The Province of Ontario has a government run health insurance plan that covers the Canadian province of Ontario called the Ontario Health Insurance Plan. Known colloquially as the OHIP, this plan is funded by taxpayers in the province and the Canadian government. It covers people who have their primary or permanent home in Ontario and gives them free access to emergency, preventive care and medical services that come under the OHIP.  As a person who has suffered harm or injury, if you wish to know about your OHIP coverage, contact a personal injury attorney who has specialized in this area of insurance law. All those who are under the OHIP scheme, including babies and children, must carry their health cards at all times and they have to be shown at the time of availing services.

Facts To Be Noted

To qualify for OHIP, people from outside Canada eligible for OHIP include those who are:

• In the process of acquiring Canadian citizenship should have submitted an application for permanent residence in Canada and received confirmation that they meet the eligibility requirements.

• Protected persons or refugees.

• Foreign workers who hold work-permits for at least six months.

• Spouses, same-sex partners, dependents.

• Live-in care-givers.

• Federal seasonal agricultural workers.

• Temporary residence permit holder.

There are several more categories and the government website would provide more information regarding this. Another source of information would be our free consultation injury lawyers, who are well-versed in this area.

OHIP Coverage Outside Ontario 

Permanent Ontario residents are eligible for OHIP even if they’re outside of the province.

OHIP policy holders are entitled to receive free basic health care in all parts of Canada. However, in provinces like Quebec, services must be paid for. You can claim reimbursement when you return to Ontario, but the amount reimbursed will be only what a similar service would have cost in Ontario.

OHIP provides for only limited health service expenditure while traveling outside Ontario. These services are assumed to be those of an emergency nature which arose outside Ontario when the person was traveling, working or attending an educational institution. Certain types of non-emergency medical care is also covered if it was recommended by a practicing Ontario physician. These services may have to be approved prior to commencement.

OHIP Coverage Outside Canada

For those OHIP policy holders traveling outside Canada, the same rule applies. The Out Of Country (OOC) Emergency Services are for travelers and is to be availed of when faced with an unexpected medical situation while traveling outside Canada. This coverage provides only limited funding. You/your insurance company would have to pay the expenses up front and claim reimbursement from OHIP later when you return to Ontario.

Ontarians can stay away for a maximum of 212 days to retain their OHIP coverage. This is designed to include those who are outside Canada on:

• Educational programs
• Work, including missionary work
• Holiday

Though OHIP coverage is available, Ontario residents traveling out of the country are encouraged to get private insurance as well. This is because certain types of services are not covered: For instance, ambulance services or medical services that could have been planned and availed of in Ontario prior to or after your travel. If you or a loved one is involved in an accident or hazardous situation while traveling outside Canada, which has been caused by another person, find a personal injury lawyer who can advise you about your claim for compensation.

Ontario residents are also eligible for Prior Approved OOC health services. These are elective services which are not urgent in nature. The person must seek and receive prior approval from OHIP and the ministry before undertaking such services, otherwise you will have to bear the entire cost yourself.

Our experienced personal injury lawyers can advise you that OHIP coverage is not available for treatments that are deemed medically unnecessary, not conducted in a licensed medical facility, experimental or non-conventional treatments, treatment for conditions that arose in Canada and transportation costs. Hence, private coverage while traveling outside Canada is essential.

How We Can Assist

Our 24×7 personal injury attorneys can assist victims of accidents etc to claim compensation both under the OHIP and private insurance policies. There are strict limitations during which claims must be submitted. OHIP claims must be submitted within 12 months of the service being rendered. A fully itemized bill listing all services and documents relating to the expenditure have to be submitted. Our serious injury lawyers can assist you with the paperwork and negotiations with the insurers.

If you, your family or a friend has been injured in an accident, please feel free to speak to one of our injury lawyers for a free consultation about how we are able to assist in making a personal injury claim. We consult in all cities across Ontario with a no win no fee guarantee. Our personal injury lawyers have helped victims secure millions of dollars in personal injury cases. Call us Toll Free On our 24/7 Injury Hotline: 1 – 844 495 7333 or Text a Personal Injury ‎Lawyer 24/7 and get instant help.TM (416 931 5015)