The Ontario Health Insurance Plan (OHIP) covers most aspects of your care; however, some medical and administrative services are not covered by OHIP and require separate payment. The typical cost of such services is listed below and are set in line with the guidelines set by the Ontario Medical Association (OMA) and the College of Physicians and Surgeons of Ontario (CPSO).
To reduce administrative overhead and provide a potential cost saving advantage to patients, Dr. Rheault will provide patients with the option of subscribing to an annual “block fee” effective June 1, 2021. Patients who subscribe will receive the services covered by the block fee at no additional cost. Patients who do not subscribe will be asked to pay for uninsured services each time they are provided.
Yearly block fee rates are:
- $240/year + HST for families of two adults and up to 3 dependents
- $120/year + HST for each patient age 18 and up
- $80/year +HST for each patient under age 18
WHAT is COVERED BY THE BLOCK FEE?
The following uninsured services are covered by the block fee:
- Prescription Renewal (without coming in for an appointment) = $20.00
- Administration of Uninsured Vaccine (other than travel advice) = $20.00
- Insurance letters/notes (prescription for orthotics/massage or other insurance-related letters) = $21.00
- Sick Note = $21.00
- Back to Work, School or Daycare Note = $21.00
- Earwax removal = 20.00 (only OHIP covered if there is hearing loss and non-responsive to cerumenolytics OR OHIP covered if removal is for diagnostic and/or therapeutic purposes, effective October 1, 2019)
- Camp, Daycare or School Form = $30.00
- Short-term Disability Form = $60.00
- Electronic or Fax Transmission of Medical Records = $35.00 and up (may vary based on length)
- Children’s Aid Society (CAS) Application Form for Prospective Foster Parent = $62.00
- Death Certificate for Life Insurance = $50.00
- Revenue Canada, Federal Disability Tax Credit Form = $79.00
- Canada Pension Plan (CPP) Disability Medical Report Form = $85.00
- Medical Certificate for Employment Insurance Compassionate Care, Parental,
or Sickness Benefits (INS5216B, INS5168, or INS5140) = $42.00
- Fitness Club Form = $40.00
- Immunization Records Replacement or Summary = $20.00
- Lost Referrals or Prescriptions = $20.00
- Pre-employment Certificate of Fitness = $50.00
- Travel Cancellation Form = $41.00
- Volunteer Form = $27.00
- Urine pregnancy test = $25.00 (only OHIP covered when an immediate determination of pregnancy is required to prevent imminent physical harm; blood pregnancy test is still OHIP covered, effective October 1, 2019)
WHAT IS NOT COVERED BY THE BLOCK FEE?
Any uninsured services not listed in the table above are not covered by the block fee. Common examples include:
- Appointment Without Valid OHIP Coverage = $40.00 – $80.00
- Appointments missed or cancelled/rescheduled less than 12 hours in advance = $40.00 – $80.00
- Private Insurance Form (including Life Insurance, Health Insurance and APS forms) = OMA rates, $153.00+
- Pre-op history and physical requested by surgeons and dentists = $80.00 (effective October 1, 2019)
- Disability Report/Insurance Form
(including long-term disability form, #OCF-3, #OCF-18 and #OCF-19 certificates) = OMA rates, $153.00
- Driver’s Medical Examination Form (without physical exam/with physical exam) = $100.00
- Canada Pension Plan (CPP) Narrative Medical Report = $185.00
- Legal Reports = OMA rates
- Letter at Patient’s Request = OMA rates
- Liquid Nitrogen Treatment of Benign Skin Lesions & Warts not covered by OHIP = $25.00/visit
- Pap Tests (when done earlier than OHIP-covered/recommended frequency) = $50.00 +lab fee
- Third-party Physical Examination = $175.00
- Travel Advice = $65.00
* For all of the above uninsured service charges, HST will be charged if applicable.
HOW TO PAY FOR INDIVIDUAL UNINSURED SERVICES AND/OR BLOCK FEE
For block fees you will have the ability to pay by credit card, debit, e-transfer or by cheque. The block fees cover your services for a 1-year period. For individual services you will be required to pay at the time the service is rendered/completed with any of the above modalities.
Refunds on block fee subscriptions are offered up to 60 days after activation or renewal of the subscription. Please note that if you received any uninsured services during this period and subsequently cancel your subscription, that we will invoice you for such services.
No refunds are available on charges for individual services once provided.