OHIP - 153 days condition not met - What to do?

[NN74]

Dear all,

Need help for one of my close friend. Her case is as follows:

1. She, along with her family, became PR in early Aug 2013
2. Family applied for OHIP card in Aug 2013, after 90 days waiting period, their coverage had started
3. Ontario is their main residence since Aug 2013 but during their first 6 months, they stayed only 121 days (instead of required 153) until Dec 2013
4. In 2014, they stayed 300+ days and so on in 2015 continued to stay in Ontario, more than 183 days
5. Their OHIP cards are still valid, even an infant renewal took place smoothly

Are they in violation of OHIP policy as they tried to contact "Service Ontario" & clarified the staff about this missing piece (first time 153 days) but were told that as long as your cards are valid, no issue?

Can anyone help as she is worried because of her pregnancy which might cause her fortune, if she is in violation and would have to pay all expenses on own?

Thanks

 

[Rob_TO]

It happened 2 years ago, I really wouldn't worry about it. OHIP probably has no clue what your residence history was back then. If there was a problem, they would have investigated it 2 years ago.

 

[NN74]

Thanks Rob for reply but end result is quite different. I advised her to visit Service Ontario office at Bloor St.

She did and agent cancelled her OHIP card (due to violation of 153 days during first 183 days condition) acknowledging her fairness saying 'She did a right thing otherwise she will be charged for all expenses incurred due to violation, if caught randomly.'

As she spent more than 153 days in Ontario after that, so she was issued new OHIP card with NO WAITING period. Plastic card will be delivered to her after 4-6 weeks.

It happened 2 years ago, I really wouldn't worry about it. OHIP probably has no clue what your residence history was back then. If there was a problem, they would have investigated it 2 years ago.

 

[Rob_TO]

That's great but it really wasn't necessary to do. As I said it happened 2 yrs ago and since then you've been meeting the residency requirement. There would not have been any issues, but I guess if it clears your doubts it was a good thing to do.

 

[Vsn85]

Hi,

I have a very similar situation to yours. However I got a letter from eligibility services, this was probably because I submitted a claim for reimbursement. I was not aware of this 153 days requirement and used some OHIP services after I came back and before receiving this letter. As I now understanding after reading online that my OHIP eligibility will restart again from the day I arrived. I have completed about 130 days. Will they ask me to pay back for all the OHIP services I received during this period and are there any exceptions if the intention was not ill?

Thanks,
Vij

 

[scylla]

Hi,

I have a very similar situation to yours. However I got a letter from eligibility services, this was probably because I submitted a claim for reimbursement. I was not aware of this 153 days requirement and used some OHIP services after I came back and before receiving this letter. As I now understanding after reading online that my OHIP eligibility will restart again from the day I arrived. I have completed about 130 days. Will they ask me to pay back for all the OHIP services I received during this period and are there any exceptions if the intention was not ill?

Thanks,
Vij

If you received OHIP benefits you weren't entitled to then yes - you should expect that you will have to pay back for the services you received. No - it won't matter that there were no ill intentions.

 

[angel1287]

Hi,

I have a very similar situation to yours. However I got a letter from eligibility services, this was probably because I submitted a claim for reimbursement. I was not aware of this 153 days requirement and used some OHIP services after I came back and before receiving this letter. As I now understanding after reading online that my OHIP eligibility will restart again from the day I arrived. I have completed about 130 days. Will they ask me to pay back for all the OHIP services I received during this period and are there any exceptions if the intention was not ill?

Thanks,
Vij

Hicould you advise that did you receive the letter as you didn’t complete 153 days
Who sent you the letter