Ontario Health Care Card and Medical Insurance

Canada is one of North America’s countries, with ten provinces. Each of these provinces has its health care system.

In Ontario, many health services are being paid for with the Ontario Health Insurance Plan (OHIP), and the good news is that there is no longer a waiting period for Ontario Health Care Card coverage once a person is eligible. The question now is, “are you eligible?” Let us find out.

You may have several questions concerning Ontario’s healthcare services, and we will be giving some, if not all, answers to your questions.

In this article [show]

How Health Care in Ontario Works?
In Ontario, the province can pay for many of its residents’ health services through the Ontario Health Insurance Plan (OHIP). Once you have applied for the card and it gets approved, you will receive your Ontario Health Care Card.

You will have to carry this card with you anytime you need medical service, like visiting your doctor, running a medical test, or going for surgery. Your Ontario Health Care Card proves that the OHIP covers you.

Ontario Health Care Card Requirements
For any Ontario resident to qualify for the Ontario Health Care Card, there are some basic requirements that you must meet and an additional requirement. Below is the list of all the minimum essential requirements that must be met:

You must make Ontario your primary residence.
must be physically in Ontario for 153 days in any 12 months
You must be physically in Ontario for at least 153 days of the first 183 days immediately after you begin living in the province.
Additional requirements
Below is a list of the additional requirements which you must meet at least of it to qualify for the Ontario Health Care Card:

You are a citizen of Canada.
a permanent resident (formerly called a “landed immigrant”)
an Indigenous person (registered under the federal Indian Act)
You are applying for permanent residence in Canada and:
have applied for Immigration, Refugees and Citizenship Canada (IRCC) and;
IRCC has confirmed that they have reviewed the application and that you meet the eligibility
Requirements to apply (see document requirements); and
You have yet to be denied.
Have a Temporary Resident Permit (this applies to only certain case types, like 86 through 95)
You are in Ontario on a valid work permit under the federal Live-in Caregiver Program.
Lived in Ontario for at least six months on a valid work permit, and you are working full-time for an Ontario employer.
Under this requirement, your spouse and dependents will also qualify for the OHIP if you do
a convention refugee or other protected person (as defined by the Immigration and Refugee Board of Canada)
A clergy member who will be ministering full-time in Ontario for at least six months and can legally stay in Canada
Under this requirement, your spouse and dependents will also qualify for the OHIP if you do.
Ontario Health Care Card Application
Your Ontario Health Care Card application must be made in person at a ServiceOntario center. The following documents will be needed for your application:

A completed Registration for Ontario Health Insurance Coverage form
Three separate documents from the list of qualifying identification documents (photocopies not accepted):
One original document that proves your identity
The original document that proves your Canadian citizenship or OHIP-eligible immigration status
Document (original, printed, or digital/electronic document as noted on the list) that proves your residency in Ontario
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Ontario Health Care Card Reapplication
If you have been out of Ontario for more than 212 days in any 12‑month length, you ought to reapply for Ontario Health Care Card at a specialized ServiceOntario Centre that gives the whole suite of health care services. You may call ServiceOntario to be sure.

Ontario Health Care Card Coverage
The following services are covered under the Ontario Health Insurance Plan:

Visits to doctors.
Hospital visits and stays.
Medical or surgical abortions.
Eligible for dental surgery in hospital.
Eligible optometry (eye-health services).
Podiatry (foot-health services).
Ambulance services.
Travel for health services if you live in northern Ontario.
The following are partially covered by OHIP:

Ambulance services, except a CAD 45 co-payment charge for residents with a valid OHIP card
Partial cost of podiatry services, up to CAD 135 per year per person with a registered podiatrist, as well as CAD 30 towards x-rays
Ontario Health Care Card Coverage Exclusions
To be covered by OHIP, you must have a medical reason to receive any benefits or treatment. For example, cosmetic surgery is not covered.

In principle, OHIP only provides essential medical services such as visits to the doctor or hospital. Some of the items not covered by OHIP are:

Prescription drug costs for those under 65 years of age.
Dental care.
Eye exams for those between 20 – 64 and prescription glasses.
Supplemental medical treatments or alternatives include chiropractors, physical therapy, massage, acupuncture, or foot reflexology.
Psychotherapy or private counseling.
Crutches or casts.
Travel vaccinations.
Missed appointment expenses and doctor’s letters.
Medical examinations when applying for permanent residence.
Ontario Health Care Card Review Request
If you are told that you do not qualify or no longer qualify for OHIP, you can request a review of the decision.

To request a review, send a letter, fax, or email to OHIP stating the following:

The reason you believe you are qualified for OHIP.
Current contact details.
Additional information or documents to demonstrate your qualification.
The letter and other documents can be sent through:

OERC@ontario.ca
Fax: 613-548-6557
Or mailed to:
OHIP Eligibility Review Committee
Ministry of Health and Long-Term Care
49 Place d’Armes, 5th floor
Kingston, ON K7L 5J3
Your submission will be reviewed, and a response will be sent to you in writing. A follow-up call can also be made to you.

Further appeals
The decision of the OHIP Eligibility Review Committee can be appealed, but this should be done within 15 days of receiving their written decision. The appeal is forwarded to the Health Services Appeal and Review Board.

The letter and other supporting information or documents are to be sent to the following:

Health Services Appeal and Review Board

151 Bloor Street West, 9th floor

Toronto, ON M5S 2T5

Phone:416-327-8512

Fax:416-327-8524

Ontario Health Insurance Plan for Babies
For babies being given birth in Ontario, the steps to apply for OHIP will vary depending on whether or not the baby was born in a hospital with maternity and delivery facilities or with the help of a registered midwife.

Babies Born in Ontario hospitals or with registered midwives.
If your baby was born in an Ontario hospital with maternity services or a registered midwife, you could follow the steps listed below to apply:

Complete the Ontario Health Insurance Baby Registration Form. It is not available online. The hospital staff or registered midwife will give you the form. On the form, you must:
Provide your baby’s name, date of birth, and mailing address;
Confirm your baby’s primary residence in Ontario;
Confirm that your baby will be in Ontario for at least 153 days in 12 months period
The hospital or midwife will submit the top part of the form on your behalf.
Please keep the bottom section of the form until you receive your baby’s Ontario health insurance card. It shows the health number that is assigned to your baby.
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Your baby’s new health card will be mailed to you within eight weeks from the date the Ontario Health Coverage Infant Enrollment Form is mailed.

Alternative Ontario Health Insurance Plan for Babies
If the hospital staff or registered midwife does not give you the Ontario Baby Registration Form, you can apply to:

ServiceOntario
The Ministry of Health’s OHIP Eligibility Review Committee (OERC) by:
OERC@ontario.ca
Fax: 613-548-6557
mail to:
OHIP Eligibility Review Committee

Ministry of Health and Long-Term Care

49 Place d’Armes, 5th floor

Kingston, ON K7L 5J3

Babies born elsewhere in Ontario or without a registered midwife
If your baby was born in an Ontario hospital without maternity services or a registered midwife, you would need to apply in person at the nearest ServiceOntario center:

If you go there within 90 days of birth, you will need to bring proof of your baby’s birth location (for example, a letter from the hospital or treating physician)
If leaving more than 90 days after the date of birth, you will bring proof of your child’s Canadian citizenship (for example, birth certificate)
Yes, even if your baby was born at home without a registered midwife, you need the baby’s Ontario Birth Certificate or Ontario Live Birth Declaration for OHIP registration. You should also bring all of the following documents to the ServiceOntario center:

a completed form to register for health insurance in Ontario
proof of your place of residence (for example, valid driver’s license, mortgage, rental or lease agreement in Ontario)
proof of your identity (e.g., passport, credit card)
Ontario Health Insurance Plan for adopted children
If you have adopted a child outside of Canada, you can apply for OHIP coverage as soon as your child arrives in Ontario.

You must apply in person at the nearest ServiceOntario center and bring all of the following documents for your child:

Proof of Canadian citizenship or OHIP allowed immigration status for your adopted child.
Proof of authorization from the Director of the Department of Children and Youth Services
Adoption/guardianship documents for your adopted child
You should also bring all of the following for yourself:
Completed form to register for Ontario health insurance.
Proof of residency (for example, valid Ontario driver’s license, mortgage, rent, or lease)
Proof of identity (e.g., passport, credit card)
If you have adopted a child from Ontario or any other Canadian province or territory, please contact ServiceOntario to confirm what documents you need (18665323161). Documentation requirements vary depending on the stage of the adoption process.

Ontario Health Insurance Plan for military family members
If you are the spouse or family member of a member of the Canadian Armed Forces or a reservist currently on active duty with the Canadian Forces, you may be eligible for OHIP coverage.

To apply, you must appear in person at a ServiceOntario center and bring all of the following:

a completed form to enroll in Ontario health insurance
Three separate original documents (no photocopies or printouts of electronic documents):
One that proves Your Canadian citizenship or OHIP-eligible immigration status (e.g., Canadian birth certificate, permanent resident card)
Shows you live in Ontario (e.g., Ontario driver’s license, income tax assessment)
one showing your confirmed identity (e.g., credit card, passport) from any country)
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Spouses or relatives of military members
To be eligible for OHIP coverage, you must also provide accepted military affiliation documents for each spouse or dependent who applied for OHIP.

If you are applying in the absence of the military personnel
You must bring one of the following:

Special passport (green passport for military personnel returning from an overseas assignment).
Canadian Forces Member’s Personnel Record Résumé (MPRR).
Letter from local Ontario Military Family Resource Centre on letterhead confirming the military family status of applicants (issued at the discretion of your local Military Family Resource Centre).
If applying in the presence of a military member
You must bring one of the following:

The military ID of a member of the Canadian Armed Forces (e.g., NDI 20).
Canadian Forces member’s Posting Message (with attached photo ID).
Special passport (green passport for military family members returning from an assignment abroad).
Canadian Forces Member’s Personnel Record Résumé (MPRR).
Letter from local Ontario Military Family Resource Centre on letterhead confirming the military family status of applicants (issued at the discretion of your local Military Family Resource Centre).
Original documents must be presented in person at a ServiceOntario center. Photocopies will not be accepted. However, the Ministry of Health reserves the right to request additional documents.

Ontario Health Insurance Plan for Visitors to Ontario
Ontario visitors from other Canadian provinces and territories or outside Canada do not qualify for OHIP. However, if you are Canadian, try to find out what your provincial/territorial plan or private health insurance covers before you travel to Ontario.

Additionally, we recommend that you buy private medical insurance for your trip.

Some more questions that you may be having may be:

Can I apply for an Ontario health card online?
No. The OHIP card application is carried out in person at a ServiceOntario center. However, if you are self-isolating and cannot visit ServiceOntario, contact the ServiceOntario Infoline at 1-866-532-3161 for more information and the next steps.

How much does an OHIP card cost?
It doesn’t cost anything. Applying for or renewing an OHIP card is free.

How long does it take to get an OHIP card?
It usually takes four to six weeks for your card to be sent to you in the mail.

How is Ontario health care coverage for international students
You can obtain health insurance through your school as an international student at a university or college in Ontario. Unfortunately, you are not eligible for the Ontario Health Insurance Plan (OHIP). However, your school has unique health plans for you.

The University Health Insurance Plan (UHIP) is mainly offered by Public universities, while private colleges and universities use other plans. In addition, your spouse and children may be eligible if they live with you in Canada.

Meanwhile, these plans are paid. So, there are health insurance costs in addition to tuition and tuition fees.

You may be exempted from the school plan if specific plans already cover you.

If you have questions about applying for OHIP, you can find help at your nearest community agency or newcomer service. Alternatively, contact the Ontario Ministry of Health and Long-Term Care at 1-800-268-1154.

Conclusion
In conclusion, the Ontario Health Care Card and Medical Insurance are great ways to save money on healthcare costs. By using these two programs, you can save yourself much money on health care costs.

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