What you were told
"Private means you pay for everything."
The three parts of the bill, and who usually pays each
Menopause HRT in Ontario comes with three separate costs: our visits, your bloodwork and the medication. Each one is paid differently. Here's who usually pays for which.
"Private means you pay for everything."
What people ask, more or less in these words:
- "Is any of this on OHIP?"
- "Will I be paying for the hormones myself?"
- "Does my benefits plan cover a nurse practitioner?"
- "Is there a package I have to sign up for?"
The honest answer starts with a question back: which part of the bill do you mean? Some of it is usually covered. Some of it usually isn't. Nobody should find out which at the pharmacy counter.
The three parts of the bill
Our visits
Who usually pays: You, or your Health Spending Account if your plan reimburses NP visits.
Our fees are for the assessment and the follow-ups.
If you have a Health Spending Account, check whether it reimburses nurse practitioner visits, and ask us for an itemised receipt.
Bloodwork
Who usually pays: Usually your Ontario health card. Done at a local collection centre with our requisition.
Our fee: None from us.
We only order bloodwork when the result will change a decision, and we tell you what each test is for.
Source: ontario.ca, What OHIP covers: medically necessary lab tests, including at community labs, when a nurse practitioner orders them (https://www.ontario.ca/page/what-ohip-covers).
Medication
Who usually pays: A public plan if you're 65+ (Ontario Drug Benefit) or 24 and under without a private plan (OHIP+). Otherwise your workplace drug plan, or you at the pharmacy.
Our fee: None from us. Paid at the pharmacy.
Source: ontario.ca, Ontario Drug Benefit and OHIP+ eligibility.
- 1You send the form. We call or email you back.
- 2You book your online assessment.
- 3Bloodwork, if it helps: you take our requisition and your health card to a local collection centre.
- 4A plan you understand. If a prescription is appropriate, you fill it at a pharmacy and pay through your public plan, your drug plan or yourself.
- 5Follow-ups. Repeat bloodwork when it's due.
- Your age. It decides whether a public drug program covers the medication.
- Your workplace drug plan. Deductibles, co-pays and dispensing fees vary from plan to plan. Ask before the first fill, not after.
- Your Health Spending Account. Whether it reimburses nurse practitioner visits is up to the plan.
- What's prescribed. Body-identical hormones come in Health Canada approved prescription products. Custom-compounded "BHRT" isn't Health Canada approved, so don't assume a plan treats it the same way. We don't prescribe custom-compounded creams.
- How many follow-ups you need. Each follow-up is a visit.
Source: SOGC, Menopause and U, "Bioidentical hormone therapy".
Asked plainly
Answered plainly.
01Is HRT covered by OHIP?
Partly. Bloodwork usually is. The medication usually isn't, unless you're 65+ or 24 and under.
02Can my Health Spending Account pay for the visits?
If your plan reimburses NP visits, it may. Check with your plan before you book, and ask us for an itemised receipt for the claim.
Ask about the bill. You'll get a straight answer.
An online assessment with the Nurse Practitioner, from home, anywhere in Ontario. Follow-ups from home too.
This page is general information, not advice about your own coverage. Your plan's answer is the one that counts.