as deadline for including nurse practitioners in provincial health plans looms, some patients still pay for services
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the federal government set an april 1, 2026, deadline for provincial and territorial health plans to cover services of nurse practitioners and other regulated health professionals providing primary care with public dollars.
tony caldwell
/
postmedia
just weeks before a federal government deadline aimed at adding nurse practitioners to public health-care plans, some patients are still paying for primary health care in ontario.
clinics in which nurse practitioners offer health care for a fee continue to operate in ottawa and across the province. ottawa’s newest user-pay nurse practitioner clinic opened on preston street earlier in march.
that preston street clinic, called treedi, bills itself as the “cheapest private medical clinic in canada.” it charges $49.99 for medical consultations — mainly done remotely — provided by a team of nurse practitioners. it operates across canada.
founder hakim benmessoud, 23, said the business was aimed at helping people who still had no access to primary care.
“millions of canadians don’t have a family doctor, and a lot who do have to wait weeks before they can see their doctor. we saw there was a problem in canada and found a good way to make family care accessible to anyone,” benmessoud said.
many nurse practitioners in ontario work in provincially funded clinics where their salaries are paid with public dollars, or in hospitals, long-term care homes or other health-care institutions.
but nurse practitioners who set up their own practices or join practices that do not receive base funding from the province have no way of being paid through public health insurance for their services. as a result, and given the high demand for primary care, some have set up clinics where they directly charge patients.
last year, partly in response to the growing number of patients paying for primary care provided by nurse practitioners, the federal government set an april 1, 2026, deadline for provincial and territorial health plans to cover services of nurse practitioners and other regulated health professionals providing primary care with public dollars. the federal government will not begin enforcing it for a year, effectively pushing back the deadline.
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that direction was part of a new interpretation of the canada health act issued by former federal health minister mark holland in early 2025. holland said charging patients for primary care was not consistent with universal health care and regulated health professionals who weren’t doctors should be able to bill the health system the way doctors did. the federal direction did not explicitly mention virtual care.
as the deadline approaches, the organization representing nurse practitioners in ontario said there was growing concern about the apparent lack of progress in developing new models of funding in the province so that nurse practitioners were covered by ohip.
michelle acorn, ceo of the nurse practitioners’ association of ontario, said a lack of communication from the province on the issue was causing uncertainty and anxiety in the health-care community. she said her organization was keen to work with the province on a plan that would allow nurse practitioners to be paid under the provincial health system.
“with over 2.5 million ontarians without access to a primary-care provider, the provincial government cannot afford to delay,” acorn said. she added that flexible funding models for nurse practitioners would improve access to health care for ontarians, reduce hospital readmissions and decrease emergency room visits.
doris grinspun, chief executive officer of the registered nurses association of ontario, said the province essentially had a year to transition into a model that included nurse practitioners, but it should not wait.
“it needs to happen one way or another. there should be no fees for service, period,” grinspun said.
a spokesperson for health minister sylvia jones said ontario’s ministry of health was reviewing and engaged in discussions with provincial and territorial partners and the federal government regarding “implementation expectations” of the federal direction.
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brockville resident eamon doherty sent a message directly to ontario’s health minister asking when ontario would begin covering medically necessary health services provided by non-physicians such as nurse practitioners.
“we would like to see the province providing ontarians with a realistic date, sooner than later, in which we can enjoy the health care we very much need and deserve,” he wrote.
in response, an unnamed spokesperson for jones said no decisions had been made about billing policies for nurse practitioners or other non-physician health providers. that was in february. the letter also said the ministry was closely monitoring and addressing concerns related to private pay for medically necessary services delivered by nurse practitioners.
ontario is working to attach every resident with a primary-care provider by 2029. by january of this year, in the first year of the initiative, the province said it had attached more than 330,000 ontario residents to primary-care providers.
among other things, the province is expanding team-based primary care, which includes some nurse practitioner-led clinics. ottawa’s first nurse practitioner-led clinic opened in vanier in september 2025. at the time, it was one of just 27 such clinics in ontario.
meanwhile, benmessoud, founder of treedi, said he was serving a need. if the way nurse practitioners are paid in the province changes, he said, the clinic will stop charging patients.
“if (nurse practitioners) can bill the province, then it will be free,” he said.
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