Applying for health cards in Ontario

The health care system in Canada requires that all Canadian citizens and permanent residents must apply for public health insurance. Once you have health insurance, you do not have to pay for most health-care services as they are paid for through taxes. When using public health services you are required to show your health insurance card at the hospital. Each province and territory has their own health insurance plan, however, free emergency health services are provided regardless of whether you have a health card or not.

We take a look at what processes are involved in applying for a health card for immigrants in the province of Ontario Canada. The insurance plan in Ontario is called the Ontario Health Insurance Plan (OHIP), the medical insurance pays for a variety of health services but it does not pay for services that are not medically necessary, cosmetic surgery for example.

Many of the Ontario health services are available across Canada to anyone with an Insurance card from the province, if you are travelling outside Ontario and require health services, the territory or province you are visiting will bill the expense to the Ontario Ministry of Health. There are circumstances, however, where you will have to pay for physician and then present your receipt to the local ministry office for payment.

Who is eligible?

In general, all Ontario residents are eligible for provincial funded health services, however, there are a few requirements that you must meet to complete the application process, namely;

  • You must be a Canadian citizen, permanent resident, and if you are a newcomer to the country, you must show your permit, whether it is a school, work or visitors permit.
  • Must have been physically present in Ontario for 153 days in a 12-month period.
  • Physically present in Ontario for no less than 153 days of the first 183 days immediately after making Ontario your place of permanent residency.
  • Make Ontario your primary area of residency.

The Ontario Health Insurance Plan usually comes into effect three months from the day you applied and made Ontario your permanent place of residence. The ministry encourages newly arrived applicants and returning residents to purchase and use private health insurance, in case you become ill during this waiting period.

The 3 Months waiting period

The three month waiting period applies to all new applicants and those who have been away from Ontario for a considerable amount of time and are returning In this waiting period there are a few exemptions that should be noted, these include;

  • New babies born in Ontario.
  • Adopted children under the age of 16, who are eligible for the Ontario Health Insurance Plan.
  • Protected people, e.g. refugees.
  • People from other provinces or territories who are moved to a long-term care facility in Ontario or who require mediate admittance to a long-term care facility in the first three months of being in Ontario.

The health services covered by OHIP

Eye care – Eye care is covered by OHIP, once every year for persons under the age of 20 and those over the age of 65. It also provides cover for a major eye exam annually for persons between the ages of 20-64, and for those who require regular eye examinations due to other medical conditions.

Dental services – The ministry will cover payment for some dental surgery, however, you will have to pay and cover the cost for regular dental services.

Physicians – The ministry will cover all the costs of any medically necessary procedures done by physicians. Physicians are however liable to bill you for any uninsured medical services they provide to you, or if your insurance card is found to be invalid.

Other health care providers – The OHIP will provide partial cover while you cover the extra costs of services provided by other health care providers, e.g. physiotherapists, and podiatrists.

Prescription drugs from pharmacies, ambulance services, and long-term care services provided in other territories or provinces are not covered. The OHIP will cover costs for emergency health services that are required while the particular individual is travelling outside Canada, and requires emergency health services that are considered acute, unexpected conditions, illness or diseases.