Understanding health-care coverage
When your child receives care at SickKids, how much you pay depends on your health coverage.
- If your child has a valid Ontario Health Insurance Plan (OHIP) card, you will not need to pay for most health-care services you receive at SickKids.
- Some services are not covered by OHIP or other insurance plans. In those cases, a parent or caregiver is responsible for payment. When possible, we will let you know about any costs in advance and explain your payment options.
- If your child does not have health coverage, they will still receive care. However, you will be responsible for paying for the services provided.
Patients with an Ontario Health Insurance Plan (OHIP) card
If your child has a valid OHIP card, most medically necessary health-care services are covered.
OHIP does not cover some services, including:
- Ambulance services
- Assistive devices (such as crutches, canes, splints, casts, or gel wraps)
- Cosmetic surgery
- Specific dental treatments
- Delisted procedures
- Chronic care co-payment
- Some eye (ophthalmology) procedures and implants
If you have private or third-party insurance, your plan may cover some of these services.
Patients with a health card from another Canadian province or territory
Most health-care services received in Ontario for out-of-province patients are covered through agreements between provinces and territories. Coverage is similar to what is provided in your home province/territory.
When you arrive at SickKids, you must provide:
- Your child’s provincial or territorial health card
- The card’s expiry date
- Your home address
Patients with third-party insurance
If you have private or third-party insurance coverage:
- Contact your insurance company to confirm what is covered
- You may need to pay for services upfront
- You can submit receipts to your insurance company for reimbursement
Patients in the Interim Federal Health Program (IFHP)
If your child is covered under the Interim Federal Health Program (IFHP), please tell the registration clerk when you arrive.
You will need to provide:
- Proof of valid refugee status
- Your IFHP certificate, including your UCI number
You can find more details about what is covered on the IFHP website.
International patients
Your child is considered an international patient if they:
- Live outside Canada at the time they receive health-care, or
- Are visiting, studying, or working in Canada temporarily, or
- Live in Canada for only part of the year, or
- Previously lived in Canada but now live outside Canada.
International patients are not covered by the Ontario Health Insurance Plan (OHIP) and must pay for the services they receive.
Before care is provided you must:
- Make a pre-payment for the estimated cost of care or
- Provide a Letter of Guarantee (LOG)
If you are an international patient with third-party insurance, please see Patients with third-party insurance.
Patients with no health coverage
If you do not have Ontario or other Canadian provincial/territorial or federal health insurance, you are expected to pay for the services you receive.
Please tell the information clerk when you arrive that you do not have health coverage.
Questions or need help?
For more information:
- Review our Frequently Asked Questions, or
- Contact the Patient Accounts Business Office
Phone: 416 813 7047
Hours: Monday to Friday, 8 a.m. to 4 p.m.
Email: business.office@sickkids.ca
Patients not covered under OHIP or other Provincial/Territorial coverage are required to pay directly for the health-care services they receive.
If you have an appointment at a clinic or visit the Emergency Department, you will be required to pay for your visit and any associated health-care services you receive, including physician fees, consults, diagnostic imaging exams (e.g., CT, MRI, X-Rays), and specialized procedures or tests.
If you are admitted as an inpatient, you will be required to pay for your hospital stay at a daily rate and the health-care services you receive, including physician fees, diagnostic imaging exams (e.g., CT, MRI, X-Ray), and specialized procedures or tests.
The daily rate is subject to the type of care you require.
If your child’s OHIP card is expired or the information is incorrect, the Ontario Ministry of Health may reject the claim. In this case, we will bill you directly if you do not provide the updated information to the Business Office (business.office@sickkids.ca by email or by phone at 416-813-7047) within 14 days of the date of your visit.
Please contact our International Patient Accounts team to arrange payment and discuss payment options.
Please see International Patients for more information.
If you have private, travel, or other insurance that may help cover your health-care costs, please contact your insurance company as soon as possible to open a claim.
Once a claim has been opened, our Accounts Receivable Associate can work with you – and where permitted, directly with your insurance company – to ensure your insurance is applied appropriately to your hospital expenses. You can reach our team by calling 416-813-8817 or emailing international.patientaccounts@sickkids.ca.
You may be required to pay some or all charges up front and submit a claim to your insurance company for reimbursement. We recommend verifying your coverage and submitting your claim as soon as possible to support timely reimbursement.
You are responsible for paying all hospital charges, including any amount not covered by your insurance.
No. Physician services at SickKids are billed separately from hospital services.
If your child has valid OHIP coverage, physicians bill OHIP directly.
If your child does not have OHIP or other eligible health coverage, you may be required to pay for their services separately. If payment is required, you will receive a receipt that may be submitted to your insurance provider for reimbursement.
If you have already received an invoice and are ready to make a payment, visit Pay Your Bill to see payment options and next steps.