Is a breast augmentation covered under OHIP In Toronto?

The main thing that decides coverage is whether the surgery is for a medical concern or just to make the person look better. In OHIP’s opinion, if you think your breasts are too small, don’t look full after breastfeeding or don’t look the way you want them to, these issues don’t need to be treated. Even if your breast size makes you feel bad about yourself or lowers your confidence, cosmetic surgery is still not covered because it’s considered an elective enhancement.

Some patients are unsure if getting a lot of asymmetry after breastfeeding or losing weight will make them eligible for coverage. Unfortunately, OHIP doesn’t usually cover changes to the size and shape of breasts that happen naturally over time. Your breasts may look and feel very different than they did before you were pregnant, but these changes are normal and not defects that need to be fixed. Extended health insurance through work often pays for minor cosmetic procedures, but full coverage is rare. As a wellness benefit, some insurance companies will pay for a few hundred dollars of breast augmentation or other cosmetic procedures. These amounts usually don’t cover the whole cost but can help a little bit with the expenses. Before you assume OHIP is your only option for health insurance, we recommend you check with your insurance company to see what other options you may have.

Most of the women who have breast implants at our Toronto office pay for them out of their own pockets. The average cost is between $8,000 and $12,000 depending on the type of implant and other factors. Although this is a big expense, many patients find that financing options make the treatment more manageable. We work with several medical finance companies that allow you to pay for your care in monthly installments that are easy to manage.

Knowing you’ll have to pay out of pocket helps you schedule your procedure on your own time instead of waiting for approval that won’t come. The good thing about paying for things yourself is you can choose when to have the surgery, choose a surgeon based on their qualifications and how comfortable you feel with them and avoid waiting lines that come with publicly funded procedures.

Some people are disappointed when procedures they think would greatly improve their health are not covered. We understand this is frustrating but we’d rather be honest about the situation than give you false hope about funding. OHIP has to stick to a budget and only pays for surgeries that fix medical concerns, not ones that are just for looks.

When it comes to procedures other than breast augmentation including Gender-affirming Top Surgery, the rules for coverage are different. Some gender-affirming surgeries do get OHIP funding in certain situations. Each procedure has its own rules for coverage which depends on whether it’s medically required.

The fact that OHIP doesn’t cover cosmetic breast augmentation shows that the healthcare system puts treatments for disease, damage and functional concerns ahead of cosmetic improvements. We may think cosmetic surgeries can greatly improve mental health and quality of life but the public system has to use its limited resources to address medical needs first.At Beber Plastic Surgery, we always disclose prices and never surprise our patients with extra fees. We want you to know exactly how much you’ll be spending before you proceed with the procedure so you can decide if breast augmentation fits your budget and priorities. Thousands of women get breast implants every year because they feel the confidence and satisfaction they get from them is worth the cost even if they have to plan for it. We can help you achieve your aesthetic goals by answering all your questions about prices, payment options and financing. Dr. Brett Beber, MD, FRCS, is a highly regarded plastic surgeon in Toronto known for his dedication to achieving natural, refined results through advanced surgical techniques and personalized patient care.

Disclaimer: The information provided by Beber Plastic Surgery is intended for general informational purposes only and should not be taken as medical advice, diagnosis, or a guaranteed cost estimate. Surgical pricing and treatment outcomes vary for each individual based on anatomy, procedure complexity, surgeon expertise, and other medical or facility-related factors.
All prices and ranges mentioned are approximate estimates meant to help patients understand general cost expectations in Toronto. Final treatment plans, surgical recommendations, and exact fees can only be determined during a personal consultation after a thorough medical assessment.
Beber Plastic Surgery encourages all prospective patients to discuss their goals, medical history, and budget directly with a qualified surgeon. We are committed to transparency, patient safety, and delivering the highest standard of care—but no information on this page constitutes a binding quote or medical guarantee.