OHIP Canada: Coverage, Benefits Schedule, and How to Apply

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OHIP Canada: Coverage, Benefits Schedule: DATOS

Explore details about OHIP Canada: What is OHIP, and how do you apply? Learn about the coverage and schedule of benefits in this article. It contains various information on OHIP Canada, including what OHIP is, how to apply, coverage details, schedule of benefits, and other important information.

Understanding OHIP Canada

OHIP is a program by the provincial government in Ontario. It covers health services citizens need. It is funded by taxes and covers necessary medical services. To get free public healthcare, people must have a health card from the Ontario Government.

To access free healthcare, individuals need to apply for OHIP. The province covers the cost of necessary health services for residents. Once approved, the government provides eligible citizens with an Ontario Health Card.

What is OHIP

OHIP is a healthcare plan made by the Ontario Government for its residents. If you are eligible, you get an Ontario Health Card after applying. This card shows that OHIP covers your healthcare. Always have this card when you visit the doctor’s emergency room or have medical tests or surgery.

Requirements for OHIP Canada:

  • There are some basic and extra requirements to qualify for OHIP Canada. These include:
  • Making Ontario your main home.
  • Being in Ontario for 153 days or more in the period of 12 months.
  • After moving to Ontario, being present physically in the province for 153 days more within the first 183 days.
Requirements and Important Points for OHIP

Additional Requirements and Important Points for OHIP:

Apart from the mentioned requirements, meet at least one of these:

  • Permanent Resident
  • Canadian Citizen
  • Indigenous Person

Check the full list of eligibility requirements for OHIP Canada. Make sure you have all the necessary documents.

If you leave the province for more than 212 days in 12 months, you must re-apply for OHIP. The process for babies depends on whether they were born in a hospital with birthing facilities or with the help of a registered midwife.

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Applying for OHIP

Once you know you qualify for OHIP, follow these steps to apply. Start by downloading the OHIP registration form from the official Ontario Government website. Then, fill in the form with your correct details.

The form has three parts – A, B, and C. Part A is for Personal Information, Part B is for New or Returning Ontario Residents, and Part C is the Agreement. When done, take the form and supporting documents to the ServiceOntario Centre for submission.

What to Bring to ServiceOntario

When you visit the ServiceOntario Center, bring these:

  • A filled Registration Form
  • 3 original documents- one showing OHIP-eligible immigration status or Canadian citizenship, one proving Ontario residency, and one proving identity.
  • Find the full list of required supporting documents on the Ontario Government website.

Understanding OHIP Canada Coverage

OHIP takes care of health services like emergency room visits, appointments with family doctors, surgeries and medical tests, and trips to walk-in clinics. To get free health care, there must be a medical reason. For instance, cosmetic surgery is not covered by OHIP.

OHIP Canada covers all or part of the following:

  • Hospital stays and visits
  • Podiatry
  • Eligible dental surgery
  • Doctor visits
  • Ambulance services
  • Laboratory testing
  • Travel for health services only in the northern Ontario
  • Surgical or Medical abortions
  • Eligible optometry

OHIP pays for many medical tests, but some special and unusual tests are not covered. To get coverage for these, citizens need to meet eligibility requirements. OHIP covers dental surgeries like reconstructive surgeries, fixing fractures, necessary tooth removal, and tumour removal.

Understanding OHIP Benefits

The benefits of the OHIP Schedule are not a list of services doctors can charge the government for. Each service has a code and an agreed-upon amount to be paid. You can download this information from the Health Ministry of Ontario’s website for reference.

The schedule includes details on Laboratory Services, Dental Services, Physician Services, and more. It is meant for use by healthcare professionals.

People May Also Ask

What does OHIP cover in Canada?

OHIP pays for medically necessary services, including visits to family doctors and specialists. It covers most basic and emergency health care services. To check if a procedure is covered, ask a healthcare professional.

Who qualifies for OHIP in Ontario?

To qualify, you must be a Canadian citizen or have immigration status as per Ontario’s Health Insurance Act. Your permanent home must be in Ontario, and you should be present there for 153 days in any 12-month period.

How long does OHIP coverage last after leaving Ontario?

If you leave Ontario temporarily within Canada, you can have OHIP coverage for up to 12 months. If you establish permanent residency in another Canadian province, apply for health insurance there.

What does OHIP fully cover?

OHIP covers the full cost of seeing a doctor if the visit is medically necessary. It also covers most hospital stay costs, including doctor and staff services, tests, medications, accommodation, and meals.

Does OHIP cover all of Canada?

OHIP pays for most health care costs when you are outside Ontario but still in Canada. However, it only covers some services when you travel outside of Canada.

Does OHIP cover medication?

OHIP helps residents access needed medications, covering 4,400 drugs. However, it does not include all drugs under the Ontario drug benefit, especially the more expensive ones.

Is the Ontario Health Card free?

Yes, the OHIP card is free. It will be mailed to you and takes one to two weeks to arrive.

Does OHIP cover work permit holders in Canada?

Temporary foreign workers in Ontario (without citizenship or permanent residency) may be eligible for OHIP if their work permit is valid for at least six months.