Is Therapy Covered by OHIP?
Ontario’s healthcare system can be very confusing. Canada offers free healthcare, but this does not include everything. Ontario's provincial plan, the Ontario Health Insurance Plan (OHIP) does not cover many medications, glasses, and visits to the dentist, for example. These are usually paid through private insurance or out-of-pocket.
Likewise, not all mental health services are OHIP-covered. While mental health is becoming more of a priority in Ontario, only some psychological services are public. Deciding to get therapy is hard, figuring out which services public healthcare covers should not be another headache.
So, is therapy covered by OHIP? The short answer is: sometimes (I know, what a frustrating answer). The answer depends on the title of the mental health professional. It also depends on whether they work for a private or government-funded institution.
As an intake specialist at KMA Therapy, I know that many people are confused about whether therapy is OHIP-covered. I am here to help.
In this article, I will outline:
- What mental health services are not covered by OHIP
- What mental health services are OHIP-covered
- Whether OHIP-covered mental health services are right for you
By the end of this article, you will know what mental health services are OHIP-covered and have a better idea of what will work best for you!
Mental Health Services Not Covered by OHIP
Unfortunately, most therapy services are not covered by OHIP. Private offices are the most common therapeutic practices. If a therapist works for a private practice, they will usually only accept private insurance or out-of-pocket payments. This includes most psychologists, psychotherapists, and social workers.
The prices and services offered by private offices range widely. Read our articles How Much Does Therapy Cost? and What Are the Different Types of Therapists? to learn more about these services and costs.
Even though many therapy services are not covered under OHIP, there are options out there.
Mental Health Services Covered by OHIP
There are three categories of mental health professionals whose services are OHIP-covered:
- Physicians who practice psychotherapy
- Psychologists, psychotherapists, and social workers in government-funded institutions
Psychiatrists are covered by OHIP. They provide drug-based therapy. This means they use medication to treat mental health issues. They can also diagnose mental illnesses, but they do not usually offer ‘talk therapy’. Oftentimes, psychiatrists will be assigned alongside a talk therapist.
Although seeing a psychiatrist is covered by public healthcare, the medication they prescribe may not be. OHIP covers most medications for people under 24 and over 65 years old, but much fewer for anyone 25 to 64 years old.
Some medical doctors have training in psychotherapy. These physicians may offer talk therapy services that are covered under OHIP. It is important to note that medical doctors are not regulated by the College of Registered Psychotherapists of Ontario. This means that while they may use the title ‘psychotherapist’, they have no mandatory therapy training. As such, they have varying levels of knowledge of mental health issues.
If you opt for a physician who practices psychotherapy, consider asking them:
- What psychotherapy training they have completed
- How much experience they have practicing therapy
- Whether they have any formal certifications
These questions will give you a better idea of whether they can provide the therapeutic services you need.
Psychologists, Psychotherapists, and Social Workers
Psychologists, psychotherapists, and social workers provide talk therapy and are sometimes OHIP-covered. This depends on whether they work at a government-funded institution. Mental health professionals that work at the following institutions will usually OHIP-covered:
- Public agencies
- Public clinics
- Community health centres
- Public schools
Are OHIP-Covered Services Right for You?
When deciding whether OHIP-covered services are right for you, there are multiple things to consider. Some of these include:
- Wait times
- What services you need
Public healthcare does not cover most mental health professionals. As such, wait times for OHIP-covered mental healthcare may be lengthy. If you are looking for help now or soon, private options may be better for you. If you are looking for specific types of therapy, it may be hard to find providers that are OHIP-covered.
A benefit of OHIP-covered mental healthcare is that payments are not out-of-pocket. If cost is a consideration, you may opt for low-cost or OHIP-covered therapeutic services.
Understanding what professionals are OHIP-covered can help you make an educated decision about your therapy journey. Psychiatrists and physicians who practice psychotherapy are OHIP-covered. Psychologists, psychotherapists, and social workers who work for government institutions may be, too. Mental health professionals in private practices usually only accept insurance or out-of-pocket payments.