One of the benefits for newcomers moving to Canada is access to publicly funded health care, which has a reputation of being world-class. Health care is delivered through each of Canada’s provinces and territories. In Ontario, it’s known as OHIP (Ontario Health Insurance Program). Here’s what you need to know about what OHIP does cover and how to apply.
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See Healthcare in Canada: Basics for newcomers for an overview of provincial health insurance, understanding health coverage provided by the government, and to learn how to find a family doctor.
Health care coverage in Ontario
OHIP offers a wide range of standard health care free of charge, as the costs for these services are covered by provincial taxes. You will need to carry an OHIP card, which is issued by the provincial government. This card shows you are eligible to receive free health care in the province. Each eligible person is issued their own card, including children. You’ll be asked to show a valid OHIP card each time you see a doctor, have a medical test or are treated in a hospital.
What’s covered under OHIP?
OHIP covers the full cost of the following:
- Visits to a family doctor or walk-in clinic
- Hospital stays including medical practitioners, diagnostic tests (such as an x-ray), medications during your hospital stay, the cost of your hospital stay including meals (it does not include private or semi-private rooms)
- One eye exam every 12 months for anyone 19-years and younger or 65-years and older
- One eye exam for anyone between 20-64 years of age if they have a specific medical condition, such as glaucoma or diabetes mellitus
- Dental surgery that needs to be performed in a hospital
- Travel to access health services if you live in northern Ontario
OHIP covers the partial cost of the following:
- Ambulance services, except a $45 CAD co-payment charge for residents with a valid OHIP card
- Partial cost of podiatry services, up to $135 CAD per year per person with a registered podiatrist, as well as $30 CAD towards x-rays
Do you need an OHIP card to go to the hospital or ER?
A hospital will treat you without a valid OHIP card. However, in order for the cost of your treatment to be covered by the Ontario Health Insurance Plan, you must present a valid OHIP card or provide a health insurance plan number.
What’s not covered under OHIP?
Generally, OHIP will only cover medically necessary basic services, such as visits to your doctor or hospital. There are a number of important items the Ontario health system does not cover, including:
- Cost of prescription drugs for anyone under the age of 65
- Dental care
- Eye examinations for anyone between 20-64 years old and cost of prescription glasses
- Complementary or alternative medical treatments, such as chiropractor, physiotherapy, massage, acupuncture, or reflexology
- Private psychotherapy or counselling
- Crutches or casts
- Immunizations required for travel
- Cost of missed appointments and doctor’s notes
- Medical examinations for permanent residency application
Who is eligible for OHIP?
To be eligible for OHIP, you need to meet the following criteria:
- You are already a Canadian citizen, permanent resident, or landed immigrant
- You have submitted an application for citizenship or permanent residence in Canada, and you meet the government’s eligibility requirements
- You are a foreign worker with a valid work permit to legally work in Canada (including the Live-in Caregiver Program and the Seasonal Agricultural Worker Program)
In order for your OHIP coverage to remain valid, you’ll also need to make Ontario your primary place of residence and be physically present in the province for at least 153 days in any 12-month period.
How long can you stay out of Ontario and still be covered under OHIP?
You can be temporarily outside of Ontario or Canada for up to 212 days in any 12-month period and still maintain coverage, provided your primary place of residence continues to be Ontario.
When does OHIP coverage start?
Prior to March 19, 2020, OHIP coverage was not available to newcomers to the province until a three-month wait. However, in response to the COVID-19 pandemic, the provincial government took action to protect the health of everyone who resides in Ontario. As a result, the Ministry of Health and Long-Term Care has currently waived the three-month waiting period.
Arrive strongly suggests you visit the Ontario government website for up-to-date information on applying for OHIP, as this decision may be reversed or changed in the future.
What documents are needed to get an Ontario health card?
In order to apply for an OHIP card, you will need the following:
- Proof of Canadian citizenship or immigration status (e.g. Permanent Resident card, work permit)
- Proof of residency in Ontario (e.g. Ontario driver’s license, utility bill, rental agreement, or pay stub)
- Proof of your identity (e.g. Passport, credit card)
- A completed Registration for Ontario Health Insurance Coverage form
How to apply for an OHIP card
Applications for OHIP must be completed in person at a ServiceOntario Centre. Check the ServiceOntario centre website for your nearest location or telephone 416-326-1234 or 1-866-532-3161 from Monday to Friday 8:30 a.m. to 5 p.m. for more information.
- Before you visit a ServiceOntario Centre, you can download and fill in the required Registration for Ontario Health Insurance Coverage form. An English and French language version of the form is available. Alternatively, pick up a copy at a Service Ontario Centre and fill a form out there. However, with the limitation of services during the current pandemic, Arrive recommends you download and complete a form ahead of time. Each person in your family will require a separate form.
- Collect your three pieces of ID that prove your eligibility to reside in Canada, proof you live in Ontario, and confirm your identity. If you are unsure which items are acceptable, the Ontario government has provided a complete list of documents you need to get a health card. ServiceOntario will not accept photocopies of documents.
- Visit a ServiceOntario Centre in person with your completed form and three original, valid forms of ID. The ServiceOntario centre may be able to advise you on their busier times to avoid long line-ups. Generally, earlier in the morning is less busy than later in the day, especially during lunchtimes. If you have children or dependents who are aged 15-and-a-half years or younger, you can apply on behalf of your children at the same time. Older children must apply in person, as they will need to sign their own form and have their photo taken. A service clerk will process your application and take your photo. An OHIP card is free of charge.
- Your card will be mailed to you and will take one to two weeks to arrive. Currently, there is no waiting period to apply for OHIP due to COVID-19. However, this may change in the future, and if so, the ServiceCentre staff will look at your documents to assess when your three-month waiting period starts. Your OHIP card will be mailed to you after that date.
Here are few more things to consider before you get started:
Can you apply for an Ontario health card online?
No. You must apply for an OHIP card in person at a ServiceOntario centre. However, if you are self-isolating and cannot visit ServiceOntario, contact the ServiceOntario INFOline at 1-866-532-3161 for more information and next steps.
How much does an OHIP card cost?
Applying for or renewing an OHIP card is free of charge.
How long does it take to get an OHIP card?
It usually takes four to six weeks for your card to be sent to you in the mail.
If you have any questions about applying for OHIP, you may be able to find help at your nearest community agency or newcomer service. Alternatively, contact the Ontario Ministry of Health and Long-Term Care on telephone 1-800-268-1154.
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