How much does an ambulance cost in Toronto?

You have to pay an ambulance fee in Ontario because ambulance services are not fully covered by the Ontario Health Insurance Plan (OHIP) under the Canada Health Act, which leaves patients responsible for a set co-payment or fee.

Why the Fee Exists

• Not Insured Fully: The provincial health system covers doctor and hospital visits, but emergency transport is treated as an extra service with a government-set fee.
• Deter Misuse: A small co-pay helps prevent unnecessary 911 calls for non-emergencies.
• Goes to the Hospital: The charge is billed by the receiving hospital, not the paramedic service.

The Cost Breakdown

• $45 Co-payment: For Ontario residents with a valid health card when a doctor decides the ambulance trip was medically necessary.
• $240 Full Fee: Charged if you do not have a valid OHIP card, have out-of-province insurance, or if the attending physician decides the ambulance was not medically necessary.

Who is Exempt from the $45 Fee?

You do not have to pay the $45 fee if you are an Ontario resident with a valid health card and you are:

• Receiving benefits under Ontario Works, the Ontario Disability Support Program (ODSP), or the Family Benefits Act.
• Being transferred between hospitals for insured, medically necessary treatment.
• Receiving professional home and community care services.
• Living in a long-term care home or a specialized psychiatric residence.

This information is for general knowledge and should not be taken as medical advice; consult with a healthcare provider for any health-related concerns. Dialing emergency services is completely free anywhere in Canada from any landline, cell phone, or payphone.

Monthly Fees and Levies

While the actual phone call to emergency services costs nothing, you might see small government or carrier fees on your phone bill:

• Wireless emergency services fees: Most provinces and mobile carriers charge a small monthly fee (ranging from about $0.40 to nearly $3.00 depending on the region) to help fund and maintain dispatch networks.
• No per-call charge: You are never charged airtime, long-distance, or per-use fees for contacting emergency services.

Associated Costs (Ambulances)

While police and fire dispatch are funded by public taxes, emergency medical transport (ambulances) is not free and is separate from the emergency call itself.

• According to a consensus of users on Reddit, the caller is never billed, but the patient who receives the transport or medical care may be charged.
• Ambulance fees vary by province and are sometimes partially covered by provincial health plans or private insurance.

If you do not pay your standard $45 or $240 ambulance co-payment bill in Ontario, the hospital that treated you will eventually send your unpaid account to an external collection agency.

The Collection Process

• Invoices and Notices: The bill does not come from the paramedic service; it is issued by the hospital that received you. They will send initial notices and a final invoice. Many hospitals forward unpaid bills to collections shortly after a final notice (often within 15 days to a few weeks).
• Collection Calls: Once assigned or sold to a third-party debt collector, you will receive phone calls and letters demanding payment of the outstanding balance.
• Impact on Credit: An unpaid debt handed over to a collection agency can be reported to credit bureaus (such as Equifax or TransUnion) and can negatively affect your credit score for up to seven years.
• Legal Action: While rare for such a small dollar amount, the hospital or collection agency technically retains the right to pursue a civil lawsuit in small claims court to obtain a judgment.

Important Exceptions and Checks

• Check for Exemptions: If you receive provincial social assistance like Ontario Works or the Ontario Disability Support Program (ODSP), or if you live in a long-term care facility, you are exempt from the $45 fee. Contact the hospital’s accounts receivable department with your benefits statement if you qualify.
• Future Care: Emergency medical care can never be withheld or denied based on unpaid past bills.

Ambulance rides are not fully covered under the Canada Health Act and are not free. Instead, the out-of-pocket cost is determined by each province’s individual healthcare plan.

For a medically necessary emergency ground transfer, a resident with a valid provincial health card will typically pay a heavily subsidized rate ranging from $45 CAD to $385 CAD. However, if you are a non-resident or the ride is deemed medically unnecessary, the bill can quickly jump to $240 CAD to $1,100+ CAD.

Ambulance Costs by Province (Ground Transport)

Important Exceptions & Waivers

• Low-Income and Seniors: Many provinces waive or further subsidize fees for low-income residents, individuals on social assistance, or seniors.
• Workplace or Auto Injuries: If the ambulance is required due to a workplace incident or a motor vehicle accident, the cost is usually fully covered by provincial worker's compensation boards or auto insurance.
• Air Ambulances: If an emergency requires a helicopter or airplane evacuation, the subsidized resident rate is usually a slightly higher flat fee (e.g., $465 in Saskatchewan). However, non-residents are billed the full cost, which often exceeds $4,000 per hour.

Note: If you have private workplace health insurance or travel insurance, it will usually reimburse your ambulance out-of-pocket fees.

Yes, you may still have to pay an ambulance fee even if you do not go to the hospital.

How No-Transport Billing Works

• Varies by location: Local policies and private EMS providers set their own rules. Some cities and districts charge nothing if you refuse a ride, while others charge a flat "treat-and-release," evaluation, or refusal fee (ranging from $50 to several hundred dollars).
• Services provided: If paramedics perform advanced life support, administer medications, check vital signs, or use medical supplies on the scene, you are much more likely to receive a bill for those specific services.
• Free in some areas: In municipalities where local tax dollars heavily subsidize emergency services, signing a refusal waiver results in a $0 balance.

Insurance and Coverage

• Insurance gaps: Health insurance plans may not cover fees when no transport occurs, leaving you responsible for the total cost.
• Medicare and Medicaid: These federal programs generally do not cover non-transport or "treat-and-release" calls, meaning any local fees assessed will likely be out-of-pocket.