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.
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 How Much Does Therapy Cost? and What Are the Different Types of Therapists? to learn more about these services and costs.
While many therapy services are not covered under OHIP, there are some options out there.
Mental Health Services Covered by OHIP
There are three categories of mental health professionals whose services are OHIP-covered:
- Psychiatrists
- Physicians who practice psychotherapy
- Psychologists, psychotherapists, and social workers in government-funded institutions
1. Psychiatrists
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.
2. Physicians
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:
- How much experience they have practicing therapy
- What psychotherapy training they have completed
- Whether they have any formal certifications
These questions will give you a better idea of whether they can provide the therapeutic services you need.
3. 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 be OHIP-covered:
- Community health centres
- Public agencies
- Public schools
- Public clinics
- Hospitals
- Shelters
Are OHIP-Covered Services Right for You?
When deciding whether OHIP-covered services are right for you, there are multiple things to consider.
1. Wait times
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.
2. Budget
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.
3. What services you need
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.
Do you know whether your insurance provider covers therapy costs? Read Is Mental Health Therapy Covered by Insurance? to learn more.
About the Author
Julieta is a compassionate and dedicated therapist who believes that everyone deserves the opportunity to live their best life. She uses an empathetic approach to create a safe and supportive environment where clients feel comfortable sharing their experiences.
Julieta's approach to therapy is holistic, drawing on a range of techniques to help clients achieve lasting change. She believes that therapy is not just about addressing immediate challenges, but about helping individuals to build a deeper understanding of the self, and the resilience they need to navigate life's ups and downs with confidence and self-assurance.
Book an appointment with Julieta to start your therapy journey today.
