Proton therapy funding in Ontario

If you live in Ontario, the Ontario Health Insurance Plan (OHIP) may pay for proton therapy outside Canada. The treatment must be medically necessary and not available in Ontario. This page explains how that works. OHIP, not this site, decides your case.

Your plan at a glance

• Plan: Ontario Health Insurance Plan (OHIP).
• Who applies: a practising Ontario physician, on your behalf. You cannot apply for yourself.
• Form: Ontario form ON00314, “Request for Prior Approval for Full Payment of Insured Out-of-Country Health Services.” An electronic version of this form has been available since April 15, 2024.
• Approval before travel: required. Without prior written approval, you are responsible for the cost, except in a true emergency.

How out-of-country funding works in Ontario

OHIP can pay for insured services delivered outside Canada if the case meets a legal test. The test is set out in Ontario’s Health Insurance Act, Regulation 552, section 28.4. In plain terms, the service must be generally accepted in Ontario and not experimental. It must also meet one of two conditions:

• The same or an equivalent service is not performed in Ontario.
• It is performed in Ontario, but the delay to get it here would result in death or in medically significant irreversible tissue damage.

Because Ontario does not have a proton therapy centre, proton therapy can fit the first of these. Your physician makes the clinical case in the application.

OHIP covers the insured medical services at a hospital or licensed health facility. It does not cover non-medical costs such as travel, accommodation, and meals. The exception is when they are part of insured hospital services.

Step by step

1. Speak with your specialist about whether proton therapy may suit your case.
2. Your physician completes and submits form ON00314 before any treatment is booked.
3. Wait for the written decision from the Ministry, which is sent to your physician and to you.
4. If approved, arrange treatment at the approved centre with your team.
5. If declined, note the appeal deadline below and act within it.

Important: who decides

OHIP decides whether your treatment abroad is funded. Do not book or start treatment before you have written approval, or you may have to pay the full cost yourself.

If you are declined

If you are declined, you can appeal to the Health Services Appeal and Review Board (HSARB) within 30 days of the written decision. Approval on appeal is very rare, however. The effort is better spent on a complete, well-documented first application prepared with your physician. According to Tribunal Watch Ontario’s review of decisions since April 2023, fewer than one percent of these appeals went the applicant’s way.

Who is Ontario’s out-of-country proton funding used for?

In 2022, the Government of Ontario described the patients this funding is used for. They are paediatric oncology patients, and adults with skull-base cancers, sarcoma, or head and neck cancer. Some patients who need re-irradiation are also included. This is not a guarantee of eligibility; every case is assessed on its own application.

Ontario approved 57 out-of-country proton applications from 2010 to September 2019, and 29 in 2024, when proton therapy was the program’s largest single expense at CAD 2.4 million.

Cancer Care Ontario’s Proton Advisory Group has described the supported uses as paediatric cancers and some head-and-neck and skull-base tumours.

Frequently asked questions

Related pages

• Out-of-country funding in Canada
• Funding in your province or territory
• About us and how we work

Sources for this page (9)▸

1. OHIP coverage outside Canada, prior approval, and appeal to HSARB within 30 days: Government of Ontario. ontario.ca (checked 2026-07-06)
2. Fewer than 1 percent of OHIP-related appeals decided for the applicant, from a review of all HSARB decisions since April 2023: Tribunal Watch Ontario, “The Ontario tribunal where claimants have almost no chance of winning,” September 2025. tribunalwatch.ca (checked 2026-07-15)
3. Legal basis and section 28.4 criteria: Health Insurance Act, R.R.O. 1990, Regulation 552. ontario.ca ; criteria described at ontario.ca (checked 2026-07-06)
4. Form ON00314: Ontario Central Forms Repository. forms.mgcs.gov.on.ca (checked 2026-07-06)
5. Patient groups Ontario’s out-of-country proton funding is used for (paediatric oncology; adults with skull-base cancers, sarcoma, head and neck cancer; re-irradiation), and Cancer Care Ontario Proton Advisory Group supported uses: Government of Ontario newsroom, “Ontario Building a Stronger, More Resilient University Health Network,” April 2022. news.ontario.ca ; and Tsang et al., Proton Therapy in Canada, Red Journal, 2022, S0360-3016(22)03642-2. redjournal.org (checked 2026-07-15)
6. Ontario approved 57 out-of-country proton applications from 2010 to September 2019: Tsang et al., Proton Therapy in Canada, Red Journal, 2022, S0360-3016(22)03642-2. redjournal.org (checked 2026-07-06)
7. Ontario approved 29 proton applications in 2024, the program’s largest single expense at CAD 2.4 million: ministry data via CBC (CBC analysis of Ontario Ministry of Health data, September 2025). cbc.ca (checked 2026-07-15)
8. Paediatric and referral context for Canadian proton therapy: CMAJ, 2019;191(24):E664. cmaj.ca (checked 2026-07-15)
9. Electronic form available since 15 April 2024: OHIP InfoBulletin 240404. ontario.ca (checked 2026-07-06)

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Every statement on this page is drawn from the sources listed below. Last updated: 15 July 2026.

This page is for general education only. It is not medical advice and it is not a decision about your care or your funding. Only your treating physician can advise you on treatment. Only your provincial or territorial health plan can decide whether it will fund treatment outside the country. protontherapy.ca is an information resource by Maple Med Global (MMG Medical Tourism Inc.), Toronto, Canada. We are not a hospital, a clinic, or a government body, and we do not provide medical care.