What You Need to Know About Supplemental Health Insurance in Ontario

Posted on December 30, 2018

An estimated 14 million people live in Ontario. It's Canada's most populous province. As in other parts of Canada, the public health care system is funded by taxes.

Like other Canadians, Ontarions don't have health care coverage for everything. In fact, they're often surprised to learn exactly what the public health care system will pay for and what it won't.

While Canadians pride themselves on their health care system, the truth is it can leave a lot to be desired.

That's why supplemental health insurance is such a good idea for Ontarions. If you're one of them, here's what you need to know about health insurance in Ontario.

Your OHIP Coverage

As we already discussed, Canadian tax dollars help pay for the public health care system. Canadians can visit hospitals and doctors' offices without paying out of pocket.

Since the provinces are responsible for health care, Canadians' coverage changes from place to place. Health coverage in Ontario is different from what you'd receive in British Columbia.

You might wonder what's covered under the Ontario Health Insurance Plan, or OHIP. This program provides many basic health services for residents of Ontario. They include:

  • Doctor's visits and services
  • Hospital stays and services
  • X-rays, blood tests, and lab services ordered by a doctor
  • Emergency dental surgeries
  • Some specialist treatments

You may also have coverage for other medical expenses, such as ambulance services. People living in remote Northern Ontario communities may have their travel expenses covered.

Extended Coverage for Some Groups

The Government of Ontario recognizes that some people need extra support. Seniors, for example, may qualify to have their prescription medications paid for.

In 2018, the government expanded prescription drug coverage to children and young adults. The province acts as a secondary insurer for those who have private coverage.

Low-income Ontarions, including people with disabilities, may also be able to receive assistance. The Trillium Drug Program provides extra coverage to those who meet certain qualifications. Only certain medications are covered under the program.

Getting Provincial Health Insurance in Ontario

Ontario's health care system is public, meaning it's funded by the taxpayers. Almost every resident of Ontario can access OHIP coverage. You're eligible if you are:

  • a Canadian citizen
  • a permanent resident
  • a person applying for permanent residency
  • an Indigenous person
  • a person working full-time in Ontario for at least six months
  • a refugee or protected person
  • a temporary resident with a specific permit type

You'll also need to make Ontario your permanent home. You'll need to be present in the province for at least 153 days every year.

Accessing OHIP

To use the program, you'll need an Ontario health card. If you don't have one already, you'll need to apply at a Service Ontario location.

Once you're approved, you'll receive a health card, which you'll use to access health services.

Your card will expire every five years, so you'll have to renew it.

What OHIP Doesn't Cover

You probably noted that OHIP doesn't cover every medical need you might have. Like every other province, Ontario's plan leaves large gaps in coverage.

Dental coverage and vision care are two areas Ontario's public system doesn't offer coverage. Other items that aren't covered include:

  • cosmetic surgery
  • private or semi-private hospital rooms
  • most prescription drugs

It's also important to note that there are many covered services that OHIP only pays for in part. An example is podiatry.

Supplementing Your Health Insurance

Given the holes in Ontario health insurance, you might wonder how you can boost your coverage. Prescription medications, for example, can be quite expensive.

Many Ontarions are also likely to experience a catastrophic illness in their lifetime. They may not have enough coverage.

Younger Ontarions are also more likely to travel. OHIP doesn't provide medical insurance abroad.

You may have some coverage provided by an employer, but it may not be enough. If you're self-employed, you likely don't have health coverage outside of OHIP.

Seniors may also not have private insurance.

Given these facts, supplemental health insurance just makes good sense for Ontario residents. Supplemental plans come in all shapes and sizes. They can help you get the coverage you need.

Popular Supplemental Health Insurance Options

For Ontarions, the most popular supplemental benefits are dental coverage and vision coverage. These options can help you reduce your out-of-pocket health care costs.

Other options include:

Some supplemental plans include other benefits, like coverage for registered massage therapy.

For Ontarions, it's also a good idea to pick a plan that provides coverage for medical devices. OHIP offers little to no coverage for most medical devices.

The Assistive Devices Program offers aid for people with long-term disabilities. Unfortunately, the program won't help if you need a device for a short period of time.

Finding the Right Insurance Plan

There are several Canadian health insurance providers offering supplemental health insurance in Ontario. Most offer several different types of plans.

You can choose the one that best suits your needs.

If you're not sure which plan is right or even what insurance you should consider, talk to a broker or agent. They can help you determine what you need in a plan.

They can also help you find the best plan.

Even if you have some private insurance through an employer, it still may not be enough. Supplemental health insurance can help you ensure you have coverage when you need it.

Better Health Care is in Your Future

Supplemental health insurance in Ontario fills in the gaps left in the public system. A great supplemental plan is your ticket to better health care in Ontario.

More than that, the right health insurance can give you peace of mind. If you're ready to protect your health, get a quote today. More coverage is only a few steps away.

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