Hair restoration for cosmetic indications is generally not covered by Canadian provincial insurance or private plans. The exceptions — burn injury, surgical scarring, certain medical conditions — are real but specific. The honest framework.
Canadian provincial insurance (OHIP in Ontario) and most private extended-health plans distinguish between cosmetic procedures (improving appearance) and reconstructive procedures (restoring function or appearance lost to medical conditions). Hair restoration for androgenetic alopecia — the most common type of pattern hair loss — is classified as cosmetic, and is therefore not covered.
The exceptions are specific. Reconstructive cases that may qualify for coverage include:
Burn-scar restoration, where the loss is the result of documented thermal injury to the scalp.
Surgical-scar restoration, where loss is from documented prior surgery (cancer resection, neurosurgery, etc.).
Trauma-related loss, with documented injury history.
Alopecia areata in some cases — particularly if it’s caused significant cosmetic disfigurement or psychological distress and conservative treatment has failed. Coverage varies by plan.
If your case potentially qualifies for insurance coverage, we provide the clinical documentation required for an insurance claim — diagnosis, treatment plan, medical justification, photo documentation, billing codes. Submitting the claim and managing the relationship with your insurer is your responsibility (or your benefits coordinator’s); we provide the medical paperwork.
Most reconstructive cases require pre-authorisation from the insurer before surgery. We can supply the pre-auth packet on request. Approval processes typically take 2–6 weeks.
We don’t bill insurance directly. Patients pay the clinic and submit claims to their insurer for reimbursement.
Mention it in your photo submission and include any relevant medical documentation (injury reports, prior surgery records, dermatology notes for alopecia areata). Dr. Jones will review and tell you whether it’s worth pursuing pre-authorisation.