all uninsured services prior to the note, service or renewal being sent or performed. Please allow 2-4 weeks for completion of forms, and allow 5 business days for medication renewal requests to be fulfilled. 

Block Fees

To reduce administrative overhead and provide a potential cost saving advantage to patients, we offer provide patients with the option of subscribing to an annual “block fee”.  Patients who subscribe will receive the services covered by the block fee at no additional cost.  Patients who do not subscribe will be asked to pay for uninsured services each time they are provided.

 

  • $250/year for families of two adults and up to 4 dependents

  • $100/year for each patient age 18 and up

  • $75/year for each patient under age 18 

What is Covered by the Block Fee? ($)

  • Prescription Renewal (without an appointment) ― 20.00

  • Uninsured Vaccine ― 15.00

  • Insurance letters/notes (prescription for orthotics/massage or other insurance-related letters) ― 20.00+

  • Sick Note ― 20.00

  • Back to Work, School or Daycare Note ― 20.00

  • Camp, Daycare or School Form ― 30.00

  • Short-term Disability Form ― 60.00

  • Electronic or Fax Transmission of Medical Records ― 35.00 and up (may vary based on length)

  • Children’s Aid Society (CAS) Application Form for Prospective Foster Parent ― 54.00

  • Death Certificate for Life Insurance ― 50.00

  • Revenue Canada, Federal Disability Tax Credit Form ― 50.00

  • Canada Pension Plan (CPP) Disability Medical Report Form ― 85.00

  • Medical Certificate for Employment Insurance Compassionate Care, Parental, or Sickness Benefits (INS5216B, INS5168, or INS5140) ― 30.00

  • Fitness Club Form ― 40.00

  • Immunization Records Replacement or Summary ― 20.00

  • Lost Referrals or Prescriptions ― 20.00

  • Pre-employment Certificate of Fitness ― 50.00

  • Travel Cancellation Form ― 40.00

  • Volunteer Form ― 27.00

  • Earwax removal  ― 35.00 (only OHIP covered if there is hearing loss and non-responsive to cerumenolytics OR OHIP covered if removal is for diagnostic and/or therapeutic purposes, effective October 1, 2019)

  • Urine pregnancy test ― 25.00 (only OHIP covered when an immediate determination of pregnancy is required to prevent imminent physical harm; blood pregnancy test is still OHIP covered, effective October 1, 2019)

 

What Isn't Covered by the Block Fee?

Any uninsured services not listed in the table above are not covered by the block fee. Common examples are listed below:

Additional Uninsured Services Not Covered by Block Fee ($)

  • Missed Appointment or cancelled/rescheduled less than 24 hours in advance ― 50.00/80.00

  • Missed Referral Consultation or Procedure or cancelled/rescheduled less than 24 hours in advance ― 100.00

  • Appointment Without Valid OHIP Coverage ― 40.00 -150.00

  • Pension Buy-Back Exam and Form ― 175.00

  • Attending Physician Statement ― 150.00+

  • Disability Report/Insurance Form (including long-term disability form, #OCF-3, #OCF-18 and #OCF-19 certificates) ― OMA rates, 140.00+

  • Driver’s Medical Examination Form (without physical exam/with physical exam) ― 56.05/150.00

  • Canada Pension Plan (CPP) Narrative Medical Report ― 185.00

  • Legal Reports ― OMA rates Letter at Patient's Request ― OMA rates

  • Liquid Nitrogen Treatment of Benign Skin Lesions & Warts not covered by OHIP ― 35.00-50.00/visit

  • Pap Tests (when not diagnostic or done earlier than OHIP-covered/recommended frequency) ― 115.00 (+lab fee)

  • Pre-op history and physical requested by surgeons and dentists ― 100.00 (effective October 1, 2019)

  • Private Insurance Form (including Life Insurance, Health Insurance and APS forms) ― OMA rates , 250.00+

  • TB Skin Test (1-step/2-step) ― 35.00/50.00

  • Third-party Physical Examination ― 175.00

  • Reviews, Legal Reports & Other Non-Insured Services ― OMA Rates

  • Letter at Patient's Request ― OMA Rates

How to Pay for Individual Uninsured Services and/or Block Fee

 For block fees and individual third-party charges, we will send you an invoice by email with instructions on how to complete payment online with a credit card.  If you prefer to not pay online with a credit card, kindly drop-off or mail us a cheque that clearly indicates the corresponding invoice number(s).  Cheques should be made out to the doctor or medical professional corporation listed on the invoice. Please note that we will not be accepting payments by debit or cash, or credit card in person.

 

How to Subscribe and Unsubscribe to the Block Fee

If you wish to subscribe to the block fee, please complete the form here and you will be sent an annual invoice automatically. To unsubscribe, please contact us to let us know.

 

Refunds

Refunds on block fee subscriptions are offered up to 60 days after activation or renewal of the subscription. Please note that if you received any uninsured services during this period and subsequently cancel your subscription, that we will invoice you for such services. No refunds are available on charges for individual services once provided.