The Ontario Health Insurance Plan (OHIP) is a vital part of public life in Ontario. As the provincial health care plan, OHIP provides residents access to a wide range of essential medical services, often at no direct cost. Whether you are a Canadian citizen, a permanent resident, or a newcomer under specific immigration programs, understanding OHIP is critical to safeguarding your health and finances in Ontario.

This guide breaks down everything you need to know about the OHIP.

What Is OHIP?

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OHIP is the publicly funded health insurance plan that the Government of Ontario runs. It covers many medically necessary services such as visits to family doctors and emergency rooms, and medical tests and surgeries. Once approved, you’ll receive an Ontario health card, which must be presented whenever you seek medical care. As of recent policy changes, there is no longer a waiting period to receive OHIP coverage. If you are eligible, you are covered immediately.

Who Qualifies for OHIP?

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To qualify for OHIP, individuals must meet all minimum residency requirements and at least one of the additional qualifying conditions.

Minimum Residency Requirements

To be eligible, you must:

  • Be physically present in Ontario for at least 153 days in any 12 months,
  • Be physically present in Ontario for at least 153 days of the first 183 days after moving to the province, and
  • Make Ontario your primary place of Canadian permanent residence.

Additional Qualifying Conditions

You must also meet at least one of the following:

  • Hold a valid Canadian work permit and be working full-time in Ontario for at least 6 months,
  • Be in Ontario under the Live-in Caregiver Program or the Seasonal Agricultural Worker Program,
  • Be a convention refugee or protected person,
  • Hold a Temporary Resident Permit (certain types only, such as codes 86 to 95), and
  • Be a clergy member ministering full-time in Ontario for at least 6 months.

Special Provisions for Emergency Humanitarian Cases

Certain individuals may qualify for OHIP coverage under emergency authorizations for humanitarian reasons, such as the Canada-Ukraine Authorization for Emergency Travel (CUAET). To qualify under this provision, you must:

  • Have documentation from IRCC confirming the emergency authorization,
  • Be physically present in Ontario for 153 days of the first 183 days,
  • Remain in Ontario for 153 days in any subsequent 12-month period.

Under these criteria, you do not need to make Ontario your primary residence, and coverage lasts for the duration of the emergency authorization.

What OHIP Covers

OHIP pays for a wide range of health care services that are medically necessary. These include:

  • Visits to family doctors and walk-in clinics,
  • Emergency room care,
  • Hospital stays and surgeries,
  • Diagnostic tests (e.g., X-rays, MRIs, bloodwork),
  • Maternity care.

However, OHIP does not cover services that are not deemed medically necessary. For example:

  • Cosmetic surgery,
  • Routine dental care,
  • Prescription medications (unless provided in a hospital or under specific government programs), and
  • Eye exams for adults aged 20–64 (some exceptions apply).

You can visit the Ministry of Health website or speak with your health care provider for a detailed list of what OHIP covers.

OHIP for Babies

You’ll receive an Ontario Health Coverage Infant Registration form directly from hospital staff or the midwife. After filling out the form, the hospital/midwife will submit it on your behalf. Your baby’s health card will be mailed to you within 8 weeks. You can apply in person at a Service Ontario centre. You’ll need to bring:

  • Proof of where the baby was born (letter from doctor/hospital),
  • If over 90 days from birth, bring the birth certificate, and
  • Your residency and identity documents.

OHIP for Adopted Children

If you adopt a child from outside Canada, you can apply for OHIP when the child arrives in Ontario. Visit a Service Ontario centre with:

  • Proof of citizenship or immigration status for the child,
  • Adoption or guardianship documents, and
  • Director approval from the Ministry of Children and Youth Services.

Also, bring your proof of residency and identity and the completed registration form. If adopting from another Canadian province or within Ontario, contact Service Ontario at 1-866-532-3161 to confirm the required documentation.

OHIP for Military Family Members

If you're a spouse or dependant of a Canadian Forces member or Reservist on active duty, you may qualify for OHIP. Apply in person with:

  • Completed registration form
  • Three original documents:
    • Citizenship or immigration status
    • Proof of Ontario residency
    • Identity document
  • Military affiliation documentation, such as:
    • Military ID card (NDI 20)
    • Special military family passport (green)
    • Military Posting Message
    • Letter from a Military Family Resource Centre

If applying without a military member, at least one of these documents must still be provided to verify your eligibility.

What to do if You Are Denied OHIP

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If Service Ontario determines you are not eligible for OHIP, you can request a review by the OHIP Eligibility Review Committee (OERC). To do this, send:

  • A copy of your denial letter or eligibility assessment,
  • An explanation of why you believe you qualify,
  • Any supporting documentation, and
  • Your contact details.

Send your request by:

  • Email: OERC@ontario.ca (preferred),
  • Fax: 613-548-6557, and
  • Mail: OHIP Eligibility Review Committee, Ministry of Health, 49 Place d’Armes, 5th floor, Kingston, ON K7L 5J3.

FAQs

What Tips Can I Use for a Smooth OHIP Application Process?

To ensure a smooth OHIP application, gather all required original documents beforehand, including proof of identity, residency, and eligibility. Double-check that your documents are valid and listed on the official ServiceOntario website. To save time, arrive early at a ServiceOntario centre and bring a completed registration form.

How Can I Appeal the OERC’s Decision?

If the OHIP Eligibility Review Committee (OERC) denies your eligibility, you can appeal their decision to the Health Services Appeal and Review Board (HSARB). You must submit your appeal within 30 days of receiving the OERC’s written decision. Be prepared to include any supporting documents and clearly explain why you believe you qualify.

Does OHIP Cover Visitors to Ontario?

No, OHIP does not cover visitors from other provinces, territories, or countries. Visitors to Ontario should check their provincial or private insurance plans before arriving in Ontario. Purchasing additional travel medical insurance is highly recommended for visitors to Ontario.

How Can I Reapply for the OHIP?

If you’ve been outside Ontario for over 212 days in 12 months, you may need to reapply for OHIP coverage. Visit a specialized Service Ontario centre with all necessary documents, just as you would for a new application. It’s best to call Service Ontario in advance to confirm the requirements for the reapplication.

Can I Apply for OHIP Before Being Physically Present for 153 Days?

Yes, you can apply for OHIP when you arrive in Ontario; there is no longer a three-month waiting period for coverage. As long as you meet the eligibility criteria, your health insurance coverage will begin immediately upon approval.

Does OHIP Cover Prescription Drugs?

OHIP covers prescription drugs only in certain situations, such as when you are hospitalized or enrolled in a unique program like OHIP+ for children and youth under 25. For most other cases, you’ll need private insurance or access to programs like the Ontario Drug Benefit (ODB) for seniors and eligible low-income residents.