Ontario Health Insurance Plan Information

The Ontario Health Insurance Plan (OHIP) was created so that every legal resident of Ontario could have free access to health care. In the vast majority of cases, coverage is valid across Canada, and the program may also cover emergency services in select countries in the event you become ill and need treatment while abroad.

The History of OHIP

• On July 1, 1966, the Ontario government launched what was then known as the Ontario Medical Services Insurance Plan (OMSIP), which was the first incarnation of the provincial health care system. By 1969, it had undergone its first face-lift, combining provincial and federal funding sources to ensure a high level of service could be provided to all Ontario residents. It then became known as the Ontario Health Services Insurance Plan (OHSIP). The OHSIP model is still in use today, though the program has since shortened its name.

Who Is Eligible?

• To qualify for OHIP coverage, you must be a Canadian citizen, landed immigrant or permanent resident. Newcomers to Canada who have settled in Ontario may also qualify if they have officially applied for resident status with Citizen and Immigration Canada.

  In addition to citizenship or resident status, you must also be physically present in Ontario for at least 153 days of any given 12-month period. If you are new to Ontario, your coverage is only valid if you are out of the province for less than 30 days of the first six months of your residency.

Services Covered by OHIP

• OHIP is intended to cover health care services that are deemed “medically necessary.” This includes a wide range of emergency and preventative treatments as well as care for chronic conditions or illnesses. Visits to family doctors or general practitioners for checkups and non-emergency medical complaints are also covered.

  There are certain services for which OHIP may cover part, but not necessarily all, of the cost. These include visits to chiropractors, physiotherapists and podiatrists as well as emergency dental services.

Services Not Covered by OHIP

• OHIP will not cover anything that is not, strictly speaking, medically necessary. Cosmetic treatments and services, for example, do not qualify. Dental care is not covered, except when provided in a hospital under emergency circumstances. Prescription drugs and medications are not covered or subsidized by OHIP at the present time. To ease the financial burden of these products and services, many people purchase supplementary health insurance coverage or obtain benefits through their employers.

Get OHIP Coverage

• Every person with OHIP coverage is assigned a unique personal number, which is validated whenever you seek medical services that are covered under the plan. This number is stored on a photo health card, which you must obtain from an OHIP office.

  To get an OHIP health card, make an appointment at the nearest field office, fill out an application and provide the service agent with the required documentation. You will need three types of documentation: proof of citizenship or immigration status, proof of Ontario residency and identity verification.

  Your proof of citizenship document could be a Canadian-issued birth certificate, naturalization certificate, passport, Canadian Immigration Identification Card or other valid proof of your legal status in Canada. Proof of residency may include tax statements, employment records, utility bills, vehicle permits or any other approved document that shows that you have been living in Ontario for the requisite amount of time. Identity verification documents are used to supplement your proof of citizenship, and include credit cards, employee ID cards, professional association licenses, student ID cards, driver’s licenses and passports.