Travelling Outside Canada

If you have a valid Ontario Health Card you are entitled to certain benefits when outside Canada. But because coverage for out-of-country health care services is limited, you should purchase supplementary insurance.

When planning a trip outside Canada, get all the facts about your health coverage first -- and get extra health insurance before you leave.

What does OHIP cover?

For people travelling outside Canada, OHIP covers only emergency health services. If you travel out-of-country for elective medical services that are available in Ontario and/or can be planned ahead of time, you are not covered.

Emergency health services are those given in connection with an acute, unexpected condition, illness, disease or injury that arises outside Canada and requires immediate treatment.

As of September 1, 1995, if you are injured or become ill while travelling outside Canada, OHIP will pay for emergency health services as follows :

• if you receive emergency care from a physician or other eligible health care provider, OHIP will pay only as much as that service would have cost in Ontario;
• emergency inpatient hospital services eligible for OHIP coverage will be paid up to a maximum of $400 (Canadian) per day or the amount billed whichever is less :
  • - up to $400 for complex hospital care, such as surgery or coronary, neonatal, paediatric or intensive care;
  • - up to $200 for less intensive medical care;
• emergency outpatient services, with the exception of dialysis, will be paid to a maximum of $50 (Canadian) for all out-patient services provided on any one day.
• Out-of-country dialysis treatment will be paid at a rate of $210 (Canadian) per treatment.
• OHIP will cover services only in hospitals or other health care facilities that are licensed by local         governments.* *  For out-of-country inpatient services
• the health care facilities must routinely perform both complex medical and complex surgical procedures. For outpatient services, they must routinely perform either complex medical or complex surgical services.

OHIP will continue to cover necessary care for travelers with chronic conditions at the rates described above.

for more information go to http://www.health.gov.on.ca/english/public/pub/ohip/travel.html

SHORT ABSENCES FROM ONTARIO

Before March 1, 1999, Ontario residents were allowed to be away from the province of Ontario for 182 days in any 12-month period. On March 1, 1999, a new regulation changed this rule by providing an extra 30 days for travel in any 12-month period.

To be eligible for OHIP coverage you must be a resident of Ontario. This means that you must :

• be physically present in Ontario for 153 days in any 12-month period and
• make your permanent and principal home in Ontario.

for details and more info go to http://www.gov.on.ca/health/english/pub/ohip/short.html

LONGER ABSENCES FROM ONTARIO

Will OHIP cover me during a longer absence?

Starting March 1, 1999, the Ministry of Health and Long-Term Care may continue your eligibility for Ontario health (OHIP) coverage when you are absent from Ontario for more than 212 days in a 12 month period, as long as you plan to return and make your permanent and principal home in Ontario.

To be eligible for continuous OHIP eligibility during a longer absence, you must first have been physically present in Ontario for at least 153 days in any 12-month period, for 2 consecutive years immediately before the absence.

For more info go to http://www.health.gov.on.ca/english/public/pub/ohip/longer.html

Why get private insurance?

• Many health services outside Canada cost much more than the ministry pays. You are liable for any difference in cost.
• Some health services are not covered by the ministry. You will have to pay the full costs for them.
• An accident can happen to anyone, even during a very short business or recreational trip. Extra insurance must be purchased before you leave Ontario. Ask an insurance broker or insurance company for further information.

There are many insurance plans, shop around.  Here are a few links, they change often

CIBC

Imagine

Liberty Health Ontario