PLAN

There is no single price.

The cost can change depending on:

• the hospital you go to
• whether the hospital charges you as an uninsured Ontario resident or as a visitor/non-resident
• how long you stay
• whether the baby is billed separately
• whether you need extra care, such as surgery, specialist care, or more tests
• whether you choose a private or semi-private room

Some hospitals list one large delivery fee. Others list separate fees for labour, room, newborn care, emergency visits, tests, and physician care.

Before your due date, call the hospital billing office and ask for a written estimate. Ask if the estimate includes both you and the baby.

Giving birth without OHIP can cost about $3,000 to $20,000 or more. Some hospitals charge lower fees, while others ask for large deposits before birth.

NOTE: Lower-cost birth options are also available in some situations. Toronto Birth Centre is a unique space led by Indigenous community members, including midwives, where pregnant people in the care of midwives can labour and give birth. It is for people living in Ontario, including people who do not have OHIP. To give birth there, you must already be in care with a registered midwife who can use the Birth Centre, and you must meet the Birth Centre’s eligibility rules. It is not a walk-in place for labour.

A midwife or community health centre may help cover some parts of pregnancy care.

This often means medical services that have an OHIP billing code. For example:

• a doctor or specialist visit
• bloodwork
• a diagnostic test
• an ultrasound
• some procedures

But hospitals bill separately.

If you do not have OHIP, the hospital may still charge fees that the CHCs cannot cover. These fees are known as “facility fees” and may include:

• room or ward fees
• hospital stay fees
• operating room or day surgery fees
• supplies, equipment, or medication charges
• charges above what the CHC agreed to cover

Hospital catchment can also matter. Some CHC or funded programs only cover care at certain hospitals or within certain areas. If you are sent somewhere outside that agreement, you may still get a bill.

Call the hospital billing office before your due date.

Then ask:

• Is this the uninsured Ontario resident rate, the non-resident rate, or another rate?
• Does this include care for the baby?
• Does this include physician fees?
• Does this include triage, room charges, lab tests, imaging, epidural, C-section, and newborn care?
• Is a deposit required?
• What happens if I cannot pay the deposit?
• Can I arrange a payment plan before birth?
• How do you count each hospital day?

Try to contact the hospital billing department at least one month before delivery, and ask about a payment plan in advance.

Some hospitals charge different rates for uninsured residents and non-residents. “Resident” here does not always mean permanent resident immigration status. It may mean that Ontario is where you live.

If Ontario is your home, say that clearly. Do not call yourself a tourist unless you are actually visiting and planning to leave.

You do not need to explain your whole immigration history to ask how you are being billed.

This matters because hospital rates can be much higher for visitors or people the hospital classifies as non-residents than for uninsured Ontario residents.

Hospitals may offer ward, semi-private, and private rooms. Semi-private and private rooms usually cost more. If you do not have insurance, ask for the lowest-cost room unless a different room is medically needed.

NOTE: Even if someone offers the room in a routine way, ask what it costs before you agree. Before signing any forms, be sure to ask if the form will add extra room charges to your bill.

Some hospitals may count hospital days by calendar date rather than by a full 24-hour stay. This means that staying past midnight may sometimes add an extra day's charge.

Do not leave if you or your baby are not medically safe. But if the care team says you are ready to go, ask whether discharge before midnight changes your bill.

Before your due date, try to write down:

• The hospital or birthplace you plan to use, and whether it has Labour and Delivery department
• The hospital’s billing office phone number
• The estimate they gave you
• Whether you are being charged as an uninsured Ontario resident or a non-resident
• The deposit amount, if any
• The lowest-cost room option
• Who to call after birth
• Where the baby will be checked after discharge from the hospital

If you get a bill, do not ignore it. Call the billing office and ask them to explain it.

Ask:

• Can I have an itemized bill?
• Was I charged as an uninsured Ontario resident, non-resident, or another category?
• Are physician fees separate?
• Does this bill include the baby?
• Can any charges be reviewed?
• Can I make a payment plan?
• Can the due date be extended while I get help?
• Will this bill be sent to collections if I cannot pay right away?

NOTE: If you cannot pay the bill, tell the billing office as soon as possible. Ask if they can review the charges, give you more time, or set up a payment plan while you get help from Legal Aid, a community legal clinic, a social worker, or a patient advocate. The hospital does not have to agree, and each hospital may handle this differently. If a bill is not paid, it may be sent to collections. If you think the bill is wrong, especially if you were charged for a private or semi-private room you did not clearly agree to, ask for a review before paying.

That can happen. Conversations about money, status, insurance, and hospital forms can feel intimidating.

Remember, you do not need to explain everything. You can also read prepared questions from your phone, show this page to the person helping you, or ask someone you trust to call with you.

Here are some simple phrases you can use when these situations come up: