How does the Health Care System Work in Ontario?
by Aruna Papp. MA, ADR, Med
Many new Canadians find the health care system in Ontario very confusing. They are told by their friends and relatives that medical care “is all free, no one has to pay the doctor or the hospitals. The government pays for everything.” Well, health care in Ontario is NOT free. It is paid for through taxes collected by the government, and we all pay for these services.
When a resident of Ontario needs health care, they need to prove that he/she lives and works in this Province, using a card called Ontario Health Insurance Plan (OHIP) card. They need to see a valid OHIP card before you receive services. It is illegal to use or borrow someone else’s card. Each eligible person, child or adult needs their own OHIP card. Always carry your Health Card with you. You should be ready to show it every time you need services.
It is important to apply for the OHIP card as soon as possible—it should be one of your first tasks after arrival— because it can take up to three months from the date you applied to receive coverage. While you are waiting for the coverage to come through, consider buying travel insurance that includes health coverage from a private company, especially if you have young children. If you do not have insurance and you or a family member becomes ill you will be asked to pay for the services and they can be very expensive.
Once you have received your OHIP card you must remain in Ontario for 153 days in any 12-month period—you can go back to your old country or on vacation for 212 days, roughly seven months. But if you leave the Province for a longer period you may have to apply again.
Who can get Ontario Health Insurance Plan?
If you fall into one of the following categories then you can get OHIP:
- Canadian citizens, permanent residents, landed immigrants or refugees.
- If you have applied for citizenship or permanent residence and have passed your medical requirements.
- You are a foreign worker who holds a valid work permit or employment authorization which names a Canadian employer situated in Ontario and your prospective occupation and is valid for at least six months.
- If you are a foreign clergy member who will be providing religious services to a congregation in Ontario for at least six months.
- As a clergy member’s spouse, same sex partner or dependent child (under 19 years of age).
- If you are a foreign worker who will be employed in Ontario for a period of at least three consecutive years.
- If you have a work permit or employment authorization under the “Live-In Caregivers in Canada Program or the Foreign Domestic Movement.”
- If you have been issued a work permit or employment authorization under the Caribbean Commonwealth and Mexican Season Agricultural Workers Program.
Ministry of Health staff can help you determine whether or not you are eligible for Ontario health coverage. Call the ministry INFOline at 1-800-268-1154 (Toll-free in Ontario only). In Toronto, call 416-314-5518. Hours of operation: 8:30am – 5:00pm or e-mail them at firstname.lastname@example.org