FAQ045: When is physiotherapy covered by OHIP?

In some circumstances in Ontario, physiotherapy can be covered by OHIP

In Ontario, physiotherapy can be covered by our provincial health insurance (OHIP) for persons over 65 and under 19. For persons in these age categories, they can receive services for injuries that have just happened (acute injuries) or flare ups of long-standing injuries (for example back pain that you’ve had in the past but is flaring up right now).

If you are not in these age categories but have just been released from hospital from a stay that was at least overnight, you may be eligible for physiotherapy as well through OHIP. Being in hospital for long periods can cause us to lose muscle strength. Strength that we often need to handle all of our day-to-day tasks.

Not every clinic is an OHIP clinic

In order for a physiotherapy clinic to be covered by provincial health insurance, they would have had to submit an application when there was a call a couple of years ago. For successful applicants, they were given a contract (that lasts for 5 years I believe). This contract gave them an OHIP billing number that allows them to charge the government for services.

To see a physiotherapist through OHIP, you NEED a doctor’s referral

As I’ve talked about before, physiotherapists are primary care clinicians. What this means is that you don’t need a doctors referral to see us for an assessment. That being said, some insurance companies require a doctors note. ]

If you are seeking care through OHIP, you need the note. There is no way around it. In order for the clinic to process your paperwork for care, they need the referral.

There are usually a couple of different applicable clinics in every city. Calling the clinic or checking out their website is a good place to start.

Sorry! STAVE OFF isn’t an OHIP-funded clinic!

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Christina Prevett

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