Hip and knee replacement in Canada: provincial coverage, waits and private options

Is it covered?

Total hip and knee replacements are insured hospital and physician services in every province (for example, R440 and R441 in Ontario). You don’t pay for the surgery or hospital stay as an insured patient.

Waiting times

Canada’s benchmark is surgery within 26 weeks of being ready for treatment. CIHI’s 2025 report found that in 2024, 68% of hip and 61% of knee replacements met it. Ontario’s Rapid Access Clinics assess hip, knee and low back pain and are covered by OHIP. Ontario Health and BC publish local surgical wait times online.

Private or out-of-province options

• In Quebec, doctors who have opted out of RAMQ can bill patients directly. Some surgeons publish all-inclusive prices for a total hip or knee replacement that include a short hospital stay but not the pre-operative consultation and tests.
• In April 2023 the Supreme Court of Canada declined to hear an appeal in the Cambie Surgeries case, so the BC Court of Appeal’s decision stands.
• OHIP only pays for surgery outside Canada with written prior approval, for example when the procedure isn’t available in Ontario or a delay would cause death or irreversible tissue damage.

How coverage works in Canada

Under the Canada Health Act, provinces insure medically necessary hospital and physician services. A procedure done by a doctor in a public hospital or clinic is usually paid by your provincial plan. Provinces that allow extra-billing or user charges for insured services lose part of their federal health transfer, so patients are generally not charged extra, although Quebec doctors who opt out of RAMQ can bill patients directly. Physiotherapy, drugs and devices outside hospital are often not insured, and many people use workplace extended health benefits for these. How coverage works in Canada.

Paying yourself: the medical expense tax credit

Eligible medical expenses above the lower of 3% of your net income or C$2,834 (2025 tax year) can be claimed on your tax return. Fees paid to a medical practitioner, including a physiotherapist recognised in your province, are generally eligible. Check the Canada Revenue Agency’s guide before you claim.

If you are refused or charged

• If you are asked to pay for a service your provincial plan insures, ask why. In Ontario, you can report it to the Ministry of Health on 1-888-662-6613.
• Ontario decisions about OHIP coverage can be appealed to the Health Services Appeal and Review Board.
• For a complaint about a private insurer, complain to the insurer first, then to the OmbudService for Life & Health Insurance (OLHI), which is free.

Frequently asked questions

How long is the wait for a knee replacement in Canada?

It varies by province and hospital. Nationally, CIHI’s 2025 report found that 61% of knee replacements in 2024 were done within the 26-week benchmark. Check your province’s wait-times website.

This page explains how coverage usually works, using public government, insurer, ombudsman and clinic sources listed above. It is general information, not medical, insurance, financial or legal advice, and it does not recommend any treatment, policy or provider. Rules differ by province and by plan and can change, so confirm with your doctor, your provincial plan, your insurer or the clinic before you decide. Protocol Archive is independent and is not affiliated with any government health plan or insurer.