Is Psychotherapy Covered by OHIP or Extended Insurance Benefits?
Fees and coverage for psychotherapy in Ontario can be confusing.
With this in mind, I put together this post to hopefully help navigate you toward some answers.
Broadly, from a provincial standpoint, emotional and mental health is considered to be the private responsibility of the individual.
Registered Psychotherapists: OHIP & EAP?
Psychotherapy services provided by Registered Psychotherapists are not covered by OHIP (Ontario Health Insurance Plans) or the majority of EAP (Employee Assistance Plan) services.
Registered Psychotherapists: Private Insurance Benefits Providers
Recently with the official proclamation of the College of Registered Psychotherapists of Ontario (CRPO), a growing number of private insurers are beginning to provide coverage for Registered Psychotherapists.
But because plans and coverage can vary greatly amongst providers, please check directly with your benefits provider for coverage specific to ‘Registered Psychotherapists’ who are members of the College of Registered Psychotherapists of Ontario.
Benefits Coverage of Other Professional Practitioners Practicing Psychotherapy
Most commonly, therapy services covered by private insurance provides coverage for ‘Registered Psychologists’, ‘Clinical Psychologists’ and/or therapy provided by Social Workers (‘MSW’ or ‘RSW’).
However, while a portion of therapy fees provided by these professionals may be covered, it is best to be clear on the details of your particular coverage.
For the most part, you will be expected to pay for the fee in full at the time of the session for later reimbursement, and coverage often only extends to a portion of the fee to a predetermined yearly maximum.
I would recommend being mindful of a therapist’s fee (which can vary substantially between practitioners) and budgeting for longer term therapeutic support, as the fee following your yearly benefits allowance may be prohibitive for work with the same therapist should you wish to continue.
In a previous post, I discuss research findings speaking to the correlation between experiencing long-term benefits from therapy and the minimum number of sessions often cited to achieve these benefits, which may be helpful for you to get a sense of how the therapeutic process can be most beneficial for you.
As for OHIP, psychotherapy is covered when it is provided by a medical professional, such as a psychiatrist or a general practitioner (GP).
In order to work with a psychiatrist, you will require a referral from your GP. Many psychiatrists work from a model favouring diagnoses and medication-based treatments, which may or may not be a good fit in approach for everyone seeking therapy.
Many general practitioners, on the other hand, do not have specific training in providing psychotherapy.
If you are looking for therapy covered by OHIP, I would recommend speaking directly with your GP to discuss your options.
The details regarding fees for psychotherapy can be quite confusing, and I hope this post has helped to provide some clarity.
For more information regarding my policies, please visit my Fees & Policies page.
The information provided on this site is intended for your general knowledge only and is not a substitute for professional advice or treatment. You should not use this information to diagnose or treat an issue, problem or concern without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have.