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Changes to OHIP coverage

Effective January 1st, 2020, Ontario’s Health Insurance Plan (OHIP) has removed its limited Out-of-Country Travelers Program for its residents to cover expenses related to emergency health and doctors’ services incurred while traveling abroad.  Although many Ontarian’s assumed that OHIP covered the majority of emergency medical expenses incurred outside of the Country, it was generally limited to $200-$500/day pending the service needed.

Costs for emergency medical services abroad can be significant and while the previous program provided a nominal level of security, this change leaves no debate on the type or amount of coverage provided by OHIP for its traveling residents.  It further highlights the existing need and strengthens the importance of securing travel insurance for your clients prior to them leaving the Country.  Although Ontario has taken the lead with this new implementation, it can be expected other Canadian Provinces will likely consider following suit over the course of the next few years.

Q – Do I need OHIP to purchase a Manulife Travel Insurance Policy?

A –    Yes.  Due to repatriation of Canadian Residents that require hospitalization in their Province or Territory of residence, a valid Government Health Insurance Plan (GHIP) must be in place to cover those costs, otherwise the eligible expenses are limited to $25,000 CDN.  Here is our policy wording below;

TO BE ELIGIBLE FOR INSURANCE UNDER THIS POLICY

You must be a resident of Canada and covered under a government

health insurance plan for the entire duration of the trip. If at time

of claim, it is discovered that you no longer have coverage under a

government health insurance plan, the maximum amount payable for all

eligible expenses combined will be limited to $25,000.

These changes in Ontario highlight the need for Canadians traveling out-of-country to purchase Travel Insurance to fully understand the limit & restrictions to any group plan or credit card coverage.  For further details on these changes in Ontario, please feel free to visit;

https://www.ontario.ca/page/ohip-coverage-while-outside-canada

Q – What’s covered when traveling elsewhere in Canada?

A – When you show your valid Ontario health card in another Canadian province or territory, you will be covered for some of the same services you’re covered for in Ontario including:

  • physician services (e.g. visit to a walk-in clinic)
  • services provided in a public hospital (e.g. emergency, diagnostic, laboratory)

Any service or treatment you receive in another Canadian province or territory must be medically necessary for it to be covered by OHIP.

Q – What’s not covered elsewhere in Canada?

A –   Services that are not covered by OHIP in another Canadian province or territory include:

  • services not covered in Ontario (e.g. cosmetic surgery)
  • ambulance services (including transport and paramedic)
  • prescription drugs and other drugs given outside a hospital
  • home-care services
  • fees charged by private hospitals or facilities
  • diagnostic or laboratory services outside of a public hospital
  • long-term care or residential services
  • assistive devices (e.g. prosthetics)