Is a podiatrist covered by OHIP? Find out using our free online tool
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Good to know
OHIP is Ontario's public health insurance plan. It covers many emergency and preventative medical care costs. The basics, such as doctor visits and emergency health care, are usually covered by OHIP, but not everything is. This tool will help you determine what's covered and for how much. The remaining costs can be paid out-of-pocket, or with supplemental private health insurance.
Is a podiatrist covered by OHIP in Ontario?
In Ontario, OHIP offers some coverage for podiatry, but it’s quite limited. OHIP’s coverage focuses on essential consultations and some minor procedures, while routine foot care and custom orthotics remain fully at your own expense. If you’re considering seeing a podiatrist, here’s what OHIP will and won’t cover, so you can plan for any potential out-of-pocket costs.
| What's Covered by OHIP | What's Not Covered by OHIP |
|---|---|
| Basic Podiatry Visits: $16 per visit, up to $135 annually | Routine Foot Care (e.g., nail trimming, callus care) |
| Minor Surgical Procedures: Up to $30 per visit | Custom Orthotics |
| Annual Coverage Limit: Up to $135 per year | Any additional costs beyond OHIP’s coverage limit |
For a more complete range of podiatry services, private insurance can help cover those extras that OHIP doesn’t include. You can use our free tool below to compare the best private health insurance plans in Canada.
Compare The Best Health Insurance Plans in Seconds
What does OHIP consider “medically necessary” for podiatric services?
OHIP considers podiatric services to be “medically necessary”, meaning they qualify for coverage if they address health conditions requiring professional intervention rather than routine or cosmetic foot care. This typically includes:
- Consultations and Assessments: When a podiatrist evaluates symptoms of foot or ankle conditions that affect mobility, posture, or quality of life.
- Minor Surgical Procedures: Medically necessary minor surgeries, such as treatment for ingrown toenails, wart removal, or other procedures addressing specific foot ailments, may receive partial OHIP coverage.
- Foot Care for Chronic Health Conditions: Patients with certain chronic conditions like diabetes, where foot health is essential for preventing complications, may have essential care covered, though this depends on the specific treatment.
Who is eligible for OHIP podiatry coverage?
OHIP provides partial podiatry coverage to all eligible Ontario residents, with no age restrictions or special eligibility criteria. This means that anyone with valid OHIP coverage, regardless of age or specific health needs, qualifies for basic podiatry coverage.
Remember that you will need an OHIP card to access any services under the provincial healthcare plan. If you don't have a card yet, read our step-by-step guide on OHIP Card: how to apply, renew, and more.
Does OHIP cover podiatrist for seniors?
OHIP offers limited coverage for podiatrist visits in Ontario, applying equally to all eligible residents, including seniors—there is no additional or specialized plan for seniors. For each eligible podiatry visit, OHIP provides $16 in coverage (up to a total of $135 per year), which means that any costs exceeding this amount will be an out-of-pocket expense for the patient.
Additionally, OHIP provides up to $30 per visit for minor surgical procedures performed by a podiatrist, but this is only for medically necessary treatments.
It’s important to note that OHIP does not cover routine foot care services, such as nail trimming, callus care, and general maintenance, which are often important for seniors, especially those with diabetes or other health conditions affecting foot health. Custom orthotics, often recommended for alignment or foot pain, are also excluded from OHIP coverage and must be paid for privately.
What do podiatry services cost without OHIP coverage?
Here’s a table showing the average costs of common podiatry services in Canada without OHIP coverage:
| Podiatry Service | Average Cost (CAD) | Notes |
|---|---|---|
| Initial Consultation | $80 - $150 | Includes assessment of foot health and any recommended treatments |
| Follow-Up Visit | $50 - $100 | For ongoing treatment, varies depending on the clinic and complexity of care |
| Custom Orthotics | $300 - $500 | Custom insoles designed to correct foot alignment and alleviate pain |
| Nail Surgery (e.g., ingrown nail) | $200 - $350 | Minor surgical procedure for painful ingrown toenails |
| Routine Foot Care | $40 - $80 per session | Includes nail trimming, callus removal, and general maintenance |
| Wart Removal | $80 - $200 per session | Often requires multiple sessions for complete removal |
| Orthopedic Shoes | $150 - $400 | Specialized footwear for comfort and support; may vary depending on customization |
| Diabetic Foot Care | $60 - $100 per session | Essential care to prevent complications, often recommended regularly for diabetic patients |
These prices vary based on location and clinic, and private insurance may help cover some of these out-of-pocket expenses.
What does private health insurance cover for podiatric services?
Private insurance often provides broader coverage for podiatry services than OHIP, filling in the gaps for services and procedures not covered by public health insurance. Here’s what private insurance typically covers for podiatry:
| Service Type | Private Insurance Coverage | Coverage Limits |
|---|---|---|
| Routine Podiatry Visits | Typically covered in full or partially | May have annual or per-visit limit |
| Custom Orthotics | Covered, often partially (e.g., $200-$500 per year) | Annual maximum varies by plan |
| Orthopedic Shoes | Partially or fully covered | Often an annual limit or set reimbursement |
| Minor Surgical Procedures | Covered, varies by procedure type | Depends on insurance policy specifics |
| Routine/Preventive Care | Often covered for conditions like diabetes or arthritis | Varies by plan; may require doctor’s note |
To find private insurance with podiatry coverage, explore our free tool to compare multiple personalized quotes online in seconds.
Compare The Best Health Insurance Plans in Seconds
FAQs on OHIP podiatry coverage
OHIP offers limited coverage for podiatrists in Ontario, including $16 per visit up to a maximum of $135 per year for insured services and up to $30 per minor surgical procedure. However, routine foot care and orthotics are not covered.
Without insurance, podiatrist visits in Canada range from $50 to $300 CAD depending on the service, with initial consultations often costing $80-$150 and specific treatments, like orthotics, adding to the total.
No, chiropodists are not covered by OHIP in Ontario. Unlike podiatry, which has partial OHIP coverage for specific services, chiropody services are generally considered outside the scope of OHIP coverage. This means that all consultations, treatments, and services provided by a chiropodist must be paid out-of-pocket or through private insurance.
OHIP does not cover routine foot care, such as nail trimming, callus care, or custom orthotics. Only certain medically necessary podiatry services may receive partial coverage under OHIP.
Yes, private insurance often covers a range of podiatric services, including consultations, minor procedures, and orthotics. Coverage varies by plan, with many offering partial or full reimbursement up to an annual limit.
I have diabetis and I also can not bend over enough to cut toe nails because of so many surgeries. Can I get coverage to have someone come to my house and cut nails?