PSA test coverage: Ontario and B.C. charge without referral

Updated Oct. 15, 2026

Ontario and British Columbia do not pay for a PSA blood test for prostate cancer when a man has no symptoms and no doctor’s suspicion of cancer, and patients there pay out of pocket, according to both provinces’ own health guidance. The Canadian Cancer Society said those are the only two jurisdictions with that gap, and it is urging both to change it.

Ontario’s prostate cancer screening page, last updated Feb. 4, 2026, said OHIP pays for a PSA test when a doctor or nurse practitioner suspects prostate cancer and refers the patient, when a man is being treated for it, or when he is being monitored after treatment. Without a referral, the page said, the patient pays for the test. The page does not describe an organized screening program.

B.C.’s provincial guideline for prostate cancer diagnosis and referral said a PSA test for men without symptoms “is not an insured benefit in BC under the Medical Services Plan.” It put the patient cost at about $35. If that test comes back abnormal, the guideline said, the repeat test is insured.

The guideline, which took effect April 15, 2020, said men aged 55 to 69 with a life expectancy of more than 10 years may choose PSA testing after an informed discussion with their doctor. It said men under 55 or over 69 without risk factors are not candidates for testing. Men of African descent, men with a family history and men whose first-degree relative has a BRCA2 mutation may consider testing from age 40 to 45, every two years, though the guideline said there is no clear evidence that earlier testing helps.

The Canadian Cancer Society said the other eight provinces and all three territories already cover a PSA test for an asymptomatic person when a health-care provider refers them. The society said cost is a barrier that may discourage people from getting tested and called on B.C. and Ontario to cover the test fully. That is the society’s account of provincial coverage. This article confirmed the Ontario and B.C. policies against those provinces’ own pages but did not independently check the other provinces and territories.

No Canadian province runs an organized PSA screening program of the kind used for breast, cervical and colorectal cancer, according to a study by University of Ottawa researchers published Dec. 1, 2025, in the journal Current Oncology. The study’s authors, who included Statistics Canada researchers, said men must ask a primary-care provider for the test.

The federal advice behind that gap has not changed on the Canadian Task Force on Preventive Health Care’s website, which said the task force “recommends against screening for prostate cancer with the PSA test.” Its 1,000-person decision tool models men aged 55 to 69 who are screened over 13 years. Of 1,000 men, the tool estimates, 102 would be diagnosed with prostate cancer, and 33 of those would never have become ill or died from it. Another 178 would have a positive PSA result, but follow-up would find no cancer.

The tool estimates that screening prevents one death per 1,000 men, with five deaths from prostate cancer among those screened and six among those not screened. It estimates that diagnosing 27 additional men would save one life.

The University of Ottawa researchers, led by Dr. Anna Wilkinson, reached a different reading of Canadian trends. They said prostate cancer deaths fell by more than half after PSA testing began and that cases found at the metastatic stage rose by about 50 per cent among men aged 50 to 74 after screening was discouraged. They also said Canadian specialty societies suggest PSA screening for healthy men with a long life expectancy. Prostate cancer accounts for 22 per cent of cancers in Canadian men, excluding non-melanoma skin cancers, the study said.

The two positions are not settled science, and this article does not recommend for or against testing. Men weighing a PSA test should talk to their doctor or nurse practitioner and confirm coverage and cost with their provincial health ministry or health authority.

For other tests that do have provincial programs, see how breast screening age and self-referral work by province, how to get a FIT kit for colon cancer screening and where each province stands on lung cancer screening.

Sources: Government of Ontario, Government of British Columbia, Canadian Task Force on Preventive Health Care, Canadian Cancer Society and Current Oncology.

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