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OHIP Form ON00314E: Out-of-Country Prior Approval

A practising Ontario physician submits this eForm on a patient's behalf to ask OHIP to fund medically necessary treatment outside Canada that is unavailable in Ontario, or unavailable without a delay risking death or irreversible tissue damage. It covers consultations, surgery, cancer care, drug therapy, emergency transfers, MRI and residential mental health treatment. Prior approval is required before treatment except in emergency circumstances.

Who completes it

The referring Ontario physician completes all parts and confirms the Part 5 regulatory criteria, attaching written confirmation from an appropriate specialist if the service is outside their scope of practice. For emergency services an approved emergency patient referral service may submit instead, and a substitute decision-maker is recorded for patients under 16.

Submitting and payment

How to submit it
Complete and submit it electronically, online or as a downloaded PDF, with relevant medical records such as discharge summaries, consult notes and imaging reports attached (15 MB total). After an emergency transfer arranged through CritiCall, the physician may apply within 24 hours of the transfer.
Who pays
No physician fee is listed; the program decides whether OHIP pays in full for the insured out-of-country service, which must be delivered at a hospital or health facility as defined in Regulation 552.

Good to know

  • Cancer requests are reviewed by Ontario Health (Cancer Care Ontario) and need its OOC Prior Approval Program questionnaire attached; a separate version exists for services already performed.
  • Proton beam therapy, CAR T-cell therapy, open MRI and residential eating disorder, OCD and trauma treatment list U.S. preferred providers; choosing another facility requires a written rationale.
  • Non-cancer drug therapy is funded only when the Executive Officer recommends payment for the drug for a person in the same medical circumstances, as Regulation 552 requires.
  • Eating disorder and OCD requests each have a checklist on the Central Forms Repository listing the medical documentation to upload with the application.

Get the official form

Download the current version from the source each time; forms change without notice.

Request for Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services

Demande d’approbation préalable du remboursement de services de santé hors pays assurés

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Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

When does OHIP pay for treatment outside Canada?

The service must be generally accepted in Ontario, medically necessary, not experimental or research, and either not performed in Ontario or not available without a delay that would cause death or medically significant irreversible tissue damage. The form calls the program a safety valve, with no discretion to pay for services that miss these criteria.

Can OHIP approve out-of-country care after it has happened?

Only if emergency circumstances existed at the time, meaning an immediate risk of death or medically significant irreversible tissue damage. The application must then include medical documentation showing the services were rendered in those circumstances, along with the date of service and details of the emergency.

Which form is used for out-of-country lab or genetic tests?

Not this one. Laboratory and genetic testing outside Ontario goes on form 4521-84E, the prior approval application for out-of-country and out-of-province laboratory and genetics testing. ON00314E covers consultations, surgery, cancer services, drug therapy, emergency transfers, MRI and mental health treatment.