Yes, OHIP will cover certain cosmetic procedures used to fix trauma scars or deformities.
- Trauma scars
- OHIP will cover the cost of repair to any trauma scars on the face or neck.
- If the scars are on any other body part OHIP will NOT cover the cost of repairs UNLESS the scars interfere with functioning or present pain or other significant symptoms.
- Post-traumatic deformities
- If you suffered deformities as a result of a traumatic event OHIP will cover the reconstructive procedure.
- OHIP will cover reconstructive procedures such as bone revision, tissue shift and grafts, prosthesis implantation, and more.
In general, OHIP will not cover procedures just to restore appearance. However, exceptions can be made if the operation is:
- recommended by a mental health facility
- for a person under 18 and is on a body part that is not normally clothed.
For an exception to be granted surgeons must fill out this form (Request for Approval of Payment for Proposed Surgery) to get the procedure approved by OHIP.
For more information on procedures covered under OHIP read Appendix D of the Schedule of Benefits: Physician Services Under the Health Insurance Act
OHIP won’t cover my medical expenses what can I do?
If OHIP does not cover your medical procedure you can file a personal injury lawsuit to recover financial compensation for past and future medical expenses for your injuries.
If you have been injured in a:
- Dog attack
- Motor vehicle accident
- Assault
- Slip and fall accident
- Biking accident
- Boating accident
Contact our personal injury lawyers at Equilibrium law for a free consultation.
If you believe OHIP has unfairly denied your claim you can submit a claim to the Health Services Appeal and Review Board.