Updated - March 3, 2022
Being an Ontarian is a blessing in so many ways, but one main reason has to be OHIP, i.e., the Ontario Health Insurance Plan, which covers Ontarians in and outside of Ontario.
Due to the COVID-19 pandemic, there has been some discussion about OHIP coverage outside Canada, especially since the Canadian government has banned all non-essential travel outside of Canada.
Let's read on to see what is covered by OHIP out of province and out of the country.
OHIP Coverage Outside of Province
What is OHIP? It is the privilege that Ontarians have — they have access to a lot of medical services for free, as it is covered under OHIP and paid for by the taxes collected by Ontario and Canada. The glories of subsidized public health care!
When you are outside of Ontario, like in some other provinces of Canada, you will still have access to certain hospital services, but they have to be medically necessary. You have access to the services of a walk-in clinic or a public hospital.
All services not covered by OHIP in the province will not be covered by OHIP outside of province or country, which seems pretty self-explanatory.
How Does OHIP Know If You Are Out Of Country?
Something that concerns Canadians is whether OHIP knows when you are out of province or out of the country, and as mentioned earlier, there is no way for OHIP to know unless you declare your travel plans to them.
Research from 2014 indicated that there would be a program that will have exit passport data transmitted to OHIP to prevent health care fraud by snowbirds or other Canadians.
These individuals don't live in Canada anymore but return occasionally to take advantage of the health care facilities and services, which causes a huge drain on Canadian health care resources.
For now, there is no sign as to when the program will be in place, but it's a good reminder to think about travel insurance for those days you are out of the country for long periods of time.
Upon further research of government websites, there has been no indication that this pilot program went into effect.
If you get charged for a medical treatment out of province, you may be eligible to make a claim to get repaid. You are able to file a claim to OHIP within 12 months of receiving the treatment.
The services that are covered by OHIP are eligible to be repaid to you, especially if you paid for them after Jan 1st, 2020.
There's a form on the Ontario government website that you can fill to claim your expenses back. This is the most recent form as of March 2022. You can also email or mail your claim in.
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OHIP Coverage Outside Canada
If you are going to live or work outside of Ontario or Canada for more than seven months in a year, then you need to report that to OHIP, so they can inform you of what to do.
If you are going to be working or studying outside of the province, or outside of Canada, you need to submit proof of employment or education to OHIP to keep your coverage going. This also applies to people who are doing charitable work outside of Canada.
If you’ll be outside of Canada for more than 7 months in any 12-month period you can keep your OHIP coverage for up to two years if you:
- Have a valid health card
- Make Ontario your primary home
- Will be in Ontario for at least 153 days a year in each of the two years right before you leave the country
Many services are not covered by OHIP when you are travelling out of province or out of the country, which is why having good travel insurance that covers all emergency medical needs is essential.
Learn About All The Necessary Vaccines for Travel as Required By Country
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Don't Leave Home Without Proper Travel Insurance
No matter which country you end up travelling to (or staying in long-term), hospital costs and ambulatory costs can add up quickly.
You could easily spend thousands of dollars for a short hospital stay. Updated data from 2021 has shown these numbers to further increase from past years, with an overnight stay costing around $11,700 with Medicare, $1,600 to $8,400 for an MRI, and $100 to $1,000 for an x-ray.
These costs are even more exorbitant if you need emergency evacuation from the country. An air evacuation from Thailand to Canada would cost an estimated $150,000, and from Southern U.S.A., it would be $20,000 and upwards.
If you are a foreigner, you usually have to visit hospitals geared towards foreigners or other very costly private hospitals. The public hospitals are mostly restricted to locals only.
You never know what might happen when you travel to another country or province. Murphy's law says that it's when you are least expecting something to happen, is when it does.
Even if you are spending time simply relaxing, you should always be 100% prepared in the event of an accident or illness. It's always essential to buy some travel insurance before travelling out of province or country.
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How Long Can You Be Out of the Country to Still Access OHIP?
You need to make Ontario your primary residence to be eligible for OHIP, which means that you need to have a rental or lease agreement, utility bills, or a recent income tax assessment.
As said earlier, you can work or study outside of the province, but you need to show proof of that to OHIP so they don't suspend your coverage if you are gone too long.
You are permitted to keep your OHIP coverage for up to two years when outside of the province and/or country if you have a valid Ontario Health Card and make Ontario your primary residence (as mentioned above).
Also, you need to ensure that you are in Ontario for 153 days a year in each of the two years immediately before you leave the country.
Before you leave, take your proof of residence and your health card to any Service Ontario location. This will ensure you never lose coverage accidentally while you are away.
OHIP Coverage Outside Canada Varies Depending on Circumstances
We recommend reading all of the fine print very carefully regarding OHIP coverage outside of Canada, and outside of the province.
This is especially important when you are going to be away from the province or country for long periods of time.
If you wish to compare rates on travel insurance, leave it to Insurdinary! The friendly and experienced staff here will take the guess work out of shopping for travel insurance by comparing side by side quotes for you from Canada's top providers. Bon Voyage!