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Question about OHIP 3 months wait

canuck_in_uk

VIP Member
May 4, 2012
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flx2015 said:
Any suggestions on what one might do to get some sort of coverage during the three month waiting period? I've got a standard health insurance thing through my employer which lets me include my wife, but I think that only covers prescription drugs and dental visits. Should I get her travel insurance for three months?
As already mentioned, extended benefits from an employer generally require the person to first have provincial coverage. Find out for sure before adding her. Don't rely on the opinion of your HR or someone within your company; contact the insurance underwriters directly.


flx2015 said:
I'm actually more concerned about her catching a cold or some sort of a stomach bug. Something like that wouldn't necessarily require a trip to the hospital, but she would need to go to the doctor. Is it worth getting travel insurance for something like that? I don't know how much doctors usually charge for a visit if the patient doesn't have OHIP.
Travel insurance only covers emergency situations. You will not find insurance that will cover regular doctor or clinic visits.
 

sapguru

Hero Member
Jul 16, 2010
327
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Toronto
LANDED..........
16-08-2009
For OHIP, the eligibility is 3 months wait for Ontario residents. Hope is that the Ontario resident can have immigration status as visitor or Student or PR or Citizen. At the time of applying the OHIP, the person should be a PR or Citizen. All OHIP seems to really care (eligibility from their website) is that the person had been resident of Ontario in last 3 months. My parents had been in Canada on super visa for 6 months and now their status will change to PR. I want to switch from paid insurance to OHIP, not only to save money, but primarily to get a family doctor for regular checkup. Recently, there had been several Parents becoming PR under PGP application. Has anyone got OHIP when their parents were staying in Canada during the PGP process?


From OHIP website -

Ontario residents are eligible for provincially funded health coverage (OHIP). Generally, to be eligible for Ontario health coverage you must :

be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; 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.

OHIP coverage normally becomes effective three months after the date you establish residency in Ontario. The ministry strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period.
 

hpjack

Star Member
Jul 1, 2013
81
1
sapguru said:
For OHIP, the eligibility is 3 months wait for Ontario residents. Hope is that the Ontario resident can have immigration status as visitor or Student or PR or Citizen. At the time of applying the OHIP, the person should be a PR or Citizen. All OHIP seems to really care (eligibility from their website) is that the person had been resident of Ontario in last 3 months. My parents had been in Canada on super visa for 6 months and now their status will change to PR. I want to switch from paid insurance to OHIP, not only to save money, but primarily to get a family doctor for regular checkup. Recently, there had been several Parents becoming PR under PGP application. Has anyone got OHIP when their parents were staying in Canada during the PGP process?


From OHIP website -

Ontario residents are eligible for provincially funded health coverage (OHIP). Generally, to be eligible for Ontario health coverage you must :

be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; 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.

OHIP coverage normally becomes effective three months after the date you establish residency in Ontario. The ministry strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period.

Just went to Service Ontario last week and my wife got her OHIP without the 3 months wait. I'm not sure if it is because she has resided in Ontario for the past two years or because she's had OHIP coverage before as a foreign worker (although that has expired, but OHIP number is same for the new card, just different version code).
The decision is solely at the discretion of the officer who is dealing with your case, but if you don't agree with the decision you can always write to appeal.
 

CDNPR2014

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Mar 1, 2016
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sapguru said:
For OHIP, the eligibility is 3 months wait for Ontario residents. Hope is that the Ontario resident can have immigration status as visitor or Student or PR or Citizen. At the time of applying the OHIP, the person should be a PR or Citizen. All OHIP seems to really care (eligibility from their website) is that the person had been resident of Ontario in last 3 months. My parents had been in Canada on super visa for 6 months and now their status will change to PR. I want to switch from paid insurance to OHIP, not only to save money, but primarily to get a family doctor for regular checkup. Recently, there had been several Parents becoming PR under PGP application. Has anyone got OHIP when their parents were staying in Canada during the PGP process?


From OHIP website -

Ontario residents are eligible for provincially funded health coverage (OHIP). Generally, to be eligible for Ontario health coverage you must :

be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; 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.

OHIP coverage normally becomes effective three months after the date you establish residency in Ontario. The ministry strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period.
meeting the criteria is only part of it. a person also has to submit specific documentation to qualify.
http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?openform&ENV=WWE&NO=014-9998E-82

usually visitors are not eligible for OHIP, no matter how long they have been in canada. can your parents submit 1 document from each of the 3 lists on the documentation list? if not, then more than likely they will not qualify. generally, PR applicants who have OHIP go through an initial coverage denial and an appeals process to qualify.

there's nothing stopping someone from trying. it will depend on the documentation provided and the discretion of the person at the office.
 

sapguru

Hero Member
Jul 16, 2010
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Thanks for the speedy response.

From the OHIP Coverage List document, below are the documents that can be submitted -

List 1: Written confirmation from CIC Canada that you are eligible to apply for permanent residence in Canada. (last bullet point under Other Immigration Status)

List 2: Valid Ontario Photo Card

List 3: CoPR or Passport (foreign)

I am yet to find out the doc in List 1 and apply for Ontario Photo Card. Let me know if I am heading for correct direction.
 

flx2015

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canuck_in_uk said:
As already mentioned, extended benefits from an employer generally require the person to first have provincial coverage. Find out for sure before adding her. Don't rely on the opinion of your HR or someone within your company; contact the insurance underwriters directly.


Travel insurance only covers emergency situations. You will not find insurance that will cover regular doctor or clinic visits.
i guess i don't really need insurance for her at this point in time. i don't know why, but i was under the impression that a single visit to the doctor/clinic would cost somewhere between 400-600 for patients without OHIP. i called my family doctor and it turns out the costs aren't really that much, so it's all good.
 

sapguru

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Jul 16, 2010
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flx2015 said:
i guess i don't really need insurance for her at this point in time. i don't know why, but i was under the impression that a single visit to the doctor/clinic would cost somewhere between 400-600 for patients without OHIP. i called my family doctor and it turns out the costs aren't really that much, so it's all good.
Correct, just $60 per visit. This is the approximate fee for walk-in.
 

tweetyishere

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Jun 22, 2016
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if you go to the hospital, you will pay a lot. A friend of mine paid $700 for her father's non-urgent visit to see a doctor at the hospital :(
but if you go to a regular clinic or a regular doctor it should be around $70 (more or less depending on the province you live in)

flx2015 said:
i guess i don't really need insurance for her at this point in time. i don't know why, but i was under the impression that a single visit to the doctor/clinic would cost somewhere between 400-600 for patients without OHIP. i called my family doctor and it turns out the costs aren't really that much, so it's all good.
 

canuck_in_uk

VIP Member
May 4, 2012
31,553
7,205
Visa Office......
London
App. Filed.......
06/12
sapguru said:
All OHIP seems to really care (eligibility from their website) is that the person had been resident of Ontario in last 3 months.

Has anyone got OHIP when their parents were staying in Canada during the PGP process?

Generally, to be eligible for Ontario health coverage you must :

be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups
who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; and


You will not be able to obtain OHIP for your parents while they are visitors, as they fail to meet the first eligibility requirement.
 

Rob_TO

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Nov 7, 2012
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Anyone wanting to apply for OHIP for parents while they are on visitor status in Ontario and a PR app in progress, should read this thread and post in particular: http://www.canadavisa.com/canada-immigration-discussion-board/important-ohip-eligibility-info-for-all-pr-applicants-residing-in-ontario-t56695.0.html;msg2518001#msg2518001

There is a stage during the outland PR process where an applicant becomes eligible for OHIP. However it's not communicated to the sponsor or applicant. So the process involves applying for OHIP, being denied, and then going through the OERC to appeal the decision and giving them permission to contact the outland visa office to determine the applicant's current PR app status and if it qualifies them or not.

This process is usually used for spouse sponsorship, but I assume parents would follow the same general rules. No harm in trying.
 

sapguru

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Rob_TO said:
Anyone wanting to apply for OHIP for parents while they are on visitor status in Ontario and a PR app in progress, should read this thread and post in particular: http://www.canadavisa.com/canada-immigration-discussion-board/important-ohip-eligibility-info-for-all-pr-applicants-residing-in-ontario-t56695.0.html;msg2518001#msg2518001

There is a stage during the outland PR process where an applicant becomes eligible for OHIP. However it's not communicated to the sponsor or applicant. So the process involves applying for OHIP, being denied, and then going through the OERC to appeal the decision and giving them permission to contact the outland visa office to determine the applicant's current PR app status and if it qualifies them or not.

This process is usually used for spouse sponsorship, but I assume parents would follow the same general rules. No harm in trying.
Thanks Rob! I should have thought/known about this step few months ago to save some money spent on Super Visa insurance. Now, my parents are going to get COPR in next 2 to 3 weeks, I will apply for their OHIP based on COPR, without waiting for another 3 months for OHIP eligibility. Hope now, I will take the correct step in right time.
 

Rob_TO

VIP Member
Nov 7, 2012
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Category........
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Visa Office......
Seoul, Korea
App. Filed.......
13-07-2012
AOR Received.
18-08-2012
File Transfer...
21-08-2012
Med's Done....
Sent with App
Passport Req..
N/R - Exempt
VISA ISSUED...
30-10-2012
LANDED..........
16-11-2012
sapguru said:
Thanks Rob! I should have thought/known about this step few months ago to save some money spent on Super Visa insurance. Now, my parents are going to get COPR in next 2 to 3 weeks, I will apply for their OHIP based on COPR, without waiting for another 3 months for OHIP eligibility. Hope now, I will take the correct step in right time.
Even with COPR, most likely they will be denied OHIP coverage until 3 months after they officially land as PRs. This is automatic response from majority of Service Ontario OHIP offices.

In order to see if they qualify to start the waiting period sooner, you probably will need to appeal and go through OERC as in the post I linked to.
 

sapguru

Hero Member
Jul 16, 2010
327
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Toronto
LANDED..........
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Rob_TO said:
Even with COPR, most likely they will be denied OHIP coverage until 3 months after they officially land as PRs. This is automatic response from majority of Service Ontario OHIP offices.

In order to see if they qualify to start the waiting period sooner, you probably will need to appeal and go through OERC as in the post I linked to.
Ok. Thanks again. I will review this topic in more details in next few days.
 

vitlen

Star Member
Jan 2, 2014
77
0
@sapguru

Do you have any updates on your attempts to get a waiver from the 3 month waiting period?
I am at the same situation like you were back in November.

Any input would be appreciated!
 

talkto_vinay

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Jul 16, 2015
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21-12-2016
Experts,
I landed in December 2016 (& thus my COPR is December 2016) and came back India in January' 2017.
For OHIP eligibility for Permanent Residency, webiste ( http://www.health.gov.on.ca/en/public/programs/ohip/ ), says:

Ontario residents are eligible for provincially funded health coverage (OHIP). Generally, to be eligible for Ontario health coverage you must

  • be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; 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.
OHIP coverage normally becomes effective three months after the date you establish residency in Ontario. The ministry strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period.
[/i]



My question is that since I landed around 4 months back (my COPR is 4 months old), am I eligible for OHIP or I have to wait for 153 days?