Revisions to the Ontario Health Insurance Plan (OHIP) means some Ontarians will have to pay out of pocket for some procedures that were once covered.
Changes to the plan went into effect October 1, and include financial and procedural adjustments to services like certain pregnancy test methods and certain types of secretion removal.
The changes were made based on recommendations by a physician-lead group, who were asked to review a number of OHIP-insured services. The assessment is part of an effort to provide more effective care in the province. According to the Ontario Ministry of Health, the modifications are expected to save Ontario taxpayers about $83 million.
Some of the changes include:
Fewer x-rays for sinus-related problems
CT scans will be used if imaging is required on sinuses as x-rays are shown to be not as effective.
New referral system for patients with chronic hip and knee pain
In an effort to minimize unnecessary hip and knee CT/MRI scans and surgical consultations, patients will now be referred to rapid access clinics with specialized care.
Ear wax cleaning will only be done when medically necessary
Coverage for ear wax cleaning is no longer available. Doctors will now charge for the service unless the ear wax is causing hearing loss, over-the-counter medicine is ineffective or it needs to be removed to deal with another condition.
Reducing the use of dipstick pregnancy tests
Blood pregnancy tests will now be used in place of dipstick tests, which will only be insured if the patients needs results to prevent imminent harm.
Physician premiums for house calls will only be funded for patients who are frail seniors, housebound and/or receiving palliative care.
The use of ambulatory cardiac monitoring devices
Loop recorders, an outdated technology used to evaluate cardiac electrical activity in out-patients, are no longer funded.
Referrals to specialists
Patients will no longer need to visit their primary care provider for a letter to see a specialists they’ve already seen for the same problem, within a two-year period.
Infertility diagnosis testing
OHIP will no longer cover post-coital testing of cervical mucous, a method now considered to be outdated.
Examination of the stomach will no longer include additional examination of the larynx, when there’s no evidence of a problem. Laryngoscopy services will only be provided when medically necessary.
"History and physical" assessments by a family doctor are usually requested before an operation by surgeons, although they’re not medically required. Now patients will be assessed by the surgeon and anesthesiologist before the surgery to determine the right anesthetic care.
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