What are "non-OHIP" covered services or "uninsured services"?
Non-OHIP covered services are those services provided to patients that are not covered by the Ontario Health Insurance Plan (OHIP). The Ministry covers all insured medically necessary services provided by physicians, however, it does not pay for services that are not medically necessary. These may include: writing sick notes, cosmetic procedures, charges for missed appointments, completing forms for daycare, insurance, legal or employment purposes, or if your health card is not valid on the day of your appointment.
Why am I being charged for these services?
OHIP pays physicians for most medical services delivered to patients. Services not covered by OHIP or another insurance plan are called uninsured services. Your physician will request a payment from you for those services. It is the patient's responsibility to pay for uninsured services.
How are the uninsured fee rates determined?
When fees are charged for uninsured services, they are based on the Ontario Medical Association's suggested fees as found in the most current edition of the OMA Physician's Guide to Third Party and Other Uninsured Services.
Non-OHIP Insured Services
Summerville Family Health Team 2025
Missed Appointments
Regular Office Visit without OHIP.......................................................................... $109.30
Office Physical without OHIP (age based) .................................................. $130.30 - $233.15
Driver's Medical Examination ................................................................................. $150
Missed Regular Appointment................................................................................... $40
Missed Physical Appointment ................................................................................. $75
Appointment Cancellation less than 24 hours ......................................................... $40
Forms
Revenue Canada Federal Disability Tax Credit .................................................... hourly rate
Medical Report for CPP Disability Benefit .............................................................hourly rate
CPP Narrative Medical Report ..............................................................................hourly rate
Medical Certificate Employment Insurance Sickness Benefits ................................ $50
Medical Certificate Employment Insurance Compassionate Care Benefits ..............$72
Sick note and Return to Work or School note .......................................................... $25.25
Pre-Employment Certificate of Fitness .................................................................... $47.75
Certificate of freedom from communicable disease................................................. $25.25
Massage, Orthotics, Orthopedic shoes and physiotherapy note,
for Insurance purposes.............................................................................................. $30
Citizenship Form Completion ................................................................................. $100
Life Insurance Death Certificate ........................................................................... hourly rate
Travel Cancellation Form ....................................................................................... $160
Jury Duty Exemption Letter .................................................................................... $32
School. Camp, Pre-School, Daycare form completion ............................................$36.25
Attending Physician Forms - Insurance/Employment ................. .........................hourly rate
Insurance Certificate OCF-3 Disability Certificate ................................................. $256
Insurance Certificate OCF-18 Treatment Plan ..........................................................$272
Insurance Certificate OCF-19 Catastrophic Impairment ..........................................$151
Insurance Certificate OCF-23 Treatment Confirmation ............................................$256
Attending Physician Statement .............................................................................hourly rate
Insurance Medical Exam (assessment and report) ...............................................hourly rate
Uninsured Procedures
Ear syringing (if no hearing loss - unilateral or bilateral) ......................................... $37.85
Liquid Nitrogen treatment for cosmetic reasons ...................................................... $33.55 +
Excision on benign lesion from skin .........................................................................$125.55 +
Medical Records
Copying............................................................................................................................$30
(first 20 pages + $0.25 per page thereafter)
Electronic Transfer .........................................................................................................$40
(includes USB)
Physician Review ...........................................................................................................$45
(per 15 minutes, after first 15 minutes)
Please be advised that the above fees are based on the guidelines set forth in the Ontario Medical Association's Physician's Guide to Uninsured Services and are subject to regular revision. The fees are also subject to change at the discretion of individual providers at the Summerville Family Health Organization.
We understand the importance of transparency and will make reasonable efforts to communicate any fee changes through our official communication channels, such as our website, email notifications, or direct correspondence. It is recommended that you regularly review our fee schedule and related policies to ensure you have the most up-to-date information regarding our charges.
Updated: January 2025