OHIP Updated May 6, 2026 - Written by Krista DeKuyper
What Does OHIP Cover for Seniors in Ontario? (2026 Guide)
Senior citizens make up a surprisingly large percentage of the population in Canada. In fact, seniors make up about 19.5% of the population in 2026, a rapid increase from previous years. This percentage is projected to increase as time goes on, and that only means that healthcare in Canada is becoming more impactful on the population’s overall lifespan.
As a health insurance brokerage in Ontario, HealthQuotes understands the unique health challenges faced by Canada’s senior population. It’s because of these age-specific needs that older Canadians require more medical care than their younger counterparts. Furthermore, it is essential that seniors stay healthy and fit to enjoy their golden years.
Luckily, OHIP offers a growing variety of services for Canadians over 65 years old. OHIP coverage for seniors has improved steadily over the last decade, so today we’re uncovering valuable health services that OHIP covers for seniors in 2026.
What OHIP Covers for Seniors in Ontario
Once you turn 65 in Ontario, your OHIP coverage automatically expands. You keep everything you had before, plus you get added benefits that kick in just because of your age.
The core services OHIP covers for all Ontarians still apply: doctor visits, hospital stays, medically necessary surgery, lab work, X-rays, and specialist referrals. But here's what changes specifically at 65:
Prescription drugs covered through the Ontario Drug Benefit (ODB) program
Eye exams every 18 months (or annually if you have a qualifying eye condition)
Physiotherapy at government-funded clinics with a doctor's referral
Home care services coordinated through Ontario Health atHome
Additional vaccines, including Shingrix (shingles) for those aged 65 to 70
Colorectal cancer screening through the Ontario Breast Screening and ColonCancerCheck programs
OHIP does not automatically cover dental care, hearing aids, ambulance trips in all situations, or glasses. There are separate programs for some of these, which we cover below.
Key Takeaways
OHIP helps cover basics like prescriptions, eye exams, physio, and some home care
It doesn’t cover common needs like dental, ambulance, or many everyday health services
Even with the Ontario Drug Benefit Program, seniors can still have out-of-pocket drug costs
Healthcare needs—and costs—tend to increase with age, especially on a fixed income
Many seniors use private coverage to fill the gaps and avoid unexpected expenses
Table of Contents
4 Services OHIP Covers for Seniors in 2026
1 - Physiotherapy
If you are 65 and over and have been referred by a physician, OHIP will cover your physiotherapy costs. Mobility and flexibility are negatively affected as we age, which is why this coverage is so important. Keeping active with regular exercise helps us maintain our fitness levels in later years.
Additionally, the Ontario government has government-funded physiotherapy clinics that provide assessment and treatment services. This also includes rehabilitation following an injury or hospital stay.
If you are eligible, a registered physiotherapist will meet with you one-on-one to determine the best treatment plan and supervise the physiotherapy process.
To find out if you’re eligible, click here.
TLDR; Ontarians 65+ can get free physiotherapy through OHIP with a doctor’s referral, including rehab and personalized treatment at government-funded clinics.
Does OHIP Cover Ambulance for Seniors?
This one surprises a lot of people. Ambulance transportation is not fully excluded from OHIP. It is partially covered, but with conditions.
If an ambulance trip is deemed medically necessary, OHIP covers most of the cost. Seniors pay a co-payment of $45 for land ambulance. Air ambulance carries a higher co-payment of $240. If the trip is determined to be non-emergency after the fact, you could be billed up to $240 for a land trip or more.
Some seniors pay nothing at all. If you receive provincial social assistance, are being transferred between hospitals, or are a resident of a licensed long-term care facility, the co-payment is waived.
Out-of-province ambulance costs are not covered by OHIP under any circumstances. If you travel outside Ontario, travel insurance is the only way to protect yourself from those costs. You can compare travel insurance options here.
The bottom line: calling an ambulance in a genuine emergency is the right call. But it is worth knowing the cost structure ahead of time, especially if you are on a fixed income.
What Does the ODB Actually Cost You?
The ODB program is not entirely free for all seniors. Here is how the costs break down:
Most seniors pay a $100 annual deductible before drug coverage kicks in. After that, you pay a co-payment of up to $6.11 per prescription.
If your income is low, you may qualify for the Seniors Co-Payment Program (SCP). If approved, the annual deductible is waived and your per-prescription co-payment drops to $2. To qualify as a single senior, your net income must be $41,500 or less (for a couple combined).
Seniors receiving the Guaranteed Income Supplement (GIS) through Old Age Security pay a flat $2 co-payment per prescription, with no annual deductible at all.
Some specific medications, like Ozempic, are covered through the ODB formulary for eligible seniors with a valid Ontario health card and a prescription. Ask your doctor or pharmacist whether your medications are listed, since not all drugs are automatically approved.
2 - Prescription Drugs
When you reach the age of retirement and lose your employee benefits, your prescription drug coverage is a important consideration. Prescription drugs are another service that is covered by OHIP for seniors. Seniors are entitled to the Ontario drug benefits (ODB) program. It covers the majority of the cost for about 5000 prescription drugs. Additionally, it helps cover allergy shots and diabetic supplies like needles, alcohol swabs, and glucose test strips.
To learn more, click here.
TLDR; Ontario seniors qualify for the ODB program, which covers most prescription drug costs plus supplies like diabetic testing materials.
3 - Vision Care
Seniors 65 and older get eye exams covered by OHIP, but the frequency depends on your health.
If you have no diagnosed eye condition, OHIP covers one full eye exam every 18 months, plus up to two minor follow-up assessments. If you have a diagnosed condition like glaucoma, cataracts, macular degeneration, or diabetic retinopathy, OHIP covers a full exam every 12 months along with two partial exams per year to monitor changes.
As with a regular doctor's visit, you just show your health card at the optometrist's office.
What OHIP does not cover is the cost of glasses or contact lenses. Those need to be paid out of pocket or through a private plan.
For more details on what's covered and what's not, read our guide: Does Ontario Offer Free Eyeglasses for Seniors?
TLDR; Seniors 65+ in Ontario get free yearly eye exams through OHIP, with additional coverage for those with specific eye conditions.
4 - Home Care Services
Finally, home care services are covered by OHIP as of 2026. This is a pivotal source of care for seniors in Ontario, as their ability to walk and take care of their home is impacted with age. Homecare workers assist older adults from the comfort of their own home with activities such as meal preparation or bathing.
This fantastic service allows retirement communities to maintain residents’ independence longer while still receiving adequate medical attention from experts! Seniors who live at home live more independently for longer than they do in a retirement community.
You can learn how to access home care services by talking with your local Community Care Access Centre or CCAC. This organization coordinates the delivery of home care and long-term care services across Ontario.
To see if you qualify and to learn more, click here.
TLDR; Seniors in Ontario can access OHIP-funded home care, allowing them to live safely and independently at home longer.
What OHIP Doesn’t Cover for Seniors in 2026
OHIP does provide more coverage for seniors, but not when it comes to everything. Here are some healthcare services OHIP doesn’t cover for seniors in 2026.
Dental Care
OHIP does not cover routine dental for most seniors. That means no cleanings, fillings, dentures, or extractions through OHIP itself.
However, there are two government programs that can help:
Ontario Seniors Dental Care Program (OSDCP)
This program provides free routine dental care to low-income seniors in Ontario. To qualify, you must be 65 or older, live in Ontario, and meet the income thresholds:
Single senior: net income of $25,000 or less
Couple: combined net income of $41,500 or less
You also cannot have access to any other dental benefits, with one exception. The federal Canadian Dental Care Plan (CDCP) does not disqualify you.
If you qualify, the OSDCP covers check-ups, cleanings, X-rays, fillings, oral surgery, and partial coverage for dentures. You apply here. Coverage runs from August 1 to July 31 each year, so timing your application matters.
Canadian Dental Care Plan (CDCP)
If your household income is under $90,000 and you do not have private dental insurance, you may also qualify for the federal CDCP. It covers exams, cleanings, fillings, and dentures for Canadians 65 and older.
If you do not qualify for either program, a private health insurance plan that includes dental coverage is the most reliable option. You can compare plans that include dental here.
Hearing Aids
OHIP does not cover the cost of hearing aids directly. However, Ontario's Assistive Devices Program (ADP) provides partial funding for eligible seniors.
To qualify, your doctor or audiologist must assess you and confirm the medical need. You also need to purchase your hearing aid from an ADP-authorized vendor. If approved, the ADP covers a portion of the cost, though you will still have an out-of-pocket portion.
Private health insurance plans that include paramedical and assistive device coverage can help cover the remainder. If hearing is a concern, it is worth factoring this into your coverage planning before you retire.
Other services that aren’t covered for seniors include:
Most Paramedical: Massage therapy, naturopathy, acupuncture, psychologists, chiropractic services.
Semi-private and private hospital rooms.
Surgeries not considered medically-necessary.
Any care that takes place in a privately-funded facility.
For these services, seniors will need to rely on a private health insurance plan.
When Does OHIP Coverage Change for Seniors?
Your expanded OHIP benefits start automatically when you turn 65. You do not need to apply for most of them.
Ontario Drug Benefit (ODB): You are enrolled on the first day of the month after your 65th birthday. The province mails a confirmation letter about three months before your birthday, so watch for it.
Eye exams: Your eligibility for free annual exams shifts to every 18 months at 65 (or annually if you have a qualifying eye condition). This happens automatically with your health card.
Physiotherapy: This requires a doctor's referral, so it is not automatic, but eligibility opens at 65.
Dental programs: Both the OSDCP and the CDCP require a separate application. Do not assume you are automatically enrolled.
If you are approaching 65 and currently have employer benefits, it is worth reviewing your coverage before those benefits end. There can be gaps between losing group coverage and understanding what OHIP now provides. A private health insurance plan can bridge those gaps or fill in what OHIP still does not cover.
The Best Private Health Coverage for Seniors
Manulife CoverMe Guaranteed Issue Enhanced
As you get older, healthcare needs become more frequent and more expensive. The Manulife CoverMe Guaranteed Issue Enhanced Plan is built specifically for seniors who want dependable coverage without the stress of medical approvals.
There are no medical questions and the plan is guaranteed acceptance, making it an ideal option for those with pre-existing conditions or anyone who’s been declined in the past. It will provide additional coverage for what OHIP doesn’t cover or only partially covers.
With predictable coverage and no surprises, you can better manage your monthly budget while staying on top of your health. Whether you’re on a fixed income, recently retired, or simply looking for peace of mind, this plan offers a simple, reliable way to protect both your health and your finances.
Manulife CoverMe Guaranteed Issue Enhanced
Average Rating: 4/5
Average Premium: $225-$300/month
Disclaimer: Actual premiums and coverage limits may vary depending on age, province, medical history, and selected policy options. This content is intended for informational purposes only and should not be considered insurance advice.
Emergency travel medical coverage included
No medical underwriting
$250,000 lifetime benefit limit
Coverage Overview & Highlights
Guaranteed acceptance. Designed for people who may not qualify for traditional health insurance
Strong prescription drug coverage for a guaranteed issue plan. The plan covers 80% of eligible prescription drugs up to $3,125 in expenses, with a maximum payout of $2,500 per year.
Additional coverage for lifestyle medications. Up to $500 per year within the drug maximum can be used for certain medications such as medical marijuana, smoking cessation.etc
Accidental dental and travel assistance benefits available.
80% coverage of dental including major dental procedures like oral surgery, endodontics (root canal treatment), periodontics, and denture services.
Get an Instant Manulife Guaranteed Issue Quote & Explore Other Health Insurance Providers
Frequently Asked Questions
What is the new $1200 benefit in Canada for seniors?
Due to the rising cost of living in Canada, a relief program was introduced in January 2025 that offers an additional $1,200 as part of Old Age Security (OAS) pension. The tax-free benefit specifically targets low income seniors in Canada who financially depend on their OAS and CPP. The $1,200 can cover necessities like housing, food, and of course, medical care. Moreover, those who qualify will receive the $1,200 in addition to their usual OAS pension automatically.
Does OHIP cover dental for seniors in Ontario?
OHIP does not cover routine dental care like cleanings or fillings. However, low-income seniors may qualify for free dental through the Ontario Seniors Dental Care Program (OSDCP). Single seniors with a net income of $25,000 or less, and couples with a combined income of $41,500 or less, can apply here. The federal Canadian Dental Care Plan (CDCP) is also available to seniors without private insurance who earn under $90,000 per household.
Does OHIP cover physiotherapy for seniors?
Yes. Seniors 65 and older can access government-funded physiotherapy through OHIP with a referral from their doctor. This covers assessment, treatment, and rehabilitation. You can find a government-funded physiotherapy clinic through Ontario's health services directory.
Does OHIP cover eye exams for seniors?
Yes. Seniors 65 and older get one comprehensive eye exam covered by OHIP every 18 months. If you have a diagnosed eye condition like glaucoma, cataracts, or macular degeneration, OHIP covers an exam every 12 months plus up to two partial follow-up exams per year. OHIP does not cover the cost of glasses or contact lenses.
Does OHIP cover home care for seniors?
Yes. OHIP covers some home care services for eligible seniors in Ontario, coordinated through Ontario Health atHome (formerly Home and Community Care Support Services). Services can include personal support, nursing visits, and therapy depending on assessed need.
Does OHIP cover hearing aids for seniors?
OHIP does not cover hearing aids directly. Seniors may be eligible for partial funding through Ontario's Assistive Devices Program (ADP) if a physician or audiologist confirms the medical need and the device is purchased from an ADP-authorized vendor.