When emergencies arise, accessing timely medical assistance is critical. In Ontario, calling an ambulance can be a matter of life or death. Many wonder about the costs associated with ambulance services and whether they will be financially liable. We’ll explore the coverage provided by the Ontario Health Insurance Plan (OHIP) regarding ambulance services, the rationale behind associated costs, and what you should expect when calling for an ambulance in Ontario.

OHIP Coverage of Ambulance and Other Medical Transportation

The Ontario Health Insurance Plan (OHIP) provides some level of coverage for ambulance services; however, there are limitations. Under OHIP, basic ambulance services cover emergencies where patients are transported to a hospital, but this depends on the situation.

Emergency ambulance services are covered by OHIP if the transport is deemed medically necessary. This means that if a healthcare professional determines that a patient requires an ambulance to receive urgent medical care, the cost may be partially covered.

In many circumstances, non-urgent or scheduled transports, such as those to appointments, will not be covered by OHIP.  There will be additional fees if the transportation is outside of the local area and is not deemed medically necessary. 

Why Is an Ambulance Not Covered by OHIP?

Despite the provision of some ambulance coverage through OHIP, patients still will face charges for ambulance services. This can be confusing, especially when individuals assume that medical emergencies should be fully covered under their provincial health plan.

Ambulance services are not entirely covered by OHIP because of the high operational costs associated with ambulance services. Ambulances require significant resources for maintenance, staff salaries, training, and equipment. Additionally, an ambulance isn’t always utilized for emergency situations. After an ambulance is called, it may be determined, once consulting with the patient, that there is no medical emergency. If the medical personnel does determine that the issue was not an emergency, OHIP will not cover the ambulance fees. You will have to pay out-of-pocket or with private insurance for the fees you incur.

What Happens When You Call an Ambulance in Ontario?

In Ontario, emergency services are reached by dialing 911. This call connects you with dispatchers who will ask important questions to assess the situation and dispatch the appropriate services.

Upon your call, the dispatcher will gather vital information, such as your location, the nature of the medical emergency, and any other relevant details. Based on this information, they will send appropriate emergency personnel to your location, including an ambulance. 

When the ambulance arrives, paramedics will assess your condition, provide necessary medical care on-site, and prepare you for transportation to the hospital if needed. Throughout the process, the paramedics will work to stabilize your condition, monitor vital signs, and address any immediate health concerns.

Will an Ambulance Take You to the Hospital of Your Choice in Ontario?

The standard procedure for ambulances is to transport patients to the closest appropriate facility to provide care. This means that you won’t be taken to your preferred hospital, especially if it is farther away or lacks the resources required for your needs. 

Keep in mind that emergency medical responders aim to make decisions based on what will provide the best outcome for the patient. For example, if a patient is experiencing a heart attack, the paramedics could choose to transport them to a facility with a specialized cardiac unit. That sometimes will mean bypassing a closer hospital. As the patient, you must trust trained emergency medical personnel to make decisions on your behalf. 

Related

Visitor Insurance Coverage For Pregnancy In Ontario

Is Birth Control Covered By Insurance in Ontario?

Does OHIP Cover Podiatrist Services?