Is Physiotherapy covered by OHIP?
We want to help!
We want to be your resource for the most up-to-date information regarding your health in Ontario. Here is our guide to OHIP coverage for physiotherapy treatments in Ontario.
What is OHIP?
The Ontario Health Insurance Plan (OHIP) is only available at a number of clinics throughout the province. This means that they are operated by public hospitals, Local Health Integration Networks (LHIN), Family health Teams or Community Hospitals and must meet certain standards in order for patients to receive their services without paying out of pocket expenses.
How to get OHIP funded physiotherapy services!
The Ontario Health Insurance Plan (OHIP) is one way to get free physiotherapy care in your community. Eligible patients can apply for this program through their doctor or nurse practitioner. After being referred, you'll be assessed and diagnosed by the clinic's professionals before developing an individualized treatment plan based on what they find out about how best to treat your condition(s). Treatments will end when your goals have been achieved, or when you can achieve your goals on your own, or through a home exercise or community plan.
It is important to note that a referral from your doctor or nurse practitioner does not
automatically mean you are approved for physiotherapy under this program.
What is covered?
OHIP covers the cost of in-clinic and virtual physiotherapy for youth, seniors (65+), adults with chronic conditions or to address a new injury, fall, accident or surgery, or situations where symptoms have become worse and affect function. There's no set limit on how many treatments you can receive - this depends entirely upon your individualized treatment plan which will be customized based off what progress has been made so far plus an additional amount if necessary!
To Qualify for physiotherapy under OHIP you must meet one or more of these criteria…
- a long-term care resident who is age 18 or older
- a resident age 18 and older who have been discharged from an Ontario hospital after overnight stays within the last 12 months
- receiving income via Ontario Works or ODSP programs (such as disability support)
- 65 years old with homecare requirements due to illness/injury that require in-home visits by a qualified practitioner.
What is not covered?
OHIP does not cover physiotherapy if you want to maintain an existing level of function or ability to move, need specialized services (e.g., for stroke and heart attack recovery), or currently receive other healthcare funded through auto insurance/WSIB programs.
An Ontario Health card is required for to be eligible for OHIP Physiotherapy, unless you are
approved for Ontario Disability Support (ODSP) or Ontario Works (OW).
Finding OHIP offices/clinics near you!
The following is a list with links about where one can find information on approved establishments which operate under contract with provincial healthcare providers:
Don’t have OHIP covered Physiotherapy near you?
Without OHIP coverage, physiotherapists are still able to help you. At Houle Healthcare we provide direct billing to most insurance providers. Our direct billing is pain free. We are able to direct bill through many insurance companies. Contact us today to find out how we can help you with your health and wellness goals.