Non-OHIP Patients
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Patient Billing Information for Admitted Patients who do not have OHIP (Ontario Health Insurance Plan) Coverage
We understand that being admitted to the Hospital is a challenging time for our patients and their families. We also know that billing for Hospital visits can be confusing. We have prepared this information to answer the most commonly asked questions about billing.
I don’t have OHIP (Ontario Health Insurance Plan) coverage. Do I have to pay my Hospital charges directly?
All patients not covered under OHIP are required to pay directly for the care provided.
There are exceptions that apply:
Visitors from another Canadian Province:
If you are a visitor from another province we will bill your provincial health insurance plan. To qualify you must:
- Provide a valid health card from your home province at the time of registration
- Complete a Declaration of Hospital Insurance Coverage Under Interprovincial Agreement
Refugee Patients:
If you have refugee status we will submit a claim on your behalf to Medavie Blue Cross. To qualify you must:
- Provide a valid Refugee Protection Claimant Document at the time of registration
Member of the Canadian Armed Forces
If you are a member of the Canadian Armed Forces we will submit a claim on your behalf to Medavie Blue Cross. To qualify you must:
- Provide a Medavie Blue Cross Identification Card issued by Veteran’s Affairs Canada
Patient Receiving WSIB Benefits
If you were injured at work and your treatment at SHSC is related to your work injury, you must provide your WSIB claim number when you receive treatment. If you are treated in the Emergency Department for work-related injury and you have not submitted a claim with WSIB, you must tell your health care team that this was a work-related injury and complete a form. Your employer should complete WSIB Form 7 and you should complete WSIB Form 6.
Ambulance Services and Assistive Devices such as crutches, canes, splints, casts etc. are payable by the patient. SHSC does not bill directly to the insurance.
Ambulance Services
Hospitals are required to bill a co-payment charge to patients for the use of an ambulance, in accordance with provincial legislation in Ontario (Health Insurance Act, Regulation 552).
The following rates are set by the Ontario Ministry of Health and Long-Term Care:
For a patient with a valid Ontario Health Number - $45
For a patient who does not have a valid Ontario Health Card, from another province, Refugee and WSIB claimant - $240
I don’t have OHIP (Ontario Health Insurance Plan) coverage and I am not part of one the exemptions listed above, what do I do?
All patients not covered under OHIP are required to pay directly for the care provided.
As an inpatient you will be charged a daily per diem. The daily per diem rates cover the cost of your Hospital stay with the exception of physician fees, diagnostic imaging exams (such as CAT scan and MRI) and specialized procedures or tests. These items will be charged in addition to the daily Hospital rate.
Physician fees are incremental and are charged directly to you by the consulting physician(s). Physician fees are NOT included on your Hospital bill.
The daily per diem rate depends on the type of care you require.
Our current standard ward daily per diem rates are:
Acute Medical Daily Rate |
$3,900 |
Acute Surgical Daily Rate |
$4,200 |
Intensive Care Unit (ICU) Medical Daily Rate |
$6,100 |
Intensive Care Unit (ICU) Surgical Daily Rate |
$6,300 |
*Prices are subject to change*
Preferred Accommodation is an extra charge.
Who Do I Speak with?
What if I have Insurance coverage?
What if I am unable to pay a portion of my bill?
Who can I call for additional information?
I need a copy of my health record to facilitate my insurance claim. How can I get one?
You can request a copy of your Health Records at:
Health Records and Patient Registration Department
Room E123
2075 Bayview Avenue
Toronto, Ontario M4N 3M5
Phone: 416-480-4433
There is an administrative cost for requests that are required for purposes other than continuing patient care. A prepayment fee must be submitted with your written request.