I love these forums, and thought they were exhaustive, but I've got something new(ish) to add for applicants in Ontario. OHIP can be approved while on Implied Status, and midwives can cover uninsured folks. Here's the whole story, including info about pregnancy without OHIP, but if you just want the letter we sent and our advice, skip the next 10 or so paragraphs.
I am Canadian, my wife is American, and we having applied for Permanent Residency for her as an Inland Spousal Sponsorship. We also submitted an open work permit application along with our Permanent Residency application.
My wife has been living and working in Canada on a one year work visa (through International Experience Canada). We applied for permanent residency and an open work permit in March 2018, received our AOR email (only I received one as Sponsor, not my wife, the PA) in April 2018. My wife's work permit expired in May 2018, and thus her OHIP expired then. She remained here on implied status. This wouldn't be that much of a problem, except that she is due to give birth in June 2018.
MIDWIFE AND PREGNANCY INFO
She was seeing an OBGYN through her pregnancy until her OHIP expired, then we asked her doctor how much it would cost to pay out of pocket. The prices we got were:
OBGYN services for the pregnancy, including delivery at the hospital (except for the hospital stay) - $4000
Since we only needed it for the last month, the price was actually - $2000
Hospital Stay - ~$1300/day
Blood Tests/Ultrasounds - No idea, we were already past most of those, probably at least $2000
These were doable prices, but the OBGYN let us know that they could refer us to a midwife, who would cover us regardless of OHIP coverage. So we went for that. My understanding is that you usually have to secure a midwife very early in pregnancy, but since we were being referred by our OBGYN and my wife was uninsured, we got a midwife no problem. She began visiting the midwife just last week.
My understanding (this may not be totally right) is that midwives in Ontario don't bill the government for each patient, but rather receive a lump amount to cover anyone that needs it. Thus, they can cover the costs for uninsured pregnancies. They cover tests, visits, delivery, any unexpected things at the hospital. The only thing we have to pay is:
Hospital stay - $500/day
OHIP INFO
Looking at these forums, I had seen people who had appealed their OHIP denial with their AOR and were successful. So we tried that route.
My wife went for her renewal appointment on May 2nd, with her AOR email printout, employment letter (stating full time employment, and intending to continue employ her for another year), insurance policy showing address, all that jazz. She was told they could not renew, but she couldn't get the denial letter until her OHIP actually expired on May 11th. So she made another appointment, went back on the 11th, got her denial letter (really its a 'transaction record' with some checkboxes on it). With that letter, we could appeal to the OHIP Eligibility Review Committee.
I looked at the example appeal letters elsewhere on this forum, and at the Ontario Health Insurance Act Section 1.4, and did not like at all what I saw, didn't think it would work. I felt like my wife would fit into the work permit class for OHIP (paragraph 6) rather than the Permanent Residence application class (paragraph 5) that the forum had said would owrk. But I still drafted this letter:
----------------------------------
My Name: [NAME]
My Home Address: [ADDRESS]
My Home Phone#: [NUMBER]
My Email Address:
Dear OHIP Eligibility Review Committee Officer,
I have applied for the spousal sponsored immigration for Permanent Residency in Canada. The sponsorship application has been received by CIC (see attached email), the immigration application was received on [DATE], and the immigration application is still in process. I have also applied for an Open Work Permit with the Permanent Residency Application, which is a bridge between now and when my Permanent Residency application is approved. That application was received on [DATE] (see attached printout and receipt).
I was previously insured with OHIP from [DATE] to [DATE], while I was working in Ontario on a closed work permit (attached). This work permit has expired, but I am still employed full time while on implied status while I await my Open Work Permit, and Permanent Residency. I have also attached an apartment insurance policy to show my residency in Ontario.
I went to the OHIP office at Sheppard Avenue in North York on [DATE] for my OHIP Renewal, and the result was NO (see denial letter), which I disagree with. So I request a review.
The law: Regulation 552: Health Insurance Act 5. Being a person who has submitted an application for permanent residence in Canada to the proper federal government authority, even if the application has not yet been approved, as long as Citizenship and Immigration Canada has confirmed that the person meets the eligibility requirements to apply for permanent residency in Canada, and the application has not yet been denied.
The CIC application is in “different stages of Application, i.e. (1) Eligibility, (2) Medical”, so, as long as the application is received by CIC (see attached email), then the immigration applicant is ELIGIBLE TO APPLY FOR the immigration application. (Please note: “eligible for immigration” is NOT the requirement.)
This is quite important for me, because I am 8 months pregnant and my expected delivery date is near the end of June. I had expected that given that I am married to a Canadian citizen, and that CIC has acknowledged that I have applied for permanent residency, would mean that I am eligible to apply for permanent residency. And, since I am working and paying taxes, that would make me eligible for OHIP.
Thank you for your consideration.
XXXXXX
----------------------
I sent this as a fax to (613) 548-6557, sent it on May 18th, and included in the fax:
-Printout of AOR email
-Printout of Permanent Residency Application on CIC website
-Denial letter from OHIP
-Expired work permit
-Copy of Passport Photo Page
-Copy of Expired Health Card
-Copy of insurance policy (as proof of residency)
-(I would have included the letter from my employer, but the OHIP renewal person took it from her)
(Please note that I know the letter wasn't very well written, fairly clunky and unclear, but I tried to stick to what had worked for other people in the forum)
On May 30th we received an email from an associate at the appeals board. She asked us to fill out and send back a consent form for CIC to release personal information to a designated individual (so that they could check on our Work Permit/Permanent Residency application).
Then on June 11th, we received a letter from the Appeals board saying that they approved our OHIP appeal (yay!) and granted my wife 6 months of OHIP coverage. But, like I thought, it wasn't for paragraph 6 (permanent residency application), it was because of implied status qualifying her for paragraph 5 (temporary foreign worker).
To quote a few paragraphs from the approval letter we received:
"Temporary foreign workers have an OHIP-eligible status provided that they meet the requirements under paragraph 6 of section 1.4 of Regulation 552. Specifically a temporary foreign worker must hold a valid work permit or other document issued under the Immigration and Refugee Protection Act (Canada) that permits the person to work in Canada..."
"A review of documentation confirms that you met the requirements for OHIP coverage as a temporary foreign worker as of [DATE] and held a work permit that expired on [DATE]"
"...the ministry contacted the IRCC who confirmed that as they received an extension application for your work permit before the work permit expiry date, you currently have implied status on your work permit."
So IMPLIED STATUS can grant you OHIP coverage.
My advice:
- If you are on implied status, you will be denied at the renewal office (they will have no idea what you're talking about, and will tell you your appeal won't work)
- Get a letter of transaction showing they denied you, and appeal the decision
- Unless you have reached eligible to apply status, (this is different than AOR), don't bother appealing under paragraph 5.
- Rewrite the appeal letter above to include paragraph 6 from section 1.4 of the Health Insurance Act. And specifically mention that you are on Implied Status.
It worked for us, it could work for you too. Let me know if you have any further questions.
I am Canadian, my wife is American, and we having applied for Permanent Residency for her as an Inland Spousal Sponsorship. We also submitted an open work permit application along with our Permanent Residency application.
My wife has been living and working in Canada on a one year work visa (through International Experience Canada). We applied for permanent residency and an open work permit in March 2018, received our AOR email (only I received one as Sponsor, not my wife, the PA) in April 2018. My wife's work permit expired in May 2018, and thus her OHIP expired then. She remained here on implied status. This wouldn't be that much of a problem, except that she is due to give birth in June 2018.
MIDWIFE AND PREGNANCY INFO
She was seeing an OBGYN through her pregnancy until her OHIP expired, then we asked her doctor how much it would cost to pay out of pocket. The prices we got were:
OBGYN services for the pregnancy, including delivery at the hospital (except for the hospital stay) - $4000
Since we only needed it for the last month, the price was actually - $2000
Hospital Stay - ~$1300/day
Blood Tests/Ultrasounds - No idea, we were already past most of those, probably at least $2000
These were doable prices, but the OBGYN let us know that they could refer us to a midwife, who would cover us regardless of OHIP coverage. So we went for that. My understanding is that you usually have to secure a midwife very early in pregnancy, but since we were being referred by our OBGYN and my wife was uninsured, we got a midwife no problem. She began visiting the midwife just last week.
My understanding (this may not be totally right) is that midwives in Ontario don't bill the government for each patient, but rather receive a lump amount to cover anyone that needs it. Thus, they can cover the costs for uninsured pregnancies. They cover tests, visits, delivery, any unexpected things at the hospital. The only thing we have to pay is:
Hospital stay - $500/day
OHIP INFO
Looking at these forums, I had seen people who had appealed their OHIP denial with their AOR and were successful. So we tried that route.
My wife went for her renewal appointment on May 2nd, with her AOR email printout, employment letter (stating full time employment, and intending to continue employ her for another year), insurance policy showing address, all that jazz. She was told they could not renew, but she couldn't get the denial letter until her OHIP actually expired on May 11th. So she made another appointment, went back on the 11th, got her denial letter (really its a 'transaction record' with some checkboxes on it). With that letter, we could appeal to the OHIP Eligibility Review Committee.
I looked at the example appeal letters elsewhere on this forum, and at the Ontario Health Insurance Act Section 1.4, and did not like at all what I saw, didn't think it would work. I felt like my wife would fit into the work permit class for OHIP (paragraph 6) rather than the Permanent Residence application class (paragraph 5) that the forum had said would owrk. But I still drafted this letter:
----------------------------------
My Name: [NAME]
My Home Address: [ADDRESS]
My Home Phone#: [NUMBER]
My Email Address:
Dear OHIP Eligibility Review Committee Officer,
I have applied for the spousal sponsored immigration for Permanent Residency in Canada. The sponsorship application has been received by CIC (see attached email), the immigration application was received on [DATE], and the immigration application is still in process. I have also applied for an Open Work Permit with the Permanent Residency Application, which is a bridge between now and when my Permanent Residency application is approved. That application was received on [DATE] (see attached printout and receipt).
I was previously insured with OHIP from [DATE] to [DATE], while I was working in Ontario on a closed work permit (attached). This work permit has expired, but I am still employed full time while on implied status while I await my Open Work Permit, and Permanent Residency. I have also attached an apartment insurance policy to show my residency in Ontario.
I went to the OHIP office at Sheppard Avenue in North York on [DATE] for my OHIP Renewal, and the result was NO (see denial letter), which I disagree with. So I request a review.
The law: Regulation 552: Health Insurance Act 5. Being a person who has submitted an application for permanent residence in Canada to the proper federal government authority, even if the application has not yet been approved, as long as Citizenship and Immigration Canada has confirmed that the person meets the eligibility requirements to apply for permanent residency in Canada, and the application has not yet been denied.
The CIC application is in “different stages of Application, i.e. (1) Eligibility, (2) Medical”, so, as long as the application is received by CIC (see attached email), then the immigration applicant is ELIGIBLE TO APPLY FOR the immigration application. (Please note: “eligible for immigration” is NOT the requirement.)
This is quite important for me, because I am 8 months pregnant and my expected delivery date is near the end of June. I had expected that given that I am married to a Canadian citizen, and that CIC has acknowledged that I have applied for permanent residency, would mean that I am eligible to apply for permanent residency. And, since I am working and paying taxes, that would make me eligible for OHIP.
Thank you for your consideration.
XXXXXX
----------------------
I sent this as a fax to (613) 548-6557, sent it on May 18th, and included in the fax:
-Printout of AOR email
-Printout of Permanent Residency Application on CIC website
-Denial letter from OHIP
-Expired work permit
-Copy of Passport Photo Page
-Copy of Expired Health Card
-Copy of insurance policy (as proof of residency)
-(I would have included the letter from my employer, but the OHIP renewal person took it from her)
(Please note that I know the letter wasn't very well written, fairly clunky and unclear, but I tried to stick to what had worked for other people in the forum)
On May 30th we received an email from an associate at the appeals board. She asked us to fill out and send back a consent form for CIC to release personal information to a designated individual (so that they could check on our Work Permit/Permanent Residency application).
Then on June 11th, we received a letter from the Appeals board saying that they approved our OHIP appeal (yay!) and granted my wife 6 months of OHIP coverage. But, like I thought, it wasn't for paragraph 6 (permanent residency application), it was because of implied status qualifying her for paragraph 5 (temporary foreign worker).
To quote a few paragraphs from the approval letter we received:
"Temporary foreign workers have an OHIP-eligible status provided that they meet the requirements under paragraph 6 of section 1.4 of Regulation 552. Specifically a temporary foreign worker must hold a valid work permit or other document issued under the Immigration and Refugee Protection Act (Canada) that permits the person to work in Canada..."
"A review of documentation confirms that you met the requirements for OHIP coverage as a temporary foreign worker as of [DATE] and held a work permit that expired on [DATE]"
"...the ministry contacted the IRCC who confirmed that as they received an extension application for your work permit before the work permit expiry date, you currently have implied status on your work permit."
So IMPLIED STATUS can grant you OHIP coverage.
My advice:
- If you are on implied status, you will be denied at the renewal office (they will have no idea what you're talking about, and will tell you your appeal won't work)
- Get a letter of transaction showing they denied you, and appeal the decision
- Unless you have reached eligible to apply status, (this is different than AOR), don't bother appealing under paragraph 5.
- Rewrite the appeal letter above to include paragraph 6 from section 1.4 of the Health Insurance Act. And specifically mention that you are on Implied Status.
It worked for us, it could work for you too. Let me know if you have any further questions.
