Uninsured Fees & Services | North Simcoe Health

FEES &

SERVICES

We got you covered

The Ontario Health Insurance Plan (OHIP) pays for most of your medical visits and services. However, there are some uninsured services, which OHIP does not cover. Your physician can request a payment from you for those services.

Uninsured Fees

Uninsure Fees

Uninsured Fees

For common medical services

Attending Physician Statements

Prescription Renewals by phone/fax

(when appropriate and only at the

request of the patient or their pharmacy)

$25

Attending Physician Statements

Transfer of Medical Records

Paper Chart

On CD or USB

$35 for first 20 pages and

$ 0.30 per page thereafter

$ 75.00

Attending Physician Statements

Letters on behalf of patients

$25-200 depending on time and work involved

Attending Physician Statements

Travel advice in office

1 person

2 person

$30

$60

Attending Physician Statements

Uninsured Vaccine Administration

$15

Attending Physician Statements

TB Test (Reading fee)

TB Test (Administration fee)

$20

Attending Physician Statements

Medical Examination for Return to Work

requested by Employer

$75

Attending Physician Statements

Driver’s Medical Form (MOT)

$135

Attending Physician Statements

Photocopying + Faxing Documents
(other than prescriptions)

(when patient requests)

$5 for first five page

+$0.50 each additional page

Attending Physician Statements

Medical supplies and dressings etc

$25

Attending Physician Statements

Medical Reports / Forms

Attending Physician Statements

Citizenship and Immigration Report

$145

Attending Physician Statements

Commercial weight loss program

$25

Attending Physician Statements

Day Care Notes

$25

Attending Physician Statements

Completion of Form Physicals for employment or fitness

$40

Attending Physician Statements

Illness and Return to work Notes

$20

Attending Physician Statements

Employment insurance / maternity certificate

$20

Attending Physician Statements

Fitness club forms

$25

Attending Physician Statements

Auto accident insurance forms

$55 when not covered by insurance company

Attending Physician Statements

Jury duty letter

$25

Attending Physician Statements

Medical certification for EI Compassionate care benefits

$55

Attending Physician Statements

Completion of Form Physicals for Schools or Camps

$30

Attending Physician Statements

Travel Cancellation Insurance Forms

$40

Attending Physician Statements

Disability Tax Credit Certificate

$85

Attending Physician Statements

Referral Note for Chiropractor,

Physiotherapy, etc. (for insurance)

$25

Attending Physician Statements

Children’s Aid Society Forms

$45

Attending Physician Statements

Replacement of Immunization Certificate

$15

Attending Physician Statements

Forms required for Volunteer Work

$25

Attending Physician Statements

Missed Appointment

$50

Attending Physician Statements

Missed Annual Physical Exam

$100

Attending Physician Statements

Insurance/Disability Forms

OMA Rate

Attending Physician Statements

Insurance Certificate OCF-3, 18, 23

$160

Attending Physician Statements

Insurance Certificate OCF-19

Catastrophic Impairment $120

$135

Attending Physician Statements

Functional Ability Forms

$160

starting from $55

Attending Physician Statements

Third party Medicals

$100

Functional Ability Form

Cosmetic procedures: Liquid nitrogen

- up to 4 lesions

- 5 or more lesions

- simple lesion - shave/punch

- full lesion excision

Steroid injections

$25 per Rx

$30 per Rx

$125

$175

$ 25