Moving to Ontario comes with a list of important tasks, and the top of that list is figuring out how to get an Ontario Health Insurance Plan (OHIP) card.
This might seem overwhelming, especially if you’re new to Canada. But there’s good news – our guide simplifies it all. We break down the process of how to get an Ontario health card into easy steps.
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The Ontario Health Insurance Plan (OHIP) provides comprehensive healthcare coverage to Ontario residents, including newcomers and immigrants. It’s crucial for new arrivals in Ontario to understand how OHIP works, as it offers access to necessary medical services and reduces personal healthcare costs. This guide aims to simplify the process and provide clear steps on how to obtain an OHIP card.
OHIP in Ontario is funded mainly by the provincial government through provincial taxes, including income and sales taxes. Additional funding comes from federal government transfers and an Employer Health Tax paid by Ontario employers. This combined funding allows OHIP to offer health services to residents at no direct cost at the point of use.
To qualify for OHIP, new immigrants must meet specific criteria. These include having a permanent resident status, having applied for immigration status, and residing in Ontario for at least 153 days in any 12-month period.
Additionally, you must physically reside in Ontario for at least 153 days of the first 183 days immediately after establishing residence in the province.
Therefore, for individuals who intend to return to their home country or spend a significant amount of time abroad, such as for retirement, it’s important to be aware that their OHIP coverage may be jeopardized or canceled due to prolonged absences from the province.
The Ontario Health Insurance Plan (OHIP) is not accessible to everyone. Those who typically don’t qualify include tourists, visitors, some temporary workers, foreign students (with specific exceptions), Canadian citizens who don’t primarily live in Ontario or have been out of Canada for more than 212 days in a year, and individuals with expired or illegal immigration status. Refugee claimants may also be ineligible, depending on their specific circumstances.
Applicants need to prepare certain documents for the OHIP application. This includes proof of identity (such as a passport), proof of residency status (like a Permanent Resident card), and proof of residency in Ontario (such as a rental agreement or utility bill). It’s important to check the latest requirements on the Ontario government’s website, as the required documents may change.
To apply for OHIP, newcomers must visit a ServiceOntario center in person. It’s advisable to book an appointment or check the walk-in hours. During the visit, you’ll need to complete an application form and submit it along with your documents. The staff at ServiceOntario will verify your documents and process your application.
After submitting your application, there’s typically a waiting period before your coverage begins. This period usually lasts up to three months. During this time, it’s wise to consider temporary health insurance to cover any necessary medical expenses.
Once you receive your OHIP card, you can use it to access a wide range of health services, including visits to doctors, hospital stays, and certain medical tests.
For certain groups such as seniors, children, and people on social assistance, OHIP offers additional coverage, including for prescription medications under the Ontario Drug Benefit program.
Remember to carry your card with you and present it at healthcare appointments.
If you forget your OHIP card when visiting the doctor, you may still be admitted for treatment, especially if the office has your details on file.
However, you might be billed directly for the service. You can typically get reimbursed by OHIP if you later present your valid OHIP card along with the original receipt.
Some healthcare providers might also verify your coverage electronically or allow you to bring your card later to adjust the billing.
In emergency situations, hospitals provide care regardless of your card, but you’ll need to provide OHIP information as soon as possible afterward.
The Ontario Health Insurance Plan (OHIP) provides coverage for a wide range of health services to eligible Ontario residents. Here’s a summary of what is typically covered:
OHIP offers limited medical coverage outside Ontario.
Within Canada, OHIP covers healthcare costs at Ontario rates, but you may have to pay the difference if local rates are higher. It provides coverage for some services, including physician services and those offered in a public hospital. Note that services such as ambulance, home care, long-term care, prescription drugs, and lab services provided outside of a hospital are not covered.
Outside Canada, coverage is very restricted, offering up to $400 per day for certain emergency services, but often insufficient for full costs.
Since January 1, 2020, overseas coverage is minimal, so additional travel health insurance is highly recommended.
Pre-approval might be needed for specific services. It’s important to verify current OHIP policies and have adequate insurance when traveling.
OHIP cards need to be renewed periodically. Ensure to keep track of the expiry date on your card and follow the renewal process, which may involve providing updated documentation and visiting a ServiceOntario center. Also, inform ServiceOntario about any changes in your address or immigration status.
Successfully obtaining an OHIP card is a crucial step in settling in Ontario as a new immigrant. It ensures access to healthcare services and contributes to a smoother transition into your new life in Canada. By following the outlined steps and utilizing available resources, the process can be straightforward and manageable.
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