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What the O in OHIP really means.

Lisa Boynton July 16, 2020
Male hiker outside a cave laying down reading a book.

As of January 1, 2020, the Ontario Health Insurance Plan, (OHIP) stopped covering any portion of out-of-country medical expenses for Ontario travellers. 

As such, most of us know that right after we book any international travel, we’ll need to purchase travel insurance to be covered in case something unexpected happens.
But what if you are travelling to a different province within Canada? Does our Ontario Health Insurance Plan (OHIP) have us fully covered? 

Not exactly.

While the government only made changes to OHIP for out-of-country medical expenses, we thought it might be a good time to remind Ontario travellers about what’s covered and what’s not for anyone who plans to travel across Canada.

Interprovincial coverage.

To be clear, your OHIP coverage travels with you when you travel from Ontario to other provinces and territories.

If you have OHIP, you get basic health care when you are in most other parts of Canada. Keep your OHIP card with you even when you are not in Ontario. You need to show the doctor this card to have medical treatment and possibly your costs paid for.

When you show your valid Ontario health card in another Canadian province or territory, you will be covered for some of the same services you’re covered for in Ontario, including:

  • physician services (e.g. visit to a walk-in clinic)
  • services provided in a public hospital (e.g. emergency, diagnostic, laboratory)
  • any service or treatment you receive in another Canadian province or territory must be medically necessary for it to be covered by OHIP

What's not covered in another province or territory:

  • any services not covered in Ontario (e.g. cosmetic surgery)
  • ambulance services (including transport and paramedic)
  • prescription drugs and other drugs given outside a hospital
  • home-care services
  • fees charged by private hospitals or facilities
  • diagnostic or laboratory services outside of a public hospital
  • long-term care or residential services
  • assistive devices (e.g. prosthetics)

Out-of-pocket costs.

Even if you show your OHIP card, some doctors may charge you upfront for certain services. Covering unforeseen medical expenses means you’ll have to spend money you weren’t expecting to or might not even have.

Yes, you can submit a claim to OHIP when you get back to Ontario, but only a portion of what you paid may actually be reimbursed.

This is why supplementary travel insurance coverage can help pay these costs and cover some of the services that OHIP may not. It’s also why OHIP strongly recommends purchasing supplementary coverage for out-of-province travel.

If you want more details on your OHIP coverage while travelling, visit the Government of Ontario FAQs for more information. 

OHIP international coverage changes.

There is a perception amongst Ontarians that OHIP provides them with medical coverage while travelling out of the country. We know that there is confusion and a lack of knowledge around this topic and it’s not clear as to what medical coverage OHIP provides for out of country travel.

The chart below outlines the changes that took effect as of January 1, 2020:
Before January 1, 2020 After January 1, 2020
Doctor's services: Covers amount billed by doctor who treated you outside of Canada or according to the rate paid to Ontario physicians (whichever is less) Doctor's services: No coverage
Emergency outpatient services: Up to $50 CAD per day or the amount billed by the hospital outside of Canada (whichever is less) Emergency outpatient services: No coverage
Emergency inpatient services Up to $400 CAD per day for services in:
  • an operating room
  • a coronary care unit
  • an intensive car unit
  • a neonatal or pediatric special care unit

or $200 CAD per day lower levels of care
Emergency inpatient services: No coverage

Note: Additionally the Ontario government announced a change in its funding for those who require kidney dialysis. However, this doesn't affect, nor is related to the changes to OHIP coverage for out of country travellers.

Before January 1, 2020 After January 1, 2020
Renal dialysis: $210 CAD Renal dialysis: Same coverage, but operated as of January 1, 2020, this new program will be operated by the Ontario Renal Network with funding from the Ontario government and patients will receive the same reimbursement rates as currently provided through existing programs.

Why CAA Travel Insurance makes sense.

Wherever you decide to travel, CAA has comprehensive travel insurance options that will help protect against the financial impacts of emergencies or illnesses while you’re away. You can expect great coverage choices for you and your family (including your pets) so everyone can enjoy a worry-free time away knowing they are covered.

Let CAA help find you the right travel insurance package so you can start dreaming about your departure date.

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