The cost of ambulance service
The Ministry of Health pays most of the cost of
an ambulance trip for a patient who is injured or very ill. This applies to an air or land
ambulance. The patient usually pays $45 of the cost, but there are some exceptions.
Medically necessary trips
The Ministry pays ambulance costs over $45 for:
- an emergency trip if the attending physician at
the hospital signs the ambulance call report after the patient has been admitted
- a non-emergency trip if the patient's doctor
states in writing, before the ambulance is used, that the patient's condition makes an
The hospital bills the patient for the $45. When
no hospital is involved, the ambulance operator bills the patient.
Air ambulances cost $45 for medically necessary
trips. If the patient also needs a land ambulance, $45 is charged only once.
The patient must pay $240 for a land ambulance
- the trip is not medically necessary or
- the patient does not have a valid Ontario Health
Card or Health 65 Card.
The $240 charge is the average cost of a land
ambulance trip in Ontario.
The patient is charged the full cost of any air
ambulance flight that is not medically necessary or is not covered by a valid Ontario
Health Card or Health 65 Card. The patient must also pay $240 for any land ambulance used.
Some people are fully covered for ambulance
services if the trip is medically necessary and the patient could not travel by other
means (such as family car, taxi or public transit). The $45 charge does not apply to those
- receiving provincial social assistance (general
welfare assistance or family benefits)
- transferring from one hospital to another for
insured, medically necessary treatment
- transferring from hospital to a rehabilitation
facility, treatment facility for physically disabled children, medical laboratory or X-ray
facility approved by the Ministry of Health
- enrolled in the ministry's Home Care Program
- living in one of the following facilities
licensed or approved by the ministry:
- nursing home
- home for the aged
- rest home
- home for special care
- home or residence for psychiatric patients.
All those listed exceptions must pay $240 if the
ambulance trip is not medically necessary and the patient could have traveled by other
means (such as family car, taxi or public transit).
Frequently Asked Questions
About Ambulance Billing
Why am I receiving a bill for ambulance service; isn't the service free?
No. Service isn't free, but the majority of your ambulance bill is covered by the
provincial Health Insurance Plan (O.H.I.P.). When transported in a licensed ambulance,
Ontario residents receive a bill only for that portion of the bill that is not covered by
your health insurance. This fee is normally $45.00.
How much does ambulance service cost?
Normal land ambulance costs are billed at a rate of $240.00, of which all but $45.00 is
covered by your provincial health insurance.
I am covered by O.H.I.P., but received a bill for $240.00. Why?
O.H.I.P. insures ambulance transportation only for those trips that are medically
essential. The hospital to which you were transported makes the determination as to
whether your ambulance trip was medically necessary. If the doctor decides that you could
have made your way to hospital by another means, you will be billed for the full amount of
the ambulance bill. This is necessary in order to ensure that the system is not abused,
and that the service is available to those who really need it.
I am visiting from the United States, or from another country, and am not insured under
O.H.I.P. How will I be billed?
Anyone who is not a resident of Ontario, or is not insured under O.H.I.P., will be billed
at the full, uninsured rate of $240.00. Some private health insurance carriers and travel
insurance carriers may reimburse you for these costs. It is up to you to discuss this with
your insurance carrier.
I was visiting from another province when I needed ambulance service. I do have health
insurance under my own province's scheme. Should I be receiving a bill?
Yes. You will be billed at the uninsured rate of $240.00. It is your responsibility to
recover any insured costs from your own provincial health insurance plan.
Will I be billed for transfers from one hospital to another?
There is no charge for this service for insured residents of Ontario. Similarly, there is
no charge applied when a patient is transferred to a nursing home, home for the aged, or
other designated special care facilities.
I am on Home Care. Does this affect whether I receive a bill?
Yes, in some circumstances. Patients being sent home on Home Care will not receive a bill
for service, but subsequent calls for ambulance service which are not ordered by your
Doctor, will be billed. Whether or not you are responsible for paying these bills should
be discussed with Home Care.
When I had my accident, the Paramedics provided first aid care at the scene, but I refused
to be taken to hospital. Is there any charge for this service?
There is no charge for this service. You will, however, be required to sign a form
releasing the Ambulance Service and its' employees from any liability arising from your
refusal to go to the hospital.
I was brought to Ottawa for emergency treatment, and it is now time to go home. I am being
sent home by ambulance. What is the charge for this service?
Out of town transfers are billed at the basic rate, plus an additional charge for each
kilometer over 60 km. traveled.