Ontario Health Insurance For Newcomers

The idea that most healthcare-related services are free for nearly anyone who needs them has become a core value shared by many Canadians and is a great representation of our community-oriented spirit. Understanding your Ontario health insurance options is an important step for newcomers.

Today, we’ll talk about Ontario health care, and how newcomers to Canada can navigate Ontario’s health insurance so that they can access quality health care in Ontario in the event of any illness, accident, or unexpected event.

For newcomers to Canada, the publicly-funded health care system is a huge benefit. If you’re settling in Ontario, a health card is the first step in securing your access. However, despite it being a universal system, there is an initial requirement that prevents many newcomers from accessing Ontario health insurance for their first three months or so in Canada.

This is why we recommend that newcomers to Canada purchase private insurance for their first few months in the country, which they can use as they navigate the Ontario health insurance system for the first time.

(We recommend getting started with a free quote from our trusted partner, Cigna.)

The Ontario Health Insurance Plan (OHIP)

In Canada, each province administers its own health insurance, which is publicly funded. Once an individual is signed up for this public health insurance, the province pays for most of their required health services. In Ontario, this public health insurance is known as the Ontario Health Insurance Plan (OHIP).

For newcomers (and even some long-time residents of Ontario), it can be challenging to determine what OHIP may cover and in what situation. Essentially, it boils down to one question – do you have a medical reason for receiving that service or treatment? If not, you will likely have to pay out-of-pocket or use private insurance.

Like private insurance, OHIP covers many services, but it does place limits on some benefits. For example, OHIP will cover the cost of one major eye exam every 12 months, but only for OHIP cardholders who are under the age of 19, or 65 and older. If you’re between the ages of 20 and 64, you must pay that expense out of pocket.

OHIP also does not cover:

• Prescription drugs in a non-hospital setting
• Dental services
• Eyeglasses
• Cosmetic surgery

Additionally, coverage for some services is discretionary. For example, taking an ambulance may or may not be covered, depending on the circumstances.

If you’re ever unsure whether or not a medical service or treatment will be covered by OHIP, you can verify on the OHIP website.

Newcomer Eligibility for Ontario Health Insurance

Typically, newcomers to Canada must be present in Ontario for three months before being covered under the Ontario Health Insurance Plan (OHIP). They must also plan to make Ontario their primary residence. To get a bit more technical about it, they are required to be physically present in the province for at least 153 days of their first 183 days in Canada.

The eligibility criteria means that a person applying for OHIP must fall into one of the following categories:

• Have applied for permanent residency
• Already be a permanent resident
• Have a valid work permit and be working in Ontario full-time for at least 6 months (or be a spouse or dependent of this person)
• Have a Temporary Resident Permit
• Be a convention refugee or other protected person.

Applying for an Ontario Health Card as an immigrant

Applying for an Ontario health card is pretty straightforward but does require an in-person visit to a ServiceOntario centre. When you visit, you will need to bring:

• A completed OHIP registration form
• A document that provides that you are eligible for OHIP (typically, your immigration documents)
• A document that provides Ontario residency (like a driver’s license)
• A document that proves your identity

A full list of valid documents can be found here. For children under the age of 16, a parent or guardian can register on their behalf without them being present.

What to do during your first few months in Canada

When you arrive in Ontario, there will likely be weeks or even months where you are uninsured while you gather your paperwork for your OHIP application or wait until you become eligible. It can take a while to receive a bill, pay stub, or official document that offers adequate proof of residency that you can use to apply for OHIP.

During that time, you will be uninsured unless you have purchased private insurance before your arrival in Canada.

It may not seem like a big deal to go a few weeks or months without insurance, but it’s a huge risk. An injury or sudden illness can happen in an instant, and if you need to seek medical care that cost will have to come out of your pocket. That’s a huge expense that can be devastating, especially as you’re settling in a new place.

Purchasing private insurance is a great way to ensure that you’re protected during your first few months in Canada, before you are eligible to apply for OHIP. Through an insurance company like Moving2Canada’s trusted partner, Cigna, you can apply and get approved in minutes, and only pay for as much insurance as you need. Get your free quote today.