OHIP Coverage for Plastic Surgery: Everything You Need to Know
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OHIP Coverage: Everything You Need to Know

When patients inquire into procedures at our clinic, they often ask whether OHIP will fully or partially cover a procedure. We totally get it. Surgical procedures can be very costly, and we completely understand the need to search for some support when looking to finance certain procedures.

That being said, the majority of what we do at The Plastic Surgery Clinic is cosmetic surgery, which means that it typically does not get covered by OHIP. If you’re looking to get procedures like a breast augmentation surgery, a mommy makeover, a tummy tuck, or a Brazilian butt lift, none of these types of surgeries will be covered by OHIP.

That’s not to say that OHIP will not cover anything. Again, this is more the exception than the norm, but in some cases certain procedures may be covered by OHIP, such as breast reduction surgery and some minor procedures. If your procedure is being considered for OHIP coverage, here are some things to keep in mind.

OHIP Coverage of Breast Reduction Surgery

Breast reduction surgery may be covered by OHIP. If you’re seeking out a breast reduction procedure, you will first have a complimentary consultation with one of our surgeons. Based on your surgeon’s assessment, they’ll advise as to whether or not you might be eligible for OHIP coverage.

It’s important to keep in mind that a breast reduction surgery is done in conjunction with liposuction to address fullness at the “side” of the breast. The liposuction portion won’t be covered by OHIP, so you will receive a quote for this part of the procedure. The liposuction part of a breast reduction surgery is not optional. We won’t perform the surgery without liposuction.

With regards to the portion of the breast reduction procedure that will be covered by OHIP, one of our patient coordinators will walk you through all the steps necessary to secure coverage.

Typically the process looks like this: an OHIP application form will be submitted by us to the Ministry of Health for approval. It can take anywhere from 6-8 weeks to hear back, so we will contact you once we have an answer from OHIP.

And you don’t need a referral form your doctor to come see us about a breast reduction surgery. If you have one, that’s great! But if not, you are welcome to come in for a complimentary consultation just the same.

OHIP Coverage and Minor Procedures

At The Plastic Surgery Clinic we also do minor procedures, from mole removal to earlobe repair. Though a referral from your doctor for a minor procedure is preferable, we will see you for a consultation if you don’t have one.

Again most minor procedures are not covered by OHIP, but in certain cases OHIP will extend coverage. We can’t tell you straight off the bat which procedures may or may not be covered, as it’s something that really needs to be assessed by one of our surgeons on a case by case basis.

Ultimately, the consultation with one of our surgeons is always the first step to knowing whether a procedure might be considered for OHIP coverage. If your surgeon feels a procedure is eligible, one of our patient coordinators will follow the same steps taken with breast reduction surgery, from filling out and submitting the OHIP application to contacting you as soon as we have an answer.

We’re always here to offer any support to our patients that we can, and to make reaching your goals as attainable as possible. If your procedure is not covered by OHIP, we have a wide range of financing options that can alleviate some of the pressure that can sometimes be felt when considering any type of surgical procedure big or small.

Never hesitate to come talk to us. We’re here to listen and to help in any way that we can.

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