What is Ontario Health Insurance Plan (OHIP)?

What is Ontario Health Insurance Plan (OHIP)

In Canada, the government provides free basic medical and health services (OHIP) to those living in the country who qualify for the scheme.

The Ontario Health Insurance Plan (OHIP) covers many health services and covers the cost of medically necessary services; these services include your visits to your family doctor and other specialist doctors. So many basic and emergency medical and health services are covered by the Ontario Health Insurance Plan.

Who is eligible for the Ontario Health Insurance Plan (OHIP)?

To be eligible to participate in the Ontario Health Insurance Plan, you must be able to answer yes to the following:

  • Section A:
  1. The province of Ontario is your primary place of residence.
  2. During the first six months of your life in Ontario, you have not been out of the province for more than 30 days; this means that you have been in the region for at least 153 days during the first 183 days of your life in Ontario.
  3. You are in Ontario for at least 153 days during 12-month periods.
  • Section B:

You should be able to answer yes to at least one of these:

  1. Are you a Canadian citizen or a permanent resident?
  2. You are a protected person or, in other words, a refugee.
  3. Under Indian law, you are recognized as an Indian in Canada (this is for Indigenous Canadians).
  4. You have applied for permanent residency and immigration to Canada, and the Immigration, Refugees and Citizenship Canada (IRCC) has certified that you are eligible to apply for permanent immigration to Canada; this means that you have “approval-in-principle.”
  5. You have applied for Canadian citizenship under Section 5.1 of the Canadian Citizenship Act. The IRCC has certified that you are eligible to apply for citizenship (this section is for foreign children adopted by Canadian citizens).

Foreign Workers and their Families

  • You have a work permit in Canada that is valid for at least six months. – You also have a formal agreement to work full-time for an employer in Ontario.
  • You have a valid work permit in Canada through the Live-In Caregiver app.
  • You have a valid work permit in Canada through the Seasonal Agricultural Workers Program.
  • You are a foreign clergyman who intends to serve in a religious group in Ontario for at least six months.
  • Your fiancé or partner is a foreign worker eligible for the Ontario Health Insurance Scheme.
  • You are the dependent child of a foreign worker eligible for the Ontario Health Insurance Scheme.

What is the 3-month waiting period for an Ontario Health Insurance Card?

You will not be able to receive an Ontario health insurance card immediately upon arrival. After entering the province, you must wait three months to receive an OHIP card.
Upon arrival, you can apply for an Ontario Health Insurance Card as soon as the required documents are ready. But you will not receive the card until you qualify (3 months later), and you will not be able to use its services.
According to the Department of Health, when you register for Ontario Health Insurance, the Department’s staff will review your documents and set a waiting period of 3 months.
You must also be physically present in Ontario for 153 days out of the first 183 days after registering for your Ontario Health Insurance Plan.

What Services Does Ontario Health Insurance (OHIP) Cover?

The Ontario Health Insurance Plan covers various medical and health services. This insurance covers many essential medical services as well as emergency services. This insurance can cover all or part of the costs.

(There are some services that Ontario Health Insurance Plan does not cover; these are services that are not medically necessary, such as cosmetic surgery.)

For some Services, OHIP Pays Part of the Cost.

For example:

  • Some services from your doctor, foot specialist, chiropractor and orthopedist
  • Physiotherapy services
  • Eye tests
  • Travel Expenses: If you live in the north of Ontario and have to travel long distances to get some specialized medical services, the Ontario Health Insurance Plan may cover part of your travel expenses.

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Outside Ontario, inside Canada

If you have an Ontario Health Insurance Card, you will receive primary health care for free in many other parts of Canada. While in Quebec, you may have to pay for medical services. When you return to Ontario, you can send your receipts to the Health Department office in your area. They will refund the money you paid for medical services in Quebec if you qualify. Always have your Ontario Health Insurance Card with you, even when you are not in the province. You must show your card to your doctor for your medical expenses to be covered by this health insurance.

What is Ontario Health Insurance Plan (OHIP)

OHIP, Outside OF Canada

When travelling outside Canada, it is a good idea to consider buying extra private health insurance. Ontario health insurance coverage is minimal when you are abroad. When you travel outside Canada, the Ontario Health Insurance Plan pays for a portion of the emergency medical services that meet specific criteria. OHIP will pay a certain amount for these services. There are many medical and health services that the Ontario Health Insurance Plan does not pay for when you are out of the province.

For example, OHIP does not cover the cost of these services:

  • When using an ambulance.
  • When to plan and receive some medical services that you can get while in Ontario.
  • How long can I stay outside Canada to maintain my Ontario health insurance coverage?
  • You can be out of Canada for 212 days in 12 months and still be covered by OHIP.
  • If you are out of Canada for more than 212 days, you can sign up for the Continuous OHIP.

OHIP can cover you longer when you are abroad

because you:

  • You are studying.
  • You work abroad.
  • You are on vacation.
  • You do religious propaganda activities.

To enroll in the Ontario Ongoing Health Insurance Scheme, you must provide proof that you have been absent for more than 212 days.

For more information on the required documents, contact the nearest OHIP office in your area.

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One Response

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