How to Claim Ambulance Costs in Ontario: Toronto $45 Co-Payment

The City of Toronto lists a co-payment of $45.00 per ambulance trip in a City of Toronto source dated 9 April 2025. The City says you may owe this amount. The source is a City of Toronto page and does not state an amount for other Ontario municipalities.

How much does an ambulance cost in Ontario?

The co-payment is $45.00 per trip. It is charged per trip, not as a monthly or annual amount, so a patient who takes two separate ambulance trips is assessed for each one that qualifies.

The City’s wording is “may owe,” which makes the $45.00 a possible charge rather than a bill issued for every ambulance use.

To confirm the amount for a specific situation, check the current City of Toronto guidance and compare it with the conditions that apply to that trip. When citing the figure, include the source date (9 April 2025), since the amount is tied to that publication.

Who has to pay the $45 co-payment?

The City of Toronto says you may owe the ambulance co-payment of $45.00 only if all four of its conditions apply. This section covers the two conditions about the patient and the medical decision. The trip route and exemption status are covered in their own sections.

Condition 1: Residency and health card

You must be an Ontario resident and hold a valid Ontario health card. The City of Toronto lists both as requirements. Check that your card is current before you rely on the co-payment rule, because a card that is not valid fails this condition even if you live in Ontario.

Condition 2: Medical necessity

A physician must deem the ambulance service medically necessary. Whether you owe the co-payment therefore depends on a clinical decision, not only on your request for transport. Ask the treating physician to document the need for transport, and keep a copy of that record with your personal paperwork. The City of Toronto guidance does not specify a required format for this record.

Conditions apply together

How does an exemption affect the fee?

The City of Toronto’s source says only that you may owe the co-payment if you do not qualify for an exemption. It does not list the exemption categories. The source material for this article documents one concrete rule. The City of Toronto says you may owe a $45.00 co-payment only if you do not qualify for an exemption (City of Toronto, 2025-04-09). An exemption therefore stops the charge from applying even when the other conditions are met. The source material does not list the exemption categories used in other Ontario municipalities, so check the rules for the place where the ambulance trip took place.

Confirming exemption before you pay

Before paying an ambulance bill, ask the organization that issued it two questions: whether the amount is a co-payment, and whether an exemption applies to your situation. Write down the answer, the date, and the name of the person you spoke with, and keep this with the bill. If the bill arrives without a clear explanation, do not treat the amount as settled until you have confirmed its basis.

Effect of exemption on the co-payment owed

When an exemption applies, no co-payment is owed for that trip, so there is no payment to record. The Canada Revenue Agency (CRA) lists ambulance service to or from a public or licensed private hospital as an eligible medical expense, but the credit covers expenses you actually paid. An exempt trip therefore produces no paid expense to claim.

When does the Toronto co-payment not apply?

The City of Toronto says you may owe the $45.00 co-payment only if all four conditions apply. If one is not met, this rule does not apply to the trip. The City’s source does not say how such a trip is covered or billed.

The trip must start and end in Ontario for the Toronto co-payment rule to apply. The City’s source does not say how a trip that starts or ends outside Ontario is billed.

The City’s source does not describe other categories of ambulance service or how they are billed. If a bill seems unusual, ask the issuer to explain its basis.

Private ambulance services billed directly to patients are the third group. Before paying, identify who issued the invoice. A bill addressed to you personally should be compared against the four conditions above.

How do you claim ambulance costs on your taxes?

For the 2025 tax year, the Canada Revenue Agency (CRA) lists ambulance service to or from a public or licensed private hospital as an eligible medical expense. Only trips that start or end at a hospital qualify under this line. Ambulance costs are then added to your other medical expenses and claimed together on the federal medical expense claim, so you enter one combined total rather than a separate ambulance figure.

The claim period is not tied to the calendar year of payment. For 2025, you can include eligible expenses paid in any 12-month period ending in 2025, as long as those same expenses were not claimed on your 2024 return. You choose the 12-month window that gives you the largest eligible total, but each payment can be claimed only once.

The federal credit applies only to the part of your medical expenses above a threshold: the lesser of $2,834 or 3% of net income (line 23600) for 2025. The rule works like this:

As an example with a net income of $50,000, 3% is $1,500. Because $1,500 is lower than $2,834, the threshold is $1,500, and only medical expenses above $1,500 count toward the federal credit. The figures are illustrative; your own threshold depends on your net income.

Ontario applies its own provincial medical expense credit, and the CRA notes that provincial or territorial limits may differ from the federal ones. The federal threshold above does not set the Ontario calculation, so check the Ontario limit separately on your provincial return.

Which line do you use on your tax return?

The CRA assigns each person’s ambulance expenses to one of two lines, based on that person’s relationship to you. For 2025, you use line 33099 for your own expenses, your spouse’s or common-law partner’s expenses, and your children’s expenses if they are under 18. For other dependants, you use line 33199. (Canada Revenue Agency, 2026-01-20)

Entering amounts per person

Before you complete the return, total the eligible ambulance amounts for each person separately. This makes it easy to see which group each total belongs to. Every person’s total goes on the line that matches their category, so the two lines hold two different groups of people and never a mix of both.

The category rule works in one direction: the line is set by the person the service was for, not by the number of trips or the total cost of the household’s claims. Each family member appears in only one category, so their amount is entered on one line only.

What receipts should you keep?

The Canada Revenue Agency (CRA) says each receipt should show four details: who was paid, the purpose of the payment, the payment date, and the patient’s name. You keep these receipts on file and do not send them with your return. The CRA guidance is dated 2026-01-20.

Checking the receipt against this table before you file it helps you catch gaps early. A receipt missing the patient’s name or the payment date will not show the CRA what it needs to see.

The CRA may also ask for proof of payment. A receipt shows what was billed and to whom, but proof of payment shows that the money actually left your account. Keep whatever record confirms the payment, such as a bank or card statement entry, along with the receipt.

Keep both the receipts and the proof of payment in the same place, organized by year. The CRA may ask for them later, so they need to be retrievable. Do not attach them to your return: the instruction is to keep, don’t attach.

What if you get a bill you disagree with?

If an ambulance bill arrives and the amount or the trip details look wrong, request the supporting records in writing, then send a written query or dispute to the billing authority. The City’s source does not describe a dispute procedure or deadline, so the steps below are general practice. If the issue is not resolved, seek legal advice before paying or ignoring the bill.

Requesting the itemized bill and trip record

Start with the itemized bill. A single total does not show how the charge was calculated. Ask for two documents:

If your Toronto invoice differs from the $45.00 co-payment published by the City of Toronto (2025-04-09), ask the billing authority to show how it reached the amount.

Written appeal to the billing authority

Put the dispute in writing and send it to the billing authority named on the invoice. Include:

• The invoice number or account reference
• The amount you dispute
• The specific reason, such as an amount that differs from the published fee or an incorrect trip detail
• Copies (not originals) of any document that supports your position
• A request for a written decision

Keep a dated copy of your letter or email. Ask for a reference number when the authority confirms receipt, so you can follow up on the same file.

Dispute deadlines

Check the invoice and any covering letter for a stated deadline and the accepted method of appeal. If neither mentions one, ask the billing authority in writing for its deadline before you assume any time limit applies.

Frequently asked questions

Can I claim ambulance costs on my federal tax return?

The Canada Revenue Agency lists ambulance service to or from a public or licensed private hospital as an eligible medical expense. For 2025, you can claim eligible expenses paid in any 12-month period ending in 2025, as long as they were not claimed in 2024. Use line 33099 for your own expenses, your spouse’s or common-law partner’s, and your children’s under 18.

What records should I keep for an ambulance claim?

Do not send receipts with your return, but keep them in case the CRA asks. Each receipt should show who was paid, the purpose, the payment date, and the patient’s name, and the CRA may also request proof of payment.

Will a small ambulance bill produce a tax credit?

Probably not on its own. For 2025, the federal credit applies only to the portion of your medical expenses above the lesser of $2,834 or 3% of your net income (line 23600). Provincial or territorial limits may differ, so check the Ontario rules separately.

Related reading

• How to Claim Prescription Drug Costs on Taxes in Canada
• How to Submit an Extended Health Benefits Claim: Step-by-Step
• How to Report Employment Income While on EI in Canada