Is a lactation consultant covered by OHIP?
The short answer is no, and you deserve to know that before you book. Here is exactly how payment works, what is covered instead, and where to go if cost is the deciding factor.
In one line: OHIP does not cover private lactation consultations, and I am not an OHIP provider. Visits are paid at the time of service, and you receive an itemized receipt to claim through your extended-health plan, which many families are reimbursed under.
What OHIP does and does not cover
OHIP funds physician and hospital care. Private lactation consulting is not on that list, in Ottawa or anywhere else in Ontario. That is true of every private IBCLC in the province, not a quirk of this practice.
There is one exception worth knowing about: some hospital-based and physician-led breastfeeding clinics in Ontario bill OHIP, because the visit is delivered under a doctor. Those clinics are a genuine option, and some carry a co-payment even so. Your midwife, family doctor or public health unit can tell you what is currently running near you.
- Not covered by OHIPPrivate lactation consultations, including mine. There is no OHIP billing code for this service and I do not submit to OHIP.
- Sometimes covered by OHIPPhysician-led breastfeeding clinics, where a doctor delivers or supervises the visit. Availability and wait times vary.
- Usually freePublic health feeding support and peer support groups. Excellent for general questions; not a substitute for a full clinical assessment.
- Usually claimableA private IBCLC visit, through an extended-health plan. This is how most families who see me pay for it.
If cost is the deciding factor
Then start with the funded options, and please do not feel awkward about it. If you contact me and a free or OHIP-covered service is the better fit for what you need, I will tell you so and point you toward it. The same is true if you need to be seen sooner than I can see you.
Need to be seen urgently? If your baby is under 1 month old and/or not gaining weight and needs to be seen as soon as possible, please text 613-986-8316. I will offer an urgent appointment if one is available, or refer you to another IBCLC so you can be seen sooner.
How most families actually pay
Through an extended-health plan, from an employer or a personal policy. The reason this works as often as it does comes down to a credential:
I am a Registered Nurse (RN, BScN) as well as an IBCLC. Plans that do not list "lactation consultant" as a benefit very often cover registered nurse services, and a receipt from an RN is read differently by an insurer than one from a practitioner without a regulated health designation. It is worth checking both lines in your plan booklet before you assume you are not covered.
Coverage still depends on your individual plan. The same insurer writes very different policies for different employers, so nobody can promise you a number in advance. What I can promise is that the paperwork will not be the reason a claim fails.
Checking your plan takes about five minutes
Open your benefits booklet or member portal
Search it for the words lactation, nursing and registered nurse. Paramedical, or "other practitioners", is usually the right section.
Note the annual maximum and any per-visit cap
Plans often cover a set dollar amount per calendar year rather than a percentage of each visit.
Ask whether a referral is needed
Some plans want a note from your doctor or midwife before they will reimburse. It is a short conversation, and worth having first.
Check for a health spending account
An HSA or HCSA typically accepts a far wider range of expenses than the core plan, and is often the simplest route.
Submit the receipt after your visit
Claim it the way you would any paramedical receipt: through the portal, the app, or on paper.
Your receipt, and tax time
Every visit comes with an itemized receipt made out for insurance purposes: my name and credentials, the date, the service and the amount paid. If your insurer asks for anything additional in order to process a claim, tell me and I will provide it.
Keep a copy even if you have no coverage at all. Nursing services appear on the Canada Revenue Agency's list of authorized medical practitioners for the medical expense tax credit, so your visits may count toward it. Your tax preparer can confirm how that applies to your return.
This page explains how payment and claims work. It is general information, not tax or insurance advice, and it is not a guarantee of coverage. Your plan booklet and your insurer are the authority on what your policy pays.
Every price on this site is the price you pay. Fees range from $50 to $250 depending on the service.
Questions about paying for care
If your question is not here, send me a message before you book. I would rather answer it up front than have you wondering.
No. OHIP does not cover private lactation consultations, and I am not an OHIP provider, so visits are paid privately at the time of service. Ontario does have some physician-led breastfeeding clinics that bill OHIP, and public health units offer free feeding support; if cost is the deciding factor, start there and I will gladly point you toward them. Most families who see me claim the visit through an extended-health plan instead.
Often, yes, through your extended-health plan rather than OHIP. Because I am a Registered Nurse (RN, BScN) as well as an IBCLC, visits frequently qualify under a plan's registered-nurse or lactation-consultant benefit. Coverage still depends on your individual plan, so confirm with your insurer first. Every visit comes with an itemized receipt showing my name, credentials, the date, the service and the amount paid.
Every visit comes with an itemized receipt made out for insurance purposes, showing my name and credentials, the date, the service and the amount paid. Submit it to your insurer the way you would any paramedical claim. Keep a copy for tax time too: nursing services appear on the Canada Revenue Agency's list of authorized medical practitioners, so your visits may also count toward the medical expense tax credit.
A travel fee applies only for in-home visits located more than 30 km from Ottawa (measured from postal code K1V 2J8). Any fee is communicated in advance and added to your total, so there are no surprises. Virtual visits, of course, have no travel fee.
Visits cancelled within 24 hours incur a $50 fee, but may be rescheduled once at no charge if rebooked within 7 days. No-shows or repeated short-notice cancellations may result in full charges for the missed visit. Workshops can be cancelled at least 48 hours in advance for a full refund or reschedule. If you or your baby are unwell, or weather affects a home visit, we'll reschedule at no additional charge. Consultation fees are non-refundable once the service has been provided. If you are unsatisfied with your experience, please reach out so we can discuss how to address your concerns.
Have a question that isn't here? Send me a message and I'll answer personally.
Ready to book, or still weighing it up?
Either is fine. Request an appointment when you're ready, or ask me about coverage first and I'll help you work out what your plan is likely to do.