FACT SHEET:
BONE MINERAL DENSITY TESTING

Ontario Health Insurance Plan
What does OHIP cover?

Osteoporosis is a disease characterized by low bone mass leading to fragile bones and increased risk of fractures. Bone mineral density (BMD) testing assesses bone loss due to osteoporosis and helps the patient and physician to measure the risk of future fractures, determine the need for medical treatment and to monitor the success of existing treatment.

Medical experts recommend that BMD testing be carried out using only the  ‘axial DXA’ machine which scans both hip and spine. This technique is clinically superior to all other testing methods and is the only method insured by OHIP.

OHIP covers all necessary BMD tests in persons at high risk for osteoporosis and future fractures. The high-risk group includes any person with any of the following major risk factors:

  • premature menopause (less than 45 years old) or longstanding premenopausal hypogonadism.

  • high dose steroid therapy for longer than 3 months or Cushing’s Syndrome.

  • family history of osteoporosis (first degree relatives).

  • past history of fragile fractures.

  • longstanding malnutrition or malabsorption.

  • longstanding use of anticonvulsant drugs.

  • primary hyperparathyroidism.

  • cancer chemotherapy.

  • weight below 57 kgs. (125 lbs.) or Body Mass Index (BMI) less than 20.

  • post-menopausal women with any two of the following risk factors: smoker, hyperthyroidism, low calcium intake, excess alcohol intake.

Effective October 1, 1999, low risk patients are eligible for BMD testing once in any 24-month period. For services on or after October 1, 1999, this 24-month period will be determined from April 1, 1998 onwards.

Low risk patients and referring physicians need to advise diagnostic facilities of the date of any previous BMD test so that the facility can verify that the planned test is insured.

 What is not covered?

BMD testing of low risk persons provided more frequently than once every 24 months is uninsured but may be provided at the patient’s expense.

 Why?

Current guidelines do not support the need for low risk patients to be tested more often than every two years. The changes in OHIP coverage reflect the current guidelines. High risk patients (determined by the physician) will continue to receive unrestricted access.

 Further Information?

This fact sheet includes material provided by the Osteoporosis Society of Canada (OSC). Further information on osteoporosis may be obtained from the OSC’s web site: www.osteoporosis.ca).

Patients should discuss their individual health needs with their family physician.


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Ontario Ministry of Health and Long-Term Care
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