Ontario Health Insurance coverage eligibility

[hasanselim]

After first time arrival as a Permanent Resident we stayed 74 days all together (29 September 2017 to 11 December 2017) at Toronto and received our Ontario Health Card. Then we returned back country. Now my wife got pregnant for almost 5 months as it is a critical pregnancy we couldn't move to Toronto within this period. Now we are indenting to come back to Toronto, Ontario for our permanent stay.

My question is that will we get Medical coverage immediately after our arrival?
We also want to know, what's the alternative if it does not cover?

 

[scylla]

After first time arrival as a Permanent Resident we stayed 74 days all together (29 September 2017 to 11 December 2017) at Toronto and received our Ontario Health Card. Then we returned back country. Now my wife got pregnant for almost 5 months as it is a critical pregnancy we couldn't move to Toronto within this period. Now we are indenting to come back to Toronto, Ontario for our permanent stay.

My question is that will we get Medical coverage immediately after our arrival?
We also want to know, what's the alternative if it does not cover?

It's not clear if you plan to come to Canada before or after your wife is scheduled to give birth.

To answer your question, you will not be covered until thee months after you return to Canada. So for the first three months of your stay in Canada, you will have to pay for any care you receive out of pocket. Unfortunately it is too late to purchase private insurance to cover any costs related to your wife's pregnancy - this insurance must be purchased before someone becomes pregnant.

 

[canuck78]

Very confused it takes 3 months to get your health cards and you left before that time. Did someone send you the cards? You are not allowed to be out of Canada for more than 30 days in the first 6 months. If you use the cards that were sent to you it will be health fraud. You shouldn't have applied if you planned to only stay for a short period. If you try to use the cards and they work it is fraud but eventually OHIP could realize you were not compliant and ask you to repay all your expenses.

 

[Wolverine17]

Very confused it takes 3 months to get your health cards and you left before that time. Did someone send you the cards? You are not allowed to be out of Canada for more than 30 days in the first 6 months. If you use the cards that were sent to you it will be health fraud. You shouldn't have applied if you planned to only stay for a short period. If you try to use the cards and they work it is fraud but eventually OHIP could realize you were not compliant and ask you to repay all your expenses.

By saying you are not allowed to be out for more than 30 days you are refering for the health insurance part only right?

 

[canuck78]

Yes those are OHIP rules.

 

[Rob_TO]

After first time arrival as a Permanent Resident we stayed 74 days all together (29 September 2017 to 11 December 2017) at Toronto and received our Ontario Health Card. Then we returned back country. Now my wife got pregnant for almost 5 months as it is a critical pregnancy we couldn't move to Toronto within this period. Now we are indenting to come back to Toronto, Ontario for our permanent stay.

My question is that will we get Medical coverage immediately after our arrival?
We also want to know, what's the alternative if it does not cover?

http://www.health.gov.on.ca/en/public/programs/ohip/ohipfaq_mn.aspx
Am I still eligible for OHIP if I temporarily leave Ontario?
You may be out of the province for up to 212 days in any 12-month period and still maintain your Ontario health insurance coverage provided that you continue to make Ontario your primary place of residence.

To maintain eligibility for OHIP coverage you must be an eligible resident of Ontario. This means that you must :

• have an OHIP-eligible citizenship/immigration status; and
• be physically present in Ontario for 153 days in any 12-month period; and
• be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and
• make your primary place of residence in Ontario.

You only stayed 74 days, when rules clearly state you need to stay 153 days minimum in the first 6 months after coming to Ontario. So basically you are no longer considered an Ontario resident. As such next time you enter Ontario, all of you will need to go through the 3 months waiting period before you are covered under OHIP.

During those 3 months, you must pay out of pocket for all medical services received.

Since insurance for pregnancy related issues are not possible to be purchased after you are already pregnant, this means all pregnancy check-up costs and most likely the delivery (depending on exact timing), will need to be paid out of pocket. If the pregnancy has already seen complications, I would budget at least $20,000 or more to be safe, but depending what actually happens this amount could skyrocket.

If this is not possible for you financially, you should consider having child in your home country and later one of you returning to Canada to sponsor the child for PR.