OHIP refused to fund treatment abroad — can I appeal?

Yes, to HSARB, within the deadline in the decision letter. Success usually depends on specialist evidence that equivalent treatment was not available in Ontario without medically significant delay.

Not required, but the medical evidence is decisive and representation helps where substantial funding is at stake.

HSARB Ontario — Appealing an OHIP Coverage Decision

Health Services Appeal and Review Board (HSARB)

HSARB hears appeals of OHIP and other health-funding decisions, most commonly refusals to fund out-of-country treatment and determinations that a service is not insured. Out-of-country funding appeals are among the most frequently pursued and require strong specialist evidence that the treatment was not available in Ontario.

What it does

Hears appeals of OHIP eligibility and coverage decisions
Decides out-of-country and out-of-province funding appeals
Reviews certain health facility licensing matters

Matters it hears

Out-of-country treatment funding refusals
Insured service and delisting determinations
OHIP eligibility and residency decisions
Prior-approval refusals

Appeals & review

Appeals generally go to Divisional Court (Ontario).

Appeal and review deadlines are short and strictly applied. Treat the decision date as the start of a clock.

Frequently Asked Questions

OHIP refused to fund treatment abroad — can I appeal?: Yes, to HSARB, within the deadline in the decision letter. Success usually depends on specialist evidence that equivalent treatment was not available in Ontario without medically significant delay.
Do I need a lawyer?: Not required, but the medical evidence is decisive and representation helps where substantial funding is at stake.

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General information about jurisdiction and process, not legal advice. LegalCounselNearMe is not a law firm and is not affiliated with Health Services Appeal and Review Board (HSARB). Procedures, forms and fees change — the official site is authoritative.