Is addiction treatment covered by OHIP in Ontario?

What Does Addiction Treatment Involve?

Addiction Clinic Toronto is an appointment-based medical clinic for opioid use disorder and alcohol use disorder. For opioid use disorder, physicians offer opioid agonist treatment (OAT): a long-acting medication, prescribed and monitored by a physician, that prevents withdrawal and reduces cravings. This can make it easier to step back from opioid use and rebuild daily routines. For alcohol use disorder, treatment can include medication to reduce cravings and help with managing withdrawal safely.

OAT is a recognized, evidence-based approach to opioid use disorder, prescribed by physicians who have training in addiction medicine. It is not a quick fix, and no single option is right for everyone - a doctor will talk with you about your history, your goals, and which treatment might suit you. There is no obligation to commit to anything before you have had a chance to ask questions.

Are Physician Visits Covered by OHIP?

Yes. Visits with a physician at Addiction Clinic Toronto for addiction treatment are covered under OHIP, the same as any other medical appointment in Ontario. This includes the initial assessment, follow-up visits, and ongoing monitoring appointments needed to manage your treatment safely. You will need a valid Ontario health card to be seen; if your coverage has lapsed or you are unsure of your status, our staff can talk you through what is needed.

Because OHIP covers the physician's time, you should not be asked to pay out of pocket for a standard consultation or follow-up appointment related to your treatment. This is separate from the cost of the medication itself, which is billed differently and depends on your personal drug coverage, explained in the next section. Knowing this distinction upfront can help take some of the guesswork out of getting started.

What About the Cost of Medication?

Medication costs work differently from physician visits. After your visit, your physician sends your prescription electronically to the pharmacy you choose. The pharmacy bills for the medication, and what you pay - if anything - depends on the drug coverage you already have, not on the clinic. Some people have coverage through the Ontario Drug Benefit (ODB) program, OHIP+, a private insurance plan through work or a family member, the Non-Insured Health Benefits (NIHB) program for First Nations and Inuit patients, or the Trillium Drug Program, which is designed for Ontarians with high drug costs relative to their income.

If you qualify for ODB - for example, if you are 65 or older, receive social assistance, or hold a valid Ontario Drug Benefit card - your prescription may be covered with little or no cost to you at the pharmacy. If you are 24 or younger and do not have a private plan, OHIP+ may cover eligible medications. If you have no other coverage, the Trillium Drug Program can help households access coverage based on a deductible tied to household income; applications can be made through the pharmacy of your choice or ServiceOntario.

We are not able to tell you an exact dollar amount you will pay, because that depends on which coverage applies to you and which pharmacy you use. What we can tell you is that our clinic team will talk with you about coverage options during your visit and can point you toward the right program or application if you need help figuring out where you stand.

What to Bring to Your First Appointment

Before your first visit, it helps to gather a few basic documents so your physician has an accurate picture of your health and coverage. Bring your Ontario health card, a list of any medications you currently take (prescribed or otherwise), and any private insurance information you have, such as a benefits card from work. If you already have a health card number but the card itself is missing or expired, let our staff know when you call and we can advise you on next steps.

You do not need to have everything figured out about your substance use before you call - the assessment itself is where those details are discussed, calmly and privately, at a pace that works for you. If you feel nervous about the appointment, you are welcome to bring a support person, such as a family member or friend. Our staff can also answer general questions by phone before you decide on a date.

• Valid Ontario health card (or health card number)
• List of current medications, including dosages if known
• Private insurance card or drug benefit information, if you have it
• Any recent hospital or clinic discharge paperwork related to substance use

Booking Your Appointment

Appointments at Addiction Clinic Toronto, located at 55 Dundas St E in Toronto, are booked in advance rather than on a walk-in basis. You can reach our team by phone at 647-748-1337 or by email at info@addictionclinictoronto.ca, and our phones are answered from 9:00 a.m. to 5:00 p.m., seven days a week, including weekends and holidays, so you can plan around a time that works for you.

When you call, staff will ask a few basic questions to arrange a time with a physician and can answer general questions about what to expect. If English is not your first language or you have other communication needs, mention this when you call so staff can plan accordingly. There is no pressure to make a decision about treatment on that first phone call - booking an appointment is simply the first step toward getting information. You can read how booking works before you call.

If You Need Help Right Now

If you or someone you care about is in crisis - for example, experiencing an overdose, severe withdrawal symptoms, or thoughts of self-harm - call 911 right away. Addiction Clinic Toronto is an appointment-based medical clinic, not an emergency service, and cannot respond quickly enough to help in a crisis situation. Please treat any emergency as exactly that, and reach out to emergency services first, even if you are already a patient here.

For confidential, free support and information about addiction, available any time of day or night, you can call ConnexOntario at 1-866-531-2600. Their trained staff can talk through what you are going through, answer questions about addiction treatment in plain language, and help you find services in your area, whether or not you ever book an appointment with us. You are not required to have a plan before you call them.