Is Therapy Covered By OHIP?

By Krista DeKuyper | January 18, 2022 | Health Insurance

Some people may be wondering if therapy is a service that is covered by OHIP-the answer is yes but it depends! This post will explore how these different aspects can affect whether or not your therapy session will be covered by OHIP and what options are available for those who don’t qualify for this type of coverage

Yes Therapy Is Covered By OHIP But It Depends

As with most things related to OHIP there is no clear-cut yes or no answer. The answer isn’t simple because if you have a family doctor or psychiatrist who provides counselling services then the service would be covered by OHIP. If not, you will need private insurance in order to cover the costs of your therapy sessions.

Also, keep in mind that there are many different types of therapy. There’s talk therapy which are therapy methods such as counselling, psychotherapy or psychological therapy. But there’s also pharmacological or drug-based therapy. Where OHIP may cover some of the costs for talk therapy it does not cover the costs for drug therapy. You would need to have additional coverage to help with the costs.

When is Therapy Covered By OHIP?

Since 2005 the Ontario government has encouraged practitioners to come together and create what they call Family Health Teams. When you visit a Family Health Team, you can meet with family doctors, registered nurses and other health care providers like dietitians and social workers.

Each team is set up to meet the needs of the local community and focuses on chronic disease management, disease prevention and health promotion.

Treatment from these health teams is covered by OHIP and will not cost you anything. So if you’re lucky to have a family doctor who is a part of a Family Health Team then you’re covered. If your family doctor is not a part of a health team then you won’t be.

You don’t need a referral to use this service but you must already be enrolled with the Family Health Team to make an appointment.

Therapy is Covered By OHIP When Done By a Medical Doctor

You may also get lucky with a family doctor that has medical training in psychotherapy, in which case it would be covered. But more likely your family doctor will just refer you to a psychiatrist. Treatment from psychiatrists is covered by public health insurance and will not cost you anything. Other mental health care providers such as registered psychologists, registered social workers, and registered psychotherapists may also be free if they work in government-funded hospitals, clinics, agencies or an employee assistance program. For example, if they’re part of a Family Health Team.

When Is Therapy Not Covered By OHIP

If you don’t have a family doctor or if they do not offer psychotherapy services then it is unlikely the service will be covered. This means that any treatment from registered psychologists, registered social workers and registered psychotherapists who are not part of a Family Health Team or hospital will cost you. If you have an employer-provided or private health insurance plan, part or all of your therapy fees may be covered.

Best Insurance Plans for Mental Health

If you go the publicly funded route to seek mental health services you’ll most likely face long wait times. If it’s in your budget and ability most people purchase a private health plan that covers the cost of mental health services. Will tell you some of the best ones below.

Manulife Flexcare Health and Dental Plans

The Manulife Flexcare Health and Dental plans offer a mental health benefit to help cover the cost of treatment from a variety of specialized registered professionals including psychologists, marriage and family therapists, social workers and more

Global Blue Vision Plan

The Blue Cross Global Blue Vision plan is another great option for those looking for mental health coverage. This plan covers physiotherapists, psychologists and speech therapists. Plus you do not require a written recommendation from your family physician.

Manulife FollowMe

The difference between the Manulife FollowMe and Manulife Flexcare is that FollowMe is a guaranteed plan. Meaning that there is no underwriting. When applying for the plan you won’t need to answer any medical questions and you’re guaranteed to be accepted. However, because there are no medical questions you’ll find that the coverage amount is less than the underwritten plans. But it’s a great option for those who are looking for a guaranteed plan.

Mental health services are an important part of overall health and well-being, yet many people don’t know that therapy is covered by OHIP. If you have a family doctor or psychiatrist who provides counselling services this will be covered by OHIP. Anything outside of that you will need private insurance to cover the costs.

If you’d like to see what other plans cover dietitian use our instant quoting tool!