The Ontario Health Insurance Plan (OHIP)
A resident of Ontario must have a health card to show that he or she is entitled to health care services paid for by OHIP. The Ministry of Health and Long-Term Care pays for a wide range of services, however, it does not pay for services that are not medically necessary, such as cosmetic surgery.
Most of your Ontario health benefits are covered across Canada. The province or territory you are visiting will usually bill the Ontario Ministry of Health and Long-Term Care directly for hospital and physician services. In Quebec, you may have to pay for physician services and then submit your receipt to your local ministry office for payment.
Ontario residents are eligible for provincially funded health coverage (OHIP). Generally, to be eligible for Ontario health coverage you must:
- be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; and
- be physically present in Ontario for 153 days in any 12-month period; and
- be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and
- make your primary place of residence in Ontario.
OHIP coverage normally becomes effective three months after the date you establish residency in Ontario. The ministry strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period. (See: http://www.health.gov.on.ca/en/public/programs/ohip/)
3-months waiting times for newcomer to Ontario
Generally speaking, if you are a newcomer to Ontario, or a former resident returning here to live after being out of the country for more than seven months, the waiting period begins on the date you establish or re-establish residence in Ontario. You may also be required to be present in Ontario for 153 days of the first 183 days immediately following the date residence is established in Ontario (you cannot be absent for more than 30 days during the first 6 months of residence).
If you are an eligible resident moving to Ontario from another part of Canada, the health insurance of your former province/territory may cover you during the waiting period for OHIP coverage.
If you are not covered by another province/territory, it is important to buy private health insurance to cover you until your Ontario health insurance coverage becomes effective. (See: http://www.health.gov.on.ca/en/public/programs/ohip/ohipfaq_dt.aspx#Q1)
If you do not have OHIP coverage
Certain groups are exempt from the three-month waiting period; contact INFOline at 1 800 268-1154 or visit your local ServiceOntario – Health Card Services – OHIP office to find out if you may be exempt from the 3-month waiting period.
Because of the 3-month waiting period, many new immigrants are forced to pay for health care out-of-pocket, in some cases incurring great financial debt at a time when they are trying to establish a new life for themselves and their family in Ontario. Others delay seeking necessary medical care, resulting in the need for much more serious and costly treatment in the future.
A Coalition, Access Alliance Multicultural Health and Community Services (website: http://www.cleonet.ca/news_organizations/3023) has launched a postcard campaign to urge Ontario MPPs and the Premier to eliminate the three-month wait. For RSVP, enquiry, or getting postcards, email: firstname.lastname@example.org.
Also, if you do not have OHIP coverage, you cannot be turned away from any hospital’s emergency department. Some health care agencies in Ontario will provide health care even if you are not covered by OHIP, for more inquiry you may call Telehealth Ontario at 1-866-797-000.
By ICAN Inc.