How Much Does an Ambulance Cost in Canada? Fees by Province

An ambulance isn’t free in Canada, even with a provincial health card. Most provinces charge residents a fee for each trip: $45 in Ontario, $80 in British Columbia, $250 in Manitoba and $385 in Alberta. Quebec charges $125 plus $1.75 for every kilometre to the hospital, although most people 65 and over don’t pay.

The bill comes by mail after the ride. Who has to pay it depends on your age, your income and how you got hurt, and an ambulance in another province is billed at a much higher rate.

How much does an ambulance cost in Canada?

For a resident with a valid health card, a trip to the hospital costs from nothing to a few hundred dollars, depending on the province. Ontario’s $45 is the lowest flat fee and Alberta’s $385 is the highest. Quebec and Saskatchewan also charge by the kilometre, so a long trip from a rural area costs more there.

These are the fees each province and territory publishes for an insured resident’s emergency trip to hospital, checked on October 28, 2026. Visitors pay more, as the section on other provinces shows.

Why isn’t an ambulance free in Canada?

The Canada Health Act requires provinces to cover hospital and doctor services, and ambulances aren’t one of them. Health Canada (opens in a new tab) lists ambulance services among the extra benefits provinces give certain groups, such as seniors or people on social assistance. Everyone else pays, out of pocket or through private insurance.

Each province still pays most of the real cost. BC’s ambulance service (opens in a new tab) says its fees aren’t an insured benefit under BC’s Medical Services Plan or the Canada Health Act, but that people with MSP coverage pay “reduced, subsidized fees”. Island EMS (opens in a new tab) in PEI says its $150 is 75% subsidized, which puts the full cost at about $600, the amount a visitor pays there.

What does an ambulance cost in each province?

Each province sets its own fee, and they work differently. Some charge one flat amount, some add a charge per kilometre, and in some the fee depends on what a doctor decides at the hospital. The territories leave much of it to local services.

Ontario

Ontario charges a $45 co-payment when the doctor who sees you at the hospital decides the trip was medically necessary, and the hospital bills it. If the doctor decides it wasn’t necessary, or you don’t have a valid Ontario health card, the charge is $240. A transfer between two Ontario hospitals costs nothing, and an air ambulance trip is $45 too, under Regulation 552 (opens in a new tab).

People on Ontario Works or ODSP, long-term care residents and people receiving certain home care services don’t pay. There’s no exemption by age, according to the province’s guide for seniors (opens in a new tab), so seniors pay $45 like everyone else. Toronto is no different, because the province sets the fee.

Quebec

In Quebec, a trip costs $125 plus $1.75 per kilometre to the hospital, so a 10 km ride comes to $142.50. The Quebec government’s page (opens in a new tab) says the person transported pays, even if someone else called 911. Urgences-santé (opens in a new tab), which runs ambulances in Montreal and Laval, says the rate hasn’t gone up since 1997. It’s the same rate everywhere in Quebec, and Urgences-santé mails its bill after the ride.

Several groups don’t pay:

• 65 and over, when the hospital doctor confirms the trip was needed for medical or social reasons and you went to the nearest suitable hospital (in French) (opens in a new tab).
• Social assistance and social solidarity recipients, also with the doctor’s approval.
• People hurt in a road accident, because the SAAQ pays.
• People hurt at work. The employer pays for the first trip, and the CNESST pays for later ones on an accepted claim.

The RAMQ (opens in a new tab) doesn’t pay for ambulances at all. If you don’t have private insurance, its public drug plan covers your prescriptions, and that plan comes with a yearly premium on your tax return.

British Columbia

BC charges a flat $80 for a 911 trip, by road or by air, to anyone covered by MSP. If paramedics come but don’t take you to hospital, the fee is $50. A transfer between hospitals is free, but a trip from a care home to hospital costs $80.

People on income assistance or supplementary benefits, Veterans Affairs clients and Indigenous Services Canada clients can have the fee covered, according to the ambulance service’s billing questions (opens in a new tab). After an injury at work, the employer pays for the first trip, and WorkSafeBC pays for later ones on an approved claim. After a car crash, ICBC pays once it has accepted the trip as part of a claim.

Alberta

Alberta’s fee (opens in a new tab) is $385 when you’re taken to hospital and $250 when paramedics assess or treat you without taking you in, with no charge per kilometre. If you’re covered by Coverage for Seniors, Income Support or an Alberta health benefit program, you may not have to pay. Transfers between approved facilities are usually free, and a visitor from outside Alberta pays $200 more.

Saskatchewan

Saskatchewan sets the most an ambulance service can charge in its ground ambulance fee policy (opens in a new tab). For a resident, that’s $325 a call from services in 20 communities, including Regina and Saskatoon, and $245 from the rest, plus $2.30 per kilometre for a call outside the ambulance’s home community. A visitor from another province pays up to $360, plus $3.05 per kilometre. Seniors 65 and over pay at most $135 a trip, and a transfer between facilities is free for them, under the province’s ambulance rules (opens in a new tab). An air ambulance costs residents $465 a flight.

Manitoba

Manitoba caps the fee at $250 a trip, down from an average of $500 in 2016, according to the province’s 2019 announcement (opens in a new tab). The province pays for medically necessary transfers (opens in a new tab) between designated facilities for tests or treatment. In Winnipeg, the city charges someone from outside Manitoba $1,100 under its 2026 rates (opens in a new tab), and adds 17% to an account it sends to a collection agency.

Atlantic Canada

The four Atlantic provinces charge residents a flat fee:

• New Brunswick: $130.60. Ambulance New Brunswick (opens in a new tab) doesn’t bill people on social assistance, people receiving the Guaranteed Income Supplement, subsidized nursing home residents or Extra-Mural Program patients. An air ambulance is free for residents.
• Nova Scotia: $146.55. Long-term care residents pay $54.50, and a transfer between facilities is free. People hurt in a car accident are billed $732.95, insured or not, under the province’s fee schedule (opens in a new tab).
• Prince Edward Island: $150, charged only if you’re transported. Seniors 65 and over pay nothing for an emergency trip, but $150 for a ride home from hospital or to an appointment.
• Newfoundland and Labrador: $115, charged for the ambulance coming, even if you aren’t transported (opens in a new tab). Air ambulance is free (opens in a new tab) for residents.

The territories

Yukon’s ambulance fee regulation sets charges only for non-residents: $250 plus $1.25 per kilometre by road, under the non-resident fee regulation (opens in a new tab). In the Northwest Territories, the territorial health plan doesn’t cover ground ambulance (opens in a new tab) except transfers between hospitals, so the local service sets the fee. In Nunavut, a medevac (opens in a new tab) costs residents $125 each way, and NIHB or Extended Health Benefits may pay it.

Who rides for free?

The groups that don’t pay vary by province, but seniors, people on social assistance, people hurt at work or in a car crash, and patients moved between hospitals are the usual ones. In Quebec, even someone on an exemption list can be billed if a doctor decides the trip wasn’t medically necessary.

• Seniors. Free in Quebec when the hospital doctor approves, in Alberta for seniors in Coverage for Seniors, and in PEI for emergencies. Saskatchewan caps a senior’s fee at $135, and New Brunswick waives it for people receiving the Guaranteed Income Supplement. We found no age exemption in Ontario, BC, Manitoba, Nova Scotia or Newfoundland and Labrador.
• Social assistance. Ontario Works and ODSP, Quebec’s social assistance and social solidarity programs, BC’s income assistance and New Brunswick’s social assistance cover the fee. Alberta’s Income Support can too, and Saskatchewan’s Supplementary Health and Family Health Benefits cover all or part of it. In Newfoundland and Labrador, some Income Support clients are covered.
• Injuries at work. In BC and Quebec, the employer pays for the first trip. In Saskatchewan, the Workers’ Compensation Board pays the fee in full.
• Car accidents. Quebec’s SAAQ and Saskatchewan’s SGI pay the bill, and ICBC pays in BC once it has accepted the trip as part of a claim. In New Brunswick, you pay the $130.60 and your car insurer may pay you back.
• Hospital transfers. A move from one hospital to another, arranged by the hospital, is free for residents in almost every province.
• End of life in Quebec. A trip to a palliative care home or to receive medical aid in dying is free at any age (in French) (opens in a new tab).

What if you need an ambulance in another province?

Your own province won’t pay. Ambulances aren’t part of the agreements that let you use your health card across Canada, so you’re billed as a visitor, and your home plan doesn’t pay you back. Ontario lists ambulance services among what OHIP doesn’t cover in other provinces (opens in a new tab), and the RAMQ says (opens in a new tab) transport fees can’t be reimbursed.

Quebec is the only province that charges Canadians from elsewhere the same rate as its own residents. Its free rides for seniors and people on social assistance are for Quebec residents only, though.

An air ambulance costs far more. In November 2025, CTV News reported (opens in a new tab) that an Ontario man who had a heart attack in Alberta was flown from Medicine Hat to Calgary and then billed $12,483 by Alberta Health Services. Ontario’s health ministry confirmed OHIP wouldn’t pay it.

In the United States? Our US guide covers what an ambulance costs there and the states that limit surprise bills.

Does insurance cover an ambulance bill?

Often, yes. The Quebec government (opens in a new tab) notes that group and individual plans often pay back all or part of the fee. Some plans also cover an ambulance in another province and an air ambulance. You usually pay the bill first and then claim it. Urgences-santé, Ambulance New Brunswick and BC’s ambulance service all ask you to do it that way.

Coverage depends on the plan, so read yours before you need it. For example, one of Manitoba Blue Cross’s individual plans (opens in a new tab) pays 100% of an emergency ambulance in Manitoba, and a higher tier adds an ambulance anywhere in Canada plus up to $5,000 for an air ambulance trip.

If you travel between provinces and your plan stops at the border, travel insurance that covers trips inside Canada fills the gap. It’s designed for bills like the $12,483 one above.

What if you can’t pay the bill?

Call the billing office before the due date. Some provinces have a formal way out: Nova Scotia can waive the fee for low incomes, New Brunswick reviews a bill if you ask within 90 days, and PEI offers a payment plan with no interest. An unpaid bill can end up with a collection agency, and in Winnipeg that adds 17% to it.

• Nova Scotia. Appeal a bill within 30 days of its date. To have it waived because your income is too low, apply within 90 days. If paying would be a hardship, the province will also set up a repayment schedule.
• New Brunswick. Ask Ambulance New Brunswick for a review within 90 days of the bill being mailed.
• Prince Edward Island. Call Island EMS within 30 days of the invoice. You can then appeal to the province within 90 days, on grounds that include not being able to pay, according to the province’s ambulance page (opens in a new tab).
• British Columbia. The fee can be waived for people on income assistance or supplementary benefits, and in a few other cases, such as a bill that arrived more than a year late and would cause real hardship.
• Ontario. If you’re charged $240 because a doctor decided the trip wasn’t necessary, ask the hospital that billed you how to have that reviewed.

If the bill has already gone to a collector, here’s what a collection agency can and can’t do in Canada.

Having a few hundred dollars ready for a bill like this

Most of these bills are a few hundred dollars, and they come with no warning. That’s the kind of cost an emergency fund is for, and $400 set aside covers a resident’s ambulance fee in most provinces.

Lodavo is a free app that makes building that fund more fun. Connect the savings or chequing account you already use, and every $25 in it earns you a ticket in a weekly draw for cash prizes. Your money stays at your own bank, and at least $100 goes to a winner every week.

Download Lodavo free on the Apple App Store (opens in a new tab) or Google Play Store (opens in a new tab).

This article is general information. Ambulance fees change, so check your province’s own page before you rely on a number here.

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