Travel adventures.

Sunday, March 08, 2009

Ontario Health Insurance Plan (OHIP)

It has been a log time since I updated my blog, so I thought I would tell you a little about my new health care benefits. After living here for three months, I now gave full medical coverage from the government. As a tax paying resident of Ontario, I have coverage from the Ontario Health Insurance Plan (OHIP). OHIP covers most "medically necessary" health services. I still can't believe the government provides health benefits. What a concept; getting something useful in return for paying taxes.

Most Americans think that Canada's health care program is an evil socialist program that provides sub-standard health care and there are long lines at every hospital in Canada. This perception is mainly a result of hundreds of millions of dollars spent by the health insurance companies and conservative organizations. They did their best to convince Americans that the Clinton health care plan would result in socialized medicine, and that this was not what Americans wanted.

Canadian health programs are far from perfect, but I feel so lucky that I don't have to worry about going bankrupt due to health expenses. In case you didn't read about it in my previous blog post, you are encouraged to watch Micheal Moore's movie called Sicko. Yes, Michael Moore is a fat obnoxious exaggerating blowhard, but this movie will shake your faith in US Medical Insurance if you have any to begin with.

OHIP Eligibility
Ontario residents are eligible for provincially funded health coverage. To be eligible for OHIP you have to be a Canadian citizen or have immigration status, make your permanent and principal home in Ontario, and be physically present in Ontario 153 days in any 12-month period. OHIP coverage has a waiting period, and coverage becomes effective three months after the date you establish residency in Ontario.

Application For Coverage
You have to visit a Service Ontario Centre to apply for a Health card. Your health card is your proof that you are entitled to health services covered by OHIP. Service Ontario will accept several forms of proof that you established residence in Ontario. The easiest way to prove your residence is with your drivers license. I was able to apply for my drivers license and health card in the same Ontario Service Centre. They will also ask to see proof of Canadian citizenship or proof of your immigration status. In my case I had to show my work permit. You could also show them proof of your permanent residency status if you get that before moving to Canada.

Coverage Limitations
From what I can tell, OHIP does not generally cover dental care, eye exams or glasses.
OHIP only covers some dental surgery, when it is done in hospital.
OHIP only covers eye examinations once per year for people under 20 or 65 and over.
OHIP does not provide coverage for medical services that are not considered "medically necessary".

Health Coverage While Traveling
Most OHIP benefits can be used across Canada. The province or territory you are visiting will usually bill Ontario directly. When you travel outside Canada, OHIP pays a set rate for emergency health services requiring immediate treatment. However, everybody seems to recommend buying travel insurance to cover any medical expenses while traveling outside Canada. I read a lot of horror stories about US hospitals charging 8-10 times as much as OHIP charges for similar services. For $82.00 you can buy a travel insurance plan from Blue Cross that covers an unlimited number of 15-day trips per year.

Did I mention how happy I am to have health coverage I can count on when I need it?

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