Recently, the Ministry of Health working alongside the Physician Appropriateness Working Group have updated the OHIP insured/uninsured benefits to reflect current evidence-based guidelines to provide best care for patients. The following changes were made to ensure Ontarians get the best possible care, while reducing redundancy and health system waste (Choosing Wisely).If you have questions about the below changes –please talk to one of your healthcare providers about the changes.
STREAMLINING PRE-OPERATIVE ASSESSMENT
WHAT:Previously, routine pre-operative assessment by a primary care provider was required by the Ontario Hospitals Act. However, Pre-Operative assessments are often best done by those involved with the surgical procedure (the surgeon, the anesthesiologist, or the medical doctor who provides hospital care/follow up). Routine pre-operative assessments will no longer be insured for primary care providers
WHAT WILL THIS MEAN FOR ME: Your primary care provider and surgeon can still make referrals to Preoperative Assessment clinics which will continue to help with pre-operative planning. These visits will still be insured by OHIP. If your surgical provider still feels they require your family physician to do a Pre-Operative physical form in addition to this assessment, there may be a cost associated of $65.00 with the completion of this assessment and forms.
PERFORM EAR WAX REMOVAL ONLY WHEN MEDICALLY NECESSARY
WHAT:Ear wax removal will only be insured when it results in hearing loss and applying topical medications has been unsuccessful, or when immediately removing the wax is necessary for diagnosis and/or therapy.
WHAT THIS MEANS FOR YOU:Your physician may ask you to try topical medications to remove ear wax prior to manual removal at an associated cost of $11.25 per ear.
ADMINISTER URINE PREGNANCY TESTS ONLY WHEN MEDICALLY NECESSARY
WHAT: Urine pregnancy tests will only be insured when an immediate determination of pregnancy is required.
WHAT THIS MEANS FOR YOU: If you are pregnant, a home pregnancy test is one way to confirm pregnancy. You can discuss with your provider if other testing including blood tests and ultrasounds might be used to confirm or date your pregnancy (these tests are still covered by OHIP). If your doctor needs to do a pregnancy test to rule for a medical reason, these will still be covered.