Healthcare in Toronto: how OHIP works day to day, and what it doesn't cover

Once you have an Ontario health card, you'll never see a bill for a doctor's visit or a hospital stay. You will still pay for your dentist, your prescriptions and your glasses, so plan for that.

The short version

• OHIP, the Ontario Health Insurance Plan, pays for medically necessary doctor visits, in person or virtual, and hospital care. There are no copays, deductibles or networks [1].
• There's no longer a waiting period for OHIP; if you qualify, coverage starts right away [2]. Our separate OHIP guide covers who qualifies and how to apply.
• Finding a family doctor is the hard part. Register with Health Care Connect online or by calling 811 [3].
• OHIP doesn't cover dental work in a dentist's office, prescriptions filled outside the hospital, or glasses and contacts for most adults [1].
• Most Americans fill those gaps with an employer benefits plan or a private health and dental plan.

How OHIP feels if you're used to US insurance

Stateside, every visit involves a card, a copay, an "in-network" check and, weeks later, an explanation of benefits you have to decode. In Ontario, you hand over your health card and that's it. The doctor bills the province directly.

What that means in practice:

• No networks. Any family doctor, walk-in clinic or hospital in Ontario takes OHIP.
• No surprise bills for medically necessary care.
• No premiums taken from your paycheck for OHIP itself.
• Referrals rule. You usually need a family doctor or walk-in physician to refer you to a specialist. You can't just book a dermatologist like you might back home.
• Waits are real. Specialist referrals, non-urgent imaging and elective surgery can take weeks or months. That's the trade-off people back home are always asking about.

Always carry your health card. If you forget it, the clinic may ask you to pay and claim it back, or reschedule.

Finding a family doctor (and what to do until you have one)

In Ontario, the family doctor (or nurse practitioner) is your quarterback: they handle checkups, prescriptions, referrals and test results. Many Toronto practices aren't taking new patients, so start early.

Health Care Connect

The province's matching service is Health Care Connect. Here's how it works [3]:

1. Get your health card number first. You need a valid Ontario health card, contact details and a mailing address linked to the card.
2. Register online or by calling 811 (TTY 711), 24/7. You can register your whole family.
3. Share basic health info if you want. It's optional, but it helps the Care Connector match you.
4. Wait for a match. A Care Connector looks for a family doctor, nurse practitioner or team accepting patients in your area. People with more urgent needs are matched first.
5. Get your referral letter. Once you're matched, the clinician's office contacts you to set up a first appointment.

Ontario doesn't promise a timeline. Its own page says joining "does not guarantee" a clinician will be found right away [3]. Meanwhile, ask coworkers, neighbors and other parents whether their doctor is taking patients. Word of mouth often works faster.

Walk-in clinics and virtual care

Until you're matched, walk-in clinics are your stand-in. They're all over Toronto, from shopping malls to strip plazas, and they bill OHIP like any other doctor. Expect to wait, especially on weekday evenings and Saturdays, and expect a different doctor every time. Many clinics now let you join a virtual line online so you can wait at home.

OHIP also covers virtual visits by video or phone with Ontario doctors [1]. For quick questions, Health811 offers free health advice and help finding services, by phone at 811 or online [3].

Where to go when

Toronto's big hospital emergency departments include Toronto General and Toronto Western (University Health Network), St. Michael's, Sunnybrook, Mount Sinai and Michael Garron. SickKids, the Hospital for Sick Children, handles pediatric emergencies downtown. ER waits for non-urgent problems can run long, so use 811 and walk-in clinics for anything that isn't an emergency.

What OHIP doesn't cover

This is where the sticker shock comes in. Canada's "free healthcare" is really "free doctor and hospital care." Here's the gap list from the province's own coverage page [1]:

USD conversions use the Bank of Canada rate of 1.3989 CAD per USD (November 5, 2026) [6].

Physiotherapy, massage therapy, psychology and most counseling aren't paid by OHIP in a private office either, though some is available through hospitals and community programs.

Prescription drugs

Ontario's public drug programs fill some of the gap [4]:

• OHIP+ covers eligible prescriptions for people 24 and under who are not covered by a private insurance plan. If your kids are on your employer plan, that plan pays first.
• Ontario Drug Benefit kicks in automatically at 65. You pay a CAD 100 deductible each August-to-July program year, then up to CAD 6.11 per prescription (about USD 71 and USD 4.37 in 2026). Lower-income seniors can apply to cut that to up to CAD 2 [4].
• Trillium Drug Program helps households with high drug costs relative to income.

Everyone else pays the pharmacy price or uses private coverage. A heads-up for Americans: drug prices here are generally lower than in the US, but "lower" isn't "free."

Dental

Dental is fully private for most working-age adults. The federal Canadian Dental Care Plan exists, but it's built for people without access to any dental insurance, with an adjusted family net income under CAD 90,000 (about USD 64,000 in 2026), who filed a Canadian tax return for the previous year and are Canadian tax residents [5]. Newly arrived Americans usually won't qualify in year one. Ontario also runs a dental program for low-income seniors.

Vision

Unless you're under 20, over 65 or have a qualifying eye condition, you'll pay for routine eye exams yourself, and everyone pays for frames and lenses [1].

Filling the gaps: employer and private plans

Most Toronto employers offer an extended health and dental plan on top of OHIP. It's the closest thing to the US benefits package you're used to, but it sits on top of public coverage rather than replacing it. A typical plan pays a percentage of:

• prescription drugs
• dental checkups and basic work, sometimes major work
• eye exams and an allowance for glasses every year or two
• paramedical practitioners like physiotherapists, chiropractors, massage therapists and psychologists
• emergency travel medical coverage outside Ontario

When comparing job offers, ask for the benefits booklet. The details (annual maximums, coinsurance, dental recall limits) vary a lot.

Self-employed, retired or on a spouse's permit without benefits? Individual health and dental plans are sold by insurers and some professional associations. Compare what they cover and what they exclude for pre-existing conditions before you sign.

Coverage before OHIP and outside Ontario

Until your OHIP is active, you need private insurance. Once you have it, remember OHIP pays very little for care outside Canada. A trip home for Thanksgiving that ends with an ER visit in Ohio can get expensive fast, so buy travel medical insurance or check your employer plan's out-of-country coverage. Medicare generally doesn't cover you while you live in Canada, so retirees should think through Part B timing before they move.

Got a question about a specific clinic or which pharmacies take your plan? Ask in our community group for Americans in Canada.

A day-one health checklist

1. Apply for your health card as soon as you're eligible.
2. Register with Health Care Connect the day your card number arrives.
3. Enroll in your employer's benefits plan before the deadline, usually your first month.
4. Find a walk-in clinic and a pharmacy near home and work.
5. Save 811 in your cell phone.
6. Bring your US records: vaccination history, prescriptions and recent test results.
7. Get travel medical coverage before your next trip to the States.

Sources

1. Government of Ontario: What OHIP covers
2. Government of Ontario: Apply for OHIP and get a health card
3. Government of Ontario: Find a family doctor or nurse practitioner
4. Government of Ontario: Get coverage for prescription drugs
5. Government of Canada: Canadian Dental Care Plan, do you qualify
6. Bank of Canada: Daily exchange rates

Keep reading

• Getting OHIP: Ontario health coverage for newcomers
• Your first weeks in Toronto: SIN, phone and paperwork
• Medicare when you live abroad
• Health insurance between countries