If you are an Ontario resident considering medical care abroad, you need to understand something upfront: OHIP's Out-of-Country (OOC) coverage is nearly meaningless for planned procedures. The reimbursement rates are so low they would not cover a single night in a US hospital, let alone a surgical procedure. And for elective surgery abroad? The coverage is effectively zero.
This article breaks down exactly what OHIP pays, what it excludes, and why the savings from medical tourism in Colombia are so substantial that OHIP coverage is irrelevant to the math.
What OHIP's Out-of-Country Program Actually Covers
The OOC program only covers emergency health services received outside Canada. The key word is emergency. If you plan a trip specifically for medical treatment, OHIP will not reimburse you.
Even for genuine emergencies, the reimbursement rates are set by Ontario regulation and have not kept pace with global healthcare costs:
- Emergency inpatient services (ICU, operating room, neonatal/paediatric special care): maximum $400 per day
- Emergency outpatient services: maximum $50 per day
- Physician services: reimbursed at Ontario Schedule of Benefits rates (often a fraction of international charges)
To put this in perspective, a single night in a US hospital averages $2,500–$4,000. OHIP would reimburse $400.
What OHIP Does Not Cover Abroad
The exclusions list is extensive:
- Planned or elective procedures — any procedure you schedule in advance abroad
- Ambulance services — land, air, or water transport
- Prescription drugs obtained outside a hospital
- Private hospital or clinic fees
- Diagnostic or laboratory services outside a public hospital
- Dental care (not covered within Ontario either, for most adults)
- Cosmetic procedures
- Home care services
The Prior Approval Exception
There is one narrow exception. Ontario does offer "prior approval" for full payment of out-of-country services — but only when the required treatment is not available in Ontario at all. You must submit an application with specialist confirmation that the procedure cannot be performed in the province. Approval is granted sparingly, and wait times within Canada (no matter how long) are not grounds for approval.
What About Other Provinces?
OHIP is Ontario-specific, but other provincial plans are similarly limited:
- British Columbia (MSP): emergency-only coverage abroad at BC rates; no planned procedures
- Alberta (AHCIP): limited emergency coverage at Alberta rates
- Québec (RAMQ): slightly more generous reimbursement in some cases, but still based on Quebec fee schedules
No Canadian province covers elective medical tourism.
Why the Math Still Works
Here is the key insight: OHIP coverage is irrelevant to the medical tourism decision because the savings are so large that you come out dramatically ahead even paying 100% out of pocket in Colombia.
| Procedure | Ontario Private Cost | Colombia Cost | You Save (Even with $0 OHIP) |
|---|---|---|---|
| Dental implant | $3,500–$6,500 CAD | $1,100–$2,000 CAD | $2,400–$4,500 |
| All-on-4 (per arch) | $22,000–$38,000 CAD | $8,500–$14,500 CAD | $13,500–$23,500 |
| LASIK both eyes | $4,500–$7,500 CAD | $1,500–$3,000 CAD | $3,000–$4,500 |
| Knee replacement | $25,000–$45,000 CAD (private) | $7,000–$17,000 CAD | $18,000–$28,000 |
Even adding $1,000–$2,000 for flights, accommodation, and travel insurance, the total cost of treatment in Colombia plus travel is typically 40–70% less than the procedure alone in Canada.
Travel Insurance: What You Actually Need
Since provincial plans do not cover you adequately abroad, you should purchase private travel medical insurance that includes:
- Complication coverage — specifically for surgical complications related to your planned procedure
- Medical evacuation — in case you need to be transported back to Canada
- Emergency hospitalisation — standard travel medical coverage
Canadian providers like Manulife, Blue Cross, and World Nomads offer plans in the $200–$500 CAD range. Some medical tourism facilitators also offer complication guarantee packages.
Tax Deductions for Medical Expenses Abroad
Canadian tax law allows medical expense deductions for procedures performed abroad if they qualify as medically necessary. This includes:
- The procedure itself
- Travel costs (flights, accommodation up to certain limits) if you must travel more than 40 km for medical care not available locally
- Companion travel expenses in some cases
Consult a Canadian tax professional — the medical expense tax credit can recover 15–25% of your total out-of-pocket costs, depending on your tax bracket and province.
OHIP Will Not Cover You. But You Can Still Save Thousands.
Tell us what procedure you need. We will provide a complete cost breakdown including flights, accommodation, and the procedure — so you can see exactly how the numbers compare.
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