Beyond OHIP: Every Province's Rules for Reimbursing Surgery Abroad

Most Canadians believe their provincial health plan covers nothing abroad. Most are wrong. Every province has some form of out-of-country medical coverage — though the rules, approval requirements, and reimbursement rates vary significantly.

Understanding your province's program before you travel is the difference between absorbing the full cost yourself and recovering a meaningful portion.

The general framework

Provincial out-of-country programs typically reimburse at the rate the province would have paid for the same service domestically. This means the reimbursement may be significantly less than what you pay abroad (especially in the US), but for procedures done in lower-cost countries like Colombia, the reimbursement can cover a substantial portion — sometimes the majority — of the actual cost.

Prior approval is almost always required. If you travel and get surgery without prior approval, most provinces will not reimburse you, even if the procedure would have been approved. The approval process typically requires a physician referral documenting medical necessity and the reason the procedure cannot be performed domestically in a timely manner.

Province-by-province overview

Ontario (OHIP)

OHIP's out-of-country program covers emergency and medically necessary services abroad at Ontario rates. Prior approval required for non-emergency care. Reimbursement is typically at the OHIP fee schedule, which is often below actual cost. Application through the Out-of-Country Prior Approval Program.

For the detailed OHIP guide, see medicaltourismabroad.com's OHIP explainer.

British Columbia, Alberta, Quebec, Manitoba

Each province operates a similar framework with province-specific rates and processes. BC's Medical Services Plan, Alberta Health Care Insurance Plan, RAMQ in Quebec, and Manitoba Health each have out-of-country provisions with prior approval requirements. Reimbursement rates and approval criteria differ — check your province's health ministry website for current guidelines.

Atlantic provinces

New Brunswick, Nova Scotia, PEI, and Newfoundland and Labrador have smaller programs with similar structures. Wait times for covered procedures are often longest in Atlantic Canada, which strengthens the prior approval argument for seeking care abroad. See surgerywaittimes.com's Atlantic Canada analysis.