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OHIP and Addiction Recovery: What You Need to Know About Insurance

There are many ways to get access to effective alcoholism and drug abuse recovery programs. One of them includes applying to an OHIP-covered addiction treatment centre. In this article, we discuss everything you need to know about finding a reputable addiction treatment centre in Toronto and surrounding cities in Ontario where you can use your OHIP health card.

What Is OHIP?

The Ontario Health Insurance Plan (OHIP) covers a wide range of primary and emergency health care services. Through OHIP, the province of Ontario subsidizes doctor appointments, diagnostic tests, treatments and surgeries in full or partial cost.

Who Is Eligible for OHIP? 

To take advantage of its benefits, you must apply for an OHIP health card which is presented to clinics and hospitals during visits. To qualify, you must meet the minimum requirements:

  • Be physically present in Ontario for 153 days out of the year
  • Be in Ontario for at least 153 days of your first 183 days after you began living in the province
  • Have Ontario as your primary residence

You must also fall into one of the following categories:

  • A citizen of Canada
  • A member of the indigenous community registered under the federal Indian Act
  • A permanent resident
  • Have applied for permanent residence and have not yet been denied by the Immigration, Refugees and Citizenship Canada 
  • Have a valid working permit and are working full-time in the province or for an Ontario-based employer for the last six months
  • In Ontario on a valid work permit under the federal Live-in Caregiver Program
  • A convention refugee or other protected person (as defined by the Immigration and Refugee Board of Canada)
  • Have a temporary resident permit (only specific case types qualify)
  • A clergy member legally staying in Canada and ministering full-time in Ontario for the last six months

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OHIP Covered Addiction Treatment

When you or a loved one makes the brave decision to get help, you have two options: enrolling in a private addiction treatment centre vs. a government rehab centre. It is possible to get access to some OHIP-covered addiction treatment, although you may encounter some limitations. 

OHIP-covered addiction treatment centres are privately owned but receive public funding to accommodate individuals with alcoholism or substance abuse disorders. 

Public OHIP Covered Addiction Treatment Centres

The OHIP health card is accepted in both government rehab centres and private addiction treatment facilities.

Publicly-funded rehab centres are most likely covered by OHIP and the cost of the majority of addiction treatment services offered. Based on specific individual needs, patients will be offered private or semi-private rooms, which are assigned. OHIP can also shoulder your lodging cost if it can be justified that it is necessary for your recovery.

On the contrary, if it is deemed unessential to your treatment plan, but you still wish to get a room upgrade, the addiction treatment centre may ask you to pay for it using your private healthcare insurance or out of pocket. There may also be instances wherein highly specialized treatments and prescription medications may not be covered by OHIP.

How to Apply for a Government-Funded Addiction Treatment Program

Basic Requirements:

  • You should be at least 18 years old. This is to ensure that patients are attending the OHIP-covered addiction treatment voluntarily.
  • You must be sober or have gone through medically-supervised alcohol or drug detox. Sometimes, medical detox is not covered by OHIP for patients seeking full residential treatment.
  • You must have a valid OHIP health card. In light of the coronavirus pandemic, the province of Ontario is waiving the three-month waiting period for OHIP coverage effective March 2020. If your membership has expired or is expiring soon, you do not need to renew and can still access health care services.

Next Steps:

Booking an appointment with an addiction counsellor at your local mental health and addiction office is the first step. The counsellor will conduct an assessment and will either:

  1. Refer you to an outpatient addiction treatment program as an immediate but short-term solution.
  2. Put you on the waiting list of an OHIP-covered residential treatment program.

Unfortunately, government addiction treatment facilities are notorious for their long waiting time, with times of up to 60 days and only offer limited treatment approaches without long-term support to prevent relapse. Despite the fact it’s affordable, delayed treatment can be troublesome for people struggling with addiction and are already in an extremely vulnerable state.

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Consider Private Addiction Treatment Centres

If you live in Ontario, another option is to research private addiction treatment centres that offer some OHIP covered addiction treatment plans. Like government rehab facilities, there may be auxiliary services that may incur additional charges. Aside from OHIP, stays in private addiction treatment facilities may also be paid for using a private health care provider.

Signing up for a private addiction treatment facility may cost more than government rehab centres, even with an OHIP card. However, there are significant advantages worth noting that Freedom From Addiction, a private addiction treatment centre near Toronto, offers its patients:

No Long Wait Times

Instead of waiting with uncertainty, we can get you admitted within days after your initial inquiry.

Advanced And Integrative Treatment Approaches

We implement the latest research and holistic treatments to get to each patient’s root cause of addiction effectively.

Emotional Recovery

We believe emotional recovery is essential to start healing from the trauma that may have led to one’s substance abuse disorder. Additional cognitive behavioural therapies and anger management are practiced to educate patients about how to process their emotions.

Support For Family Members

Addiction and alcoholism affect friends and family as well. We provide awareness and emotional support through family counselling in addition to group and individual counselling sessions.

Balanced Patient To Therapist Ratio

Rest assured that patients are well taken care of while in our recovery home. Unlike government rehab centres, Freedom From Addiction has a sufficient number of trained medical professionals, staff members, counsellors and therapists on our team to make sure that every patient’s need is met.

To inquire about the possibility of an OHIP covered addiction treatment plan with Freedom From Addiction for you or a loved one, please do not hesitate to reach out to us. A member of our team will get back to you shortly!

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