Ontario diagnostic blood test on its way to permanent OHIP coverage after pilot extended to March 2024.
Updated as March 29, 2023.
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We are excited to share that the Ontario Ministry of Health announced it is extending the pilot program in which diagnostic blood testing for celiac disease (IgA and tTg IgA) is free through community based labs until March 31, 2024.
During a call with the Minister of Health, Celiac Canada was told that the extension of the pilot will provide the Ministry time to integrate the screenings into its long term planning and administration.
Ontario has been the ONLY province in the country not to cover the blood screening test for CD.
This is despite the tests being part of standard clinical practice around the world. Ontario patients have had to pay anywhere from $60-$150 for the test. For many families, this cost is unaffordable. Since celiac testing is not on the standard lab requisition form, it is often missed by doctors in their health screening. This cost also impacts the ongoing disease management for currently diagnosed celiac disease patients who are required to monitor their bloodwork on an ongoing basis.
The extension announcement from the Ontario Ministry of Health was made in a March 29, 2023 INFOBulletin.
Please note: The free blood screening only qualifies for purposes of diagnosis only and NOT ongoing monitoring of symptoms.
What do I do Next?
Step 1: Talk to your doctor.
If you live in Ontario and you think you or a family member have celiac disease and have not yet been formally diagnosed, you must be consuming gluten in order for the test to be accurate. The individual must be over 2 years of age and must have a lab requestion from an eligible medical practitioner (see below).
- It is advised you have both the tTg-IgA and total IgA tests. You do NOT need a full “celiac panel” to screen for celiac disease. The CCA recommends that only the IgA and tTg IgA tests are needed and these are the only tests covered by the pilot. If you do receive other tests or your practitioner is requesting additional ones, you will need to pay out of pocket, if they are not already covered by Third Party Insurance and cannot be reimbursed.
- Visit your health care practitioner who is eligible to order laboratory tests. This includes physicians, midwives, and nurse practitioners. Naturopaths are not included. Please review the Q&A below for more information and questions.
- Have a valid Ontario Health Card and are qualified to receive services under the government health insurance program.
Step 2: Share the Good News!
Share the news with your friends and family who you think have chosen not to get tested because of cost.
Ontario Celiac – Patient Q&A
This guide has been developed in conjunction with the Ontario Ministry of Health (Current as of December 13, 2021).
What is this pilot about?
The Ministry has begun a pilot study where patients can receive coverage for celiac disease (serum IgA and tTg IgA) blood test to inform a diagnosis. The goal of the program is to increase access to these screening services to improve patient choice and access to testing services that are appropriate to be provided in a community setting.
Who is eligible?
1) You must be an Ontario resident, insured person within the meaning of the Health Insurance Act, over the age of two and not previously diagnosed with celiac disease (biopsied). The test is to help inform a celiac disease diagnosis. 2)You must be on a gluten-containing diet.
Who can order the lab tests?
For the purposes of the Community Access Pilot, the ministry has restricted ordering clinicians to physicians, nurse practitioners and midwives. Services ordered by naturopaths are not funded under the Pilot. Laboratory tests ordered by naturopaths are not insured under OHIP, and for consistency, the tests introduced via the Pilot are not funded when ordered by a naturopath.
Celiac and other tests introduced under the Pilot can still be ordered by a naturopath (provided the specific test falls within their standard of practice) but the tests would be private-pay.
Where do I take my lab requisition?
You can have your specimen(s)collected at one of the following Ontario Laboratories:
- Alpha Laboratories Inc.;
- Bio-Test Laboratory Inc.;
- Dynacare-Gamma Laboratory Partnership (Dynacare);
- Eglinton Diagnostic Laboratories Ltd.;
- LifeLabs LP;
- Med-Health Laboratories Ltd.; and,
- Medical Laboratories of Windsor Ltd.
When I visit my doctor or health care practitioner, what do I ask for?
A tissue transglutaminase (tTG) IgA and serum IgA.
What are the tests looking for?
A tissue transglutaminase IgA (tTg-IgA) test is a step used to help doctors diagnose celiac disease (CD). CD is an autoimmune disease, where the body’s immune system mistakenly perceives a nonthreatening substance, in this case gluten (a protein found in wheat, barley, rye, and oats). Gluten is seen as a foreign invader and is attacked by the body’s own immune system. This test measures the presence of tissue transglutaminase (tTG)-IgA antibodies in the blood.
“My family member was screened and had to pay for a “Celiac Panel.” Is this something I need to get?
You do NOT need a full “celiac panel” to screen for celiac disease. The CCA recommends that only the IgA and tTg IgA tests are needed and these are the only tests covered by the pilot. If you do receive other tests or your practitioner is requesting additional ones, you will need to pay out of pocket, if they are not already covered by Third Party Insurance and cannot be reimbursed.
It is strongly recommended that you call the community laboratory in advance to understand what is covered and what is private pay (out of pocket). You may wish to check if you have Third Party Insurance that covers any additional blood tests not covered by the pilot.
As always it is important to speak with your medical practitioner about your specific case.
I have been off gluten for a few years but not yet diagnosed. How can I take the test to ensure it is accurate?
To obtain an accurate celiac screen, you need to be on a gluten-containing diet. If a gluten-free diet has been initiated, the celiac serology is unreliable and can be falsely negative. In this situation you may require a gluten challenge. A gluten challenge is a systematic approach to re-introducing gluten into the diet over a specific period. Once the challenge has been completed you can move forward with blood testing. For more information click here: Gluten Challenge or to a short video click here: Gluten Challenge – YouTube
I had my test after November 1 but was charged the full amount at the laboratory? How can I get reimbursed?
The pilot provides funding to the community laboratories for tTG IgA and serum IgA for an Ontario resident, insured person within the meaning of the Health Insurance Act, over the age of two and not previously diagnosed with celiac disease (biopsied) and on a gluten-containing diet – effective November 1, 2021 and up to March 31, 2023. We encourage you to contact the laboratory provider and inquire about costs associated with the tTG IgA and serum IgA test. If further ministry assistance is required, please contact LGB@Ontario.ca.
I was already biopsied and screened for celiac disease. Can I have a blood test to get ongoing symptoms and management of my disease.
No. Unfortunately, ongoing blood screening tests are not covered by the pilot.
Are there any resources I can take to my healthcare practitioner to help them understand my symptoms and suspicion of celiac disease?
The Canadian Celiac Association has many resources available to assist both and your primary care provider in understanding symptoms and a suspicion of celiac disease. Here is link to a valuable resource for both you and your healthcare provider to review: Screening & Diagnosis of Celiac Disease – Canadian Celiac Association
If I have a family member with celiac disease, and I don’t have symptoms, should I be screened?
Celiac disease is genetic autoimmune disease and is more common in those with a family history of the condition. All first-degree relatives should be screened for celiac disease, regardless of symptoms. You may be asymptomatic or displaying other atypical signs of the disease. Visit this link to learn more about the signs and symptoms: https://www.celiac.ca/gluten-related-disorders/atypical-symptoms/
What other autoimmune conditions are at risk of celiac disease?
Evidence tells us that certain autoimmune diseases increase your overall risk for developing celiac disease. Some of these other autoimmune diseases include, but are not limited to: Type 1 Diabetes, Down Syndrome, Turner Syndrome, William’s Syndrome, Addison’s Disease, Autoimmune Thyroiditis, and both juvenile idiopathic arthritis and rheumatoid arthritis. If you have one of these conditions, it is recommended that you be tested for celiac disease. Click here to learn more.
If you have any further questions about the pilot, please contact LGB@Ontario.ca.
“Many people with celiac disease remain undiagnosed for years, and Ontario has been the only province where celiac testing has not been covered by provincial insurance until now. Undiagnosed celiac patients may be struggling with symptoms that could be treated if their condition were diagnosed, and therefore, access to tests for celiac diagnosis was a big need in our community. The Celiac Clinic at McMaster University has been partnering with the Canadian Celiac Association to advocate for celiac testing access in the community for years, and it is very encouraging to see this first step moving forward. We are committed to continue providing support to our celiac community, and we hope that after this pilot the access for celiac testing remains permanent.”
– Maria Ines Pinto Sanchez, Celiac Clinic at McMaster University
CCA’s Vision: Every Canadian with celiac disease diagnosed and empowered.
This first step comes after 10 years of advocacy efforts of many volunteers and staff, 3,500+ petition signatures submitted BY YOU to Queens Park Delegations, presentations made at the Ontario Legislative Assembly, Budget Round Tables, and local meetings.
Let’s make sure this becomes a permanent addition to OHIP!
Watch our website and social media channels for ways you can help all people who may have celiac disease in Ontario get timely diagnosis with covered blood screening.
Donate to our Advocacy Work on Securing Permanent Coverage.
