Ontario Health Premium: Rates, Who Pays, and Late Filing

The Ontario Health Premium is an annual provincial tax owed by Ontario residents whose taxable income exceeds $20,000, ranging from $0 to a maximum of $900 depending on income. It’s collected through your personal income tax return, calculated on Form ON428, and applies to individuals based on their own taxable income rather than household income.¹ The rate brackets have not changed since the premium took effect for the 2004 tax year.²

Who Owes It

You owe the premium if you were a resident of Ontario on the last day of the taxation year and your taxable income for the year was more than $20,000.² For most people that last day is December 31. If you emigrated from Canada during the year, it’s the day you left. If a resident dies during the year, the date of death is treated as the last day for premium purposes.³

The premium is individual. A married or common-law couple where both spouses earn over $20,000 will each owe their own premium based on their own taxable income; family income is not part of the calculation.¹

One boundary worth stating plainly: the premium is not linked to OHIP. Paying it or not paying it has no effect on your eligibility for Ontario health care. It’s a tax that funds health services, not an insurance premium.¹

How Much You Pay

The premium uses a graduated structure set directly in the Income Tax Act. Each rate applies only to the income within its band, so the amount climbs in steps.²

$20,000 or less: $0
$20,001 to $25,000: 6% of income above $20,000 (up to $300)
$25,001 to $36,000: $300 flat
$36,001 to $38,500: $300 plus 6% of income above $36,000 (up to $450)
$38,501 to $48,000: $450 flat
$48,001 to $48,600: $450 plus 25% of income above $48,000 (up to $600)
$48,601 to $72,000: $600 flat
$72,001 to $72,600: $600 plus 25% of income above $72,000 (up to $750)
$72,601 to $200,000: $750 flat
$200,001 to $200,600: $750 plus 25% of income above $200,000 (up to $900)
Over $200,600: $900 (the cap)

The “taxable income” that drives the calculation is the amount on line 26000 of your federal return. RRSP contributions, union dues, childcare expenses, and other deductions reduce that figure before the premium is computed, so claiming everything you’re entitled to can pull you into a lower band.

A couple of worked examples. At $30,000 of taxable income you sit in the $25,001 to $36,000 band and owe a flat $300. At $50,000, you’ve cleared the $48,600 threshold and owe $600. The 25% transitions sound severe, but each applies to a window of at most $600, so the largest jump between flat tiers is $150.

The premium cannot be reduced by Ontario tax credits. Credits like the Ontario personal amount, the age amount, or charitable donation credits reduce your regular provincial tax; they do not touch the health premium, which is added on afterward. Retirees whose credits wipe out their regular Ontario tax can still owe the full premium.

How You Pay

If you’re employed, your employer deducts an estimated amount for the premium from each paycheque along with federal and provincial income tax. It’s built into the standard payroll withholding tables, so there’s no separate remittance to make. If you’re self-employed, the premium is calculated on your annual return and paid when you file, or through quarterly instalments if your balance is large enough to require them.

The calculation itself lives on Form ON428 (Ontario Tax), filed with your federal return, at Step 7.⁴ If your employer withheld too little, you pay the shortfall at filing time. If too much came off, the overpayment is refunded or applied to other amounts owing.

Who Doesn’t Pay

The broadest exemption is income-based. If your taxable income is $20,000 or less, your premium is $0, and no separate claim is required — the ON428 calculation produces a zero automatically.¹

If you hold a Certificate of Indian Status, the premium applies only to taxable income earned off-reserve. Income earned on a reserve is exempt. When off-reserve taxable income is $20,000 or less, nothing is owed.¹

Trusts are excluded from the premium under the Income Tax Act, even where a trust is otherwise a taxpaying entity resident in Ontario.²

Non-residents who earn Ontario-source income but are not residents of the province on the last day of the tax year are not subject to the premium. If you moved out of Ontario to another province before December 31, you’re generally not an Ontario resident on the relevant date and the premium doesn’t apply, though your new province may have its own levies.

Note that the premium is not prorated. Move to Ontario in July and stay through year-end, and you owe the same amount as someone who lived there all twelve months, calculated on your total taxable income for the year.³ If you were resident in Ontario and another jurisdiction on the last day of the year, the statute treats you as residing only in the jurisdiction that is your principal place of residence.²

What Happens If You File Late

Because the premium rides on your income tax return, missing the filing deadline exposes it to the same penalties as any other unpaid federal balance. The Canada Revenue Agency charges a late-filing penalty of 5% of the balance owing plus 1% for each full month the return remains outstanding, up to 12 months.⁵ If you were assessed a late-filing penalty in any of the three preceding years and received a formal demand to file, the penalty doubles to 10% plus 2% per month for up to 20 months. Interest also accrues daily on any unpaid balance.

If you can’t pay the full amount, filing on time still avoids the initial 5% penalty, and you can arrange a payment plan with the CRA for the balance.

1
Government of Ontario. Health Premium
2
Ontario.ca. Ontario Code R.S.O. 1990, c. I.2 – Income Tax Act
3
Canada Revenue Agency. Ontario Tax Information for 2025
4
Canada Revenue Agency. 5006-C ON428 – Ontario Tax
5
Canada Revenue Agency. Interest and Penalties on Late Taxes – Personal Income Tax