Whether you like to vacation outside of the country for the holidays, or you’re a seasoned snowbird that heads south of the border for the entire winter, be aware that on January 1, 2020, your OHIP will no longer offer emergency coverage when you’re outside of Canada.

A portion of emergency costs incurred has long been eligible for reimbursement through the Out-of-Country Travellers Program which is what will be discontinued in the new year.

The Ontario government therefore highly recommends that people purchase private health insurance before leaving Ontario to cover emergency medical expenses. For now, continue to send in your claims for medical/health emergency expenses incurred up to the end of this year.

The below is only for expenses incurred up to December 31, 2019

Coverage details:

  • Doctor Services: OHIP will pay whichever of the following is less: the actual amount billed by doctor(s) who treated you outside of Canada, or rates listed in and paid to Ontario physicians in the Ontario Schedule of Benefits for Physicians Services.
  • Emergency outpatient services: OHIP will pay whichever of the following is less: up to $50 per day or the amount billed by the hospital.
  • Emergency inpatient services: OHIP will pay up to $400 per day for services provided in: an operating room, a coronary care unit, an intensive care unit, a neonatal or pediatric special care unit; or $200 per day for lower levels of care.

Eligibility for coverage:

This coverage includes if you are travelling outside of Canada for more than seven months, within a 12-month period (and will be living in Ontario at least 153 days a year in each of the two-years immediately before leaving the country), if you are travelling for work (including non-paid charity), and if you are travelling for study.

How to be reimbursed:

If you have paid medical services outside of Canada that qualify under the criteria explained, you may be able to get some of your money back if you submit an OHIP claim within 12 months of receiving, and paying for, the services. This includes emergency services through the Out-of-Country Travellers Program.

For more information see the OHIP info page here or call 1-800-262-6524.

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