OHIP COVERED PHYSIOTHERAPY
Is Any Physiotherapy Covered Under OHIP?
Yes, physiotherapy is covered by OHIP. We-Fix-U Physiotherapy and Foot Health Centres in Cobourg and Port Hope are approved to accept OHIP funding for eligible Physiotherapy patients! If you meet any of the following criteria, you may be eligible to benefit from our OHIP covered physiotherapy services. If you:
- Referred by a physician or nurse practitioner…..
- are 65 years of age or older
- are 19 years of age or younger
- are eligible/receiving funding from the Ontario Disability Support Program (ODSP)
- are eligible/receiving funding from Ontario Works
- have recently been discharged (as an inpatient) from Hospital and are in need of Physiotherapy services for the condition, illness or injury that you were admitted for.
OHIP patients will now be able to receive the same great services we offer our existing patients!
Frequently Asked Questions
What is the OHIP physio coverage? What services are covered under publicly funded physiotherapy services?
Under the “Episode of Care” (EOC) funding model, funded physiotherapy services include: assessment, diagnosis and treatment to improve, develop or rehabilitate physical function and promote mobility lost or impaired as a result of a debilitating event or disease, pain, injury or surgical procedure. Funding for physiotherapy services includes payment in full for the assessment, diagnosis, treatment and discharge summary reporting to the referring physician or nurse practitioner.
The funding under the program is not intended for group exercise, activation, or falls prevention classes or services provided solely to maintain an existing level of function, or services provided concurrently with physiotherapy services already provided or funded by other Ministry of Health and Long-Term Care (MOHLTC) or health system programs or through automotive insurance or the insurance plan established under the Workplace Safety and Insurance Act.
Is maintenance funded?
No. The clinic physiotherapy services funded under this program are aimed at addressing acute episodes or worsening of symptoms that lead to decreased function or mobility (e.g. debilitating event or disease (including chronic disease), pain, injury or surgical procedure). Should a patient’s condition change or deteriorate, their function decrease or their mobility level worsen, (i.e. as a result of a debilitating event or disease, pain, injury or surgical procedure), they may become eligible for funding for an EOC in a clinic setting provided that all eligibility criteria, including a separate referral, are met.
Is there a waiting list for OHIP physiotherapy services?
Physiotherapy will be funded in a manner similar to many other publicly funded programs including hospitals, long-term care homes, etc. There is an overall provincial budget for funding of clinic-based physiotherapy services. Clinics may have waiting lists for publicly funded care. The ministry’s expectation is that clinics will continue to provide services in every month during which the funding agreement is effective and, as such, clinics will need to manage their EOC and their budget to best meet this need.
Wait lists may occur and we will work to manage our wait list within the budget we have been allocated by the MOHLTC with transparency of process, diligence and efficiency.
Please review our wait list management framework:
Client’s name and contact information, eligibility criteria (as per MOHLTC), physician/nurse practitioner diagnosis and date of referral are documented at the time of referral. Client’s are prioritized based on acuity of condition:
- post-op or recent fractures
- recent soft tissue injuries
- chronic conditions
Clients are generally provided with an estimated wait time based on guidelines noted above (taking into consideration referral volume) and provided with alternate, privately funded and OHIP physiotherapy providers in the area in cases of excessive wait times or in response to queries.
If you have any questions or concerns or would like us to provide you with options for privately funded physiotherapy services please feel free to ask us.
Can a patient receive more than one episode of care in a year?
Yes. A patient can receive more than one episode of care in a year provided that all eligibility criteria, including a separate referral is met for each individual episode of care. Each episode of care is one discrete group of condition/diagnosis specific, time-limited, goal-oriented physiotherapy services provided to a specific patient and must involve an assessment, diagnosis, treatment (according to a set plan with treatment goals, and discharge (including reporting on specific outcome measures).
To Get Started
For more information, feel free to book a free no obligation appointment here.