Depending on your insurance coverage, some services might not be covered under your plan. The following table lists the fees for commonly requested services that most often fall outside of coverage plans.
| Uninsured service | Fee |
|---|---|
| Chart summary | $30.00/15 minutes of MD time to prepare. Minimum $30.00. |
| Transfer of medical records | $20.00 plus expenses. |
| Transfer of medical records (over five pages) | $20.00 plus $0.50 per page after five pages |
| Federal tax credit form | $15.00 |
| Travel advice (not including immunizations) for students and dependents |
$50.00 - individual vacation |
| Travel advice (not including immunizations) for others | $70.00 - individual vacation $120.00 - extended stay $120.00 - couple vacation $185.00 - couple extended stay $65.00/person - family of 3 or more |
| Travel cancellation form | $10.00 |
| Injections (not covered by provincial or UHIP plans) | $10.00 |
| Removal of skin lesions (not medically necessary) | Minimum of $35.00. |
| Removal of uninsured warts | $35.00 per treatment. |
| Certificate of Health (no examination required) | Minimum $30.00. |
| Certificate of Health (Exam required) | Minimum of $100.00. |
| Department of Transport physical exam and completion of form | $80.00 |
| Complete physical and form completion (paid for by patient) | Minimum of $100.00. |
| Pre-employment physical and form completion (paid for by third-party) | Minimum of $160.00. |
| Pre-employment physical and form completion (paid for by patient) | Minimum of $100.00. |
| Medical legal or insurance exam and report (usually paid for by third-party) | Minimum of $75.00. |
| Mantoux Skin Test (TB) |
First test: $35.00 Second test: $15.00 |
| Verification of illness form | $20.00 |
| Accessibility forms | Minimum of $60.00 - $125.00. |
| Emergency contraception (Plan B) | $20.00 |
| Missed appointment fees |
Short appointments: $30.00 |
Uninsured services with a fee for alumni
|
Uninsured service |
Fee |
|---|---|
|
Nurse injections (ex. Allergy, medication, immunizations) |
$10.00/injection |
|
Ear syringing by a nurse |
$20.00 |
|
Venipuncture |
$10.00 |
|
Telephone advice from your doctor/nurse practitioner |
$20.00 |
|
Prescription renewal by telephone (exceptional circumstances only) |
$20.00 |
|
Long distance charges on your behalf (phone calls and faxes) |
Minimum $3.00 |
|
Photocopying |
$1.00/page, minimum $3.00 |
|
Notes for supplementary health insurance carrier (ex. Massage, orthotics, etc) |
$20.00 |
|
Federal Tax Credit form |
$30.00 |
|
Certificate of Health |
No exam required $40.00 Exam required, minimum $80.00 |
|
Workplace absence certificate |
$20.00 |
|
Insurance forms – Attending physician statement |
Minimum $91.50 |
|
Travel cancellation form |
$25.00 |
|
Transfer of medical records (HS protocol) |
$20.00 |
|
Chart summary/transfer of medical records |
Minimum $37.60 |
|
Removal of skin lesions and warts (not medically indicated) |
Minimum $50.00 |
|
Third party physicals and form filling fees |
$80.00 - $125.00 |
|
Nurse counselling |
$35.00/half hour |
|
Mantoux TB skin test |
First step: $50.00 Second step: $20.00 |
|
Missed appointment fees |
Short appointments: $40.00 |
