OHIP eligibility

[shannon388]

Hello,

A friend of mine got a job in ON, and arrived on Aug. 1st, 2022. His moved his primary residence to ON (rental, utilities, bank accounts, car plate, insurance, etc. are all at his ON address), and fully meant to stay 153 out the first 183 days. However, his job required him to travel outside ON on very short notice, and he had several more work related travels here and there until January 2023. He then stayed for the full period from January 10th to July 20th 2023 in ON.
He applied for his OHIP card in April 2023 (card arrived in May 2023) but on the form there was a question about when he arrived in ON, to which he said he moved to ON on Aug. 1st, 2022 (he did satisfy the 153 out the first 183 days requirement only using the period January-July 2023). He has not used his OHIP card yet, but intends to do so very soon to get influenza vaccine. Is he currently in the clear with OHIP requirements, and can he use the card he already has?

Thanks!

 

[rcincanada2019]

Hello,

A friend of mine got a job in ON, and arrived on Aug. 1st, 2022. His moved his primary residence to ON (rental, utilities, bank accounts, car plate, insurance, etc. are all at his ON address), and fully meant to stay 153 out the first 183 days. However, his job required him to travel outside ON on very short notice, and he had several more work related travels here and there until January 2023. He then stayed for the full period from January 10th to July 20th 2023 in ON.
He applied for his OHIP card in April 2023 (card arrived in May 2023) but on the form there was a question about when he arrived in ON, to which he said he moved to ON on Aug. 1st, 2022 (he did satisfy the 153 out the first 183 days requirement only using the period January-July 2023). He has not used his OHIP card yet, but intends to do so very soon to get influenza vaccine. Is he currently in the clear with OHIP requirements, and can he use the card he already has?

Thanks!

If his employer is in ON, and he pays rent/utilities in ON, then he is a resident of Ontario. Short business trips doesn't mean his residence changed.

 

[shannon388]

@rcincanada2019 Thanks a lot! His main doubt was that he satisfied the 153 out of 183 days rule during January-July 2023, instead of August 2022-January 2023 which were the 6 months immediately after he arrived in ON. So, if I understood correctly, this is not an issue?

 

[rcincanada2019]

@rcincanada2019 Thanks a lot! His main doubt was that he satisfied the 153 out of 183 days rule during January-July 2023, instead of August 2022-January 2023 which were the 6 months immediately after he arrived in ON. So, if I understood correctly, this is not an issue?

I am not an immigration lawyer, so this is just based from my understanding. He is still employed with this ON company and just goes aways for a few days on a business trip. He did not change company. He is also a renter in ON and have bills in ON. So, he is an ON resident.

 

[Canada2020eh]

@rcincanada2019 Thanks a lot! His main doubt was that he satisfied the 153 out of 183 days rule during January-July 2023, instead of August 2022-January 2023 which were the 6 months immediately after he arrived in ON. So, if I understood correctly, this is not an issue?

Shouldn't be a problem.

 

[canuck78]

If his employer is in ON, and he pays rent/utilities in ON, then he is a resident of Ontario. Short business trips doesn't mean his residence changed.

That actually is incorrect. He must be present in Ontario for three first 153 out of the first 183 days and 183 days out of the 365 days based on when he applied for OHIP and make Ontario his permanent residence. Having a home in Ontario is not sufficient you must be present in Ontario during those days.

 

[canuck78]

I am not an immigration lawyer, so this is just based from my understanding. He is still employed with this ON company and just goes aways for a few days on a business trip. He did not change company. He is also a renter in ON and have bills in ON. So, he is an ON resident.

@rcincanada2019 Thanks a lot! His main doubt was that he satisfied the 153 out of 183 days rule during January-July 2023, instead of August 2022-January 2023 which were the 6 months immediately after he arrived in ON. So, if I understood correctly, this is not an issue?

Was he present for 153 days out of 183 days based on when he applied for OHIP so whatever day he applied in April 2023? That is what will be important because that is when he signed a form indicating that he qualifies for OHIP and will be meeting the residency requirement to qualify for OHIP. If he has not met the residency requirement starting on whatever day in April 2023 he has to reapply and the restart the residency requirement calculator based on the new start date of his new OHIP card.

 

[rcincanada2019]

That actually is incorrect. He must be present in Ontario for three first 153 out of the first 183 days and 183 days out of the 365 days based on when he applied for OHIP and make Ontario his permanent residence. Having a home in Ontario is not sufficient you must be present in Ontario during those days.

But according to

https://www.ontario.ca/laws/regulation/r09133

1.6 (1) A resident is considered to meet the physical presence requirement for up to 12 full months, if he or she temporarily goes to another province or territory of Canada.

https://www.ontario.ca/laws/regulation/900552#BK2

Establishing Status
3. (1) Where any one asserts that he or she is a resident, or is entitled to any exemption from the requirements to be recognized as a resident, or in any other way is entitled to payment from the Plan, it is the obligation of the person making the assertion to prove to the General Manager that he or she meets the requirements to be an insured person. O. Reg. 133/09, s. 3.

https://www.ontario.ca/document/resources-for-physicians/registration-of-ontario-health-insurance-coverage#:~:text=To be eligible for Ontario health insurance coverage, generally speaking,any given 12-month period

In addition, most new and returning applicants for OHIP coverage must also be physically present in Ontario for at least 153 of the first 183 days after establishing residence in the province (exceptions are noted in Regulation 552).

Any comments?

 

[canuck78]

But according to

https://www.ontario.ca/laws/regulation/r09133

Generally people apply for OHIP as soon as they qualify which adds a level of confusion. You could probably argue that residency start date was January 2023 but not before that because OP didn’t meet the RO before that and doesn’t qualify to count time outside of Ontario. Residency obligations change after first year and are typically less strict. Longterm residents are able to take a sabbatical essentially and be out of Canada for 2 years. Post secondary students are typically able to keep their provincial healthcare while going to college/university in another province b/c they often only stay for 8 months out of the yr and are only temporarily in the other province. Most also keep their mailing address at their parents home in another province. When you apply for OHIP you indicate that you are planning to meet the residency obligations to qualify for OHIP. Would need to reas the most recent form.

https://www.ontario.ca/laws/regulation/900552#BK2

You have to read further.
3) This section only applies if the resident meets any of the following requirements, or any combination of the following requirements, for at least 153 days out of the 12 months immediately before he or she leaves Ontario:

1. Being physically present in Ontario.

2. Being a mobile student or mobile worker. O. Reg. 133/09, s. 2.

https://www.ontario.ca/document/resources-for-physicians/registration-of-ontario-health-insurance-coverage#:~:text=To be eligible for Ontario health insurance coverage, generally speaking,any given 12-month period

OP doesn’t meet exceptions.

Any comments?

 

[laracroooft28]

thanks

 

[shannon388]

Was he present for 153 days out of 183 days based on when he applied for OHIP so whatever day he applied in April 2023? That is what will be important because that is when he signed a form indicating that he qualifies for OHIP and will be meeting the residency requirement to qualify for OHIP. If he has not met the residency requirement starting on whatever day in April 2023 he has to reapply and the restart the residency requirement calculator based on the new start date of his new OHIP card.

Thanks a lot for the clarification. He was not present 153/183 following the April date when he applied, he had to travel for work in July, August, and September.

Thanks for the link. We took a look at https://www.ontario.ca/laws/regulation/r09133, in particular

1.5 (1) The following requirements must be met for a person to be continued to be recognized as a resident:

1. The person must be in Ontario for at least 153 of the first 183 days after becoming a resident, except for,

i. a person who has moved to Ontario directly from another province or territory of Canada where he or she was insured under a publicly funded health care insurance plan,

ii. a mobile student or a mobile worker, [emphasis mine]

iii. a child to whom section 6 applies, or

iv. a person who is exempt from the waiting period under subsection 11 (2.1) of the Act.

Would he be considered a mobile worker? He travels a lot for work, and often on very short notice. It would be practically impossible for him to know in advance if he can stay the next 153/183 days in ON -- it was by pure chance that he did not need to travel outside ON during Jan-Jul (though he travelled a lot for work inside ON).

 

[canuck78]

Thanks a lot for the clarification. He was not present 153/183 following the April date when he applied, he had to travel for work in July, August, and September.

Thanks for the link. We took a look at https://www.ontario.ca/laws/regulation/r09133, in particular

Would he be considered a mobile worker? He travels a lot for work, and often on very short notice. It would be practically impossible for him to know in advance if he can stay the next 153/183 days in ON -- it was by pure chance that he did not need to travel outside ON during Jan-Jul (though he travelled a lot for work inside ON).

Normally you need a period of presence in Ontario initially before you qualify for any of the programs that allow you to spend a longer period out of Ontario. At this point he likely has not qualified for OHIP given that he was out of Ontario fir so long.