Medical Insurance in Ontario, Canada – Information For New Residents

June 27th, 2010 admin

Medical Insurance in Ontario, Canada – Information For New Residents

In Ontario, as well as in all other Canadian provinces, citizens, permanent residents and work permit holders receive free medical assistance. Family doctors, major specialists, hospitals, laboratory analyses and ultrasound, X-ray, CT and even MRI – all are generally free of charge. In some cases, however, the government program “Ontario Health Insurance Plan” OHIP does not provide any coverage, or the coverage is not sufficient.

Travel and Visitors insurance

Out of Country (and Out of Province) emergency health services are very limited. Practically, you have no coverage when you cross the Ontario border. The OHIP website warns:

“The Ontario Health Insurance Plan (OHIP) only covers emergency health services at very limited rates. For example, an outpatient visit to a U.S. emergency room may cost thousands of dollars for the duration of your care, however OHIP will only reimburse up to a total of $50.00 CDN per day for this service regardless of the severity of the situation. If you plan to travel outside of Ontario, it is strongly recommended that you obtain additional private medical insurance and fully understand what your policy covers.” [1]

Buying such insurance is very easy. Insurance agents and travel agents will fill in a very simple form for you, asking just a few dollars per day (depending on your age). It’s important to check what’s included. Some policies, for instance, include dental help. Others may not. The maximum coverage can also be different in those plans, so read the terms and conditions very thoroughly and ask your agent to provide you with all the details. If you have friends or relatives coming to visit you, you can purchase the same medical insurance plan for them, for the period of their presence in Ontario. It’s possible to start such insurance program even before the arrival – starting from the departure from their country. In that case the insurance will cover all medical expenses during the flight, too.

First three months in Ontario

The very first thing new immigrants are faced with in Ontario is the absence of any medical coverage during the first three months. Here is a citation from the OHIP official website:

“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.” [2]

The private health insurance mentioned by OHIP is essentially the same insurance plan that covers you when traveling outside Ontario.

Prescription drugs, Vision and Dental care

OHIP generally does not cover these. Exceptions are: prescriptions for seniors with little or no income and optometrist’s services for children. Large businesses usually provide their employees with insurance plans that cover drugs, vision, dental and additional health services. Small business do it rarely, though it’s possible to purchase so-called “group insurance plan” for any business size, even for sole proprietors. Individuals can register for a (quite costly) private medical insurance plan that covers drugs and dental or participate in the provincial “Trillium Drug Plan”. These plans may give you benefits if you need to purchase expensive prescription drugs regularly.

Additional insurance plans people usually buy include critical illness insurance and disability insurance. Discussion of these is beyond the scope of this article.

The correct information about insurance in Canada in general, and specifically about insurance in Toronto, Ontario will help newcomers to Canada understand the variety of insurance services and make as little mistakes as possible at the first stage of living on the new country. Life in Canada is organized so that it becomes very difficult without a whole set if consulting services – juridical, financial, real estate and insurance. Do not hesitate to talk to the specialists. In most cases, you will receive free consultation.

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