Are Dermatologists Covered by OHIP? Here's What You Need to Know

Wondering if your Ontario Health Insurance Plan (OHIP) covers dermatology services? It’s not a straightforward yes or no. Generally, OHIP will cover medically necessary dermatology services—things like diagnosing and treating a skin condition that impacts your health. But if it’s a cosmetic procedure, that’s usually not covered. Here's what you need to know.

What's covered by OHIP?

Most medical dermatology procedures are only covered by OHIP if they’re considered medically necessary, such as:

• Acne treatment

• Cyst treatment

• Eczema treatment

• Psoriasis treatment

• Skin cancer treatment

• Suspicious mole removal

Keep in mind that where a lesion is located can impact whether it’s covered by OHIP. 

What's not covered by OHIP?

Any consultations or procedures considered non-medically necessary (like cosmetic procedures) are not covered by OHIP, including:

• Age spots or liver spots

• Angiofibroma

• Benign skin growths

• Botox or fillers for wrinkles

• Cherry angiomas

• Cosmetic mole removal

• Cyst (non-medically necessary) treatments

• Dermatofibromas

• Epidermoid cysts

• Lipomas

• Laser treatments for scars

• Seborrheic keratosis

• Skin tag removal

• Syringomas

• Wart removal (if not harmful or affecting mobility)

• Xanthelasma

Do I need a referral to see a dermatologist?

To see a dermatologist for a medical condition, you’ll need a referral from your primary care physician or another specialist. First, you'll need to discuss your condition with your doctor to determine if it requires a general dermatology appointment. Once the referral is received, the dermatology office will either reach out to you directly or send the appointment details to your referring doctor. Each dermatological condition requires its own referral. And yes, these appointments are covered by OHIP.

However, some skin conditions aren’t covered by OHIP, which means you can see a dermatologist without needing a referral. For example, benign lesions are usually classified as non-essential services under the Ministry of Health guidelines, so you can book an appointment directly.

How to see a dermatologist in Ontario

If you need to see a dermatologist in Ontario, the process depends on whether your concern is medical or cosmetic.

Medical dermatology services

For medical concerns like skin infections, suspicious moles, or potential skin cancer, you’ll need a referral. You can get one from your family doctor, a walk-in clinic, or a nurse practitioner. In urgent situations, even an emergency room (ER) doctor can provide a referral.

And remember, medically necessary treatments are covered by OHIP, so you won’t have to pay for the consultation. The downside? Wait times for OHIP-covered dermatologists can be long—sometimes several months. Common conditions that need a referral include eczema, psoriasis, acne, and skin cancer screenings.

Non-medical dermatology services

For cosmetic procedures like Botox™ injections or non-suspicious mole removal, OHIP doesn’t cover the costs. The good news is that you can go straight to a dermatologist for dermatology consultations regarding cosmetic procedures without needing a referral. However, you’ll need to pay out of pocket or use private insurance to cover the costs, as these procedures aren’t free unless your private insurance includes them.

Final thoughts

Your Ontario Health Insurance Plan (OHIP) will cover consultations and procedures for skin conditions it deems medically necessary, such as severe acne, eczema, psoriasis, suspicious mole removal, skin infections, and skin cancer. However, OHIP will not cover cosmetic procedures like Botox™ injections or skin tag removal.

If you’re in the Toronto area and considering cosmetic dermatology treatments, we’d love to help you at FACET Dermatology. Dr. Geeta Yadav and her skilled nursing team are committed to providing top-notch care and personalized treatment plans to enhance your skin health and boost your confidence.

Reach out to us by phone or fill out our online contact form. We look forward to hearing from you!

FAQs

Is dermatology covered by OHIP?

Generally, OHIP will cover medically necessary dermatology services—things like diagnosing and treating a skin condition that impacts your health. But if it’s a cosmetic procedure, that’s usually not covered.

What skin conditions are covered by OHIP for dermatology?

Most medical dermatology procedures are only covered by OHIP if they’re considered medically necessary, such as severe acne, eczema, psoriasis, suspicious mole removal, skin infections, and skin cancer.

Are OHIP-covered dermatology services limited to certain treatments?

Yes. In general, OHIP only covers dermatology services that are deemed medically necessary—like diagnosing and treating skin conditions that affect your health.

Is acne treatment covered by OHIP under a dermatologist?

Basic acne consultations and treatments are covered by OHIP if they’re considered medically necessary. But cosmetic treatments, like chemical peels  or cortisone injections for acne scars, aren’t covered—you’ll need to pay for those out of pocket.

Is scar treatment covered by OHIP?

In most cases, OHIP considers scars a cosmetic issue, so it doesn’t cover the cost of treatment.

How much does it cost to see a dermatologist in Ontario?

In Ontario, OHIP covers visits to a dermatologist for medical issues, so you can get care for your skin at no cost. However, cosmetic procedures aren’t included, so you’ll need to pay for those yourself. If you’re considering a cosmetic service, it’s a good idea to ask about pricing during your consultation or when scheduling your appointment.