What Is an Uninsured Service?
Uninsured services are medical or administrative tasks not covered by OHIP. Learn what they are, common examples, and why patients pay for them directly.
When you visit your primary care provider, most routine medical care is covered by OHIP — Ontario's provincial health insurance plan. However, not every service a physician provides falls under that coverage. Services that are not covered by OHIP are known as uninsured services, and the cost is paid directly by the patient.
Why are some services uninsured?
The provincial government does not reimburse physicians for services that are not deemed medically necessary under OHIP guidelines. Because these tasks still require your physician's time, expertise, and administrative resources, the cost is passed directly to the patient.
Common examples of uninsured services:
- Sick notes for work or school
- Attending Physician Statements (APS) for insurance or disability claims
- Disability Tax Credit (DTC) forms
- Medical clearance letters for travel, employment, or legal purposes
- WSIB forms and workplace injury documentation
- Prescription renewals requested outside of an appointment
- Missed appointment fees
- Photocopying or transferring medical records
- Third-party examinations requested by employers or licensing boards
What does this mean for you as a patient?
Your primary care provider is required to inform you of the cost before providing any uninsured service. Fees are often based on Ontario Medical Association (OMA) guidelines and vary by provider and service type.
💡 Good to know: The quality of care you receive does not depend on whether you are enrolled in an Annual Plan or how you choose to pay for uninsured services.