Am I eligible for Ontario health insurance coverage?

On April 1, 2009, changes were made to the OHIP eligibility rules under Regulation 552 of the Health Insurance Act.  As a result of these changes, you may be eligible for the Ontario Health Insurance Plan (OHIP) if you are included under one of the following categories :

• you are a Canadian citizen, permanent resident or landed immigrant, or are registered as an Indian under the Indian Act;
• you have submitted an application for permanent residence in Canada, and Citizenship and Immigration Canada has confirmed that you meet the eligibility requirements to apply for permanent residence in Canada (please note: applicants for permanent residence are no longer required to provide confirmation of having satisfied the Immigration medical as a condition for OHIP coverage);
• you have applied for a grant of citizenship under section 5.1 of the Citizenship Act (Canada), and Citizenship and Immigration Canada has confirmed that you meet the eligibility requirements to apply for citizenship (i.e., children adopted internationally by Canadian citizens);
• you are a “protected person” - i.e. a Convention Refugee or a person in need of protection;
• you are a foreign worker who holds a work permit valid for at least six months that allows you to work in Canada, and you also have a formal agreement in place to work full-time for an employer situated in Ontario which sets out the employer’s name, your occupation, and states that you will be working for no less than six consecutive months;
• you are a foreign clergy member who will be ministering to a religious congregation in Ontario for at least six months;
• you hold a Temporary Resident Permit with case type 80 (for adoption only), 86, 87, 88, 89, 90, 91, 92, 93, 94 or 95;
• you are the spouse, same sex partner, or dependent child (under 22 years old or 22 years and over if dependent due to a mental or physical disability) of an OHIP-eligible foreign worker or an OHIP-eligible foreign clergy member;
• you hold a valid work permit under the federal Live-in Caregiver Program;
• you hold a valid work permit under the federal Seasonal Agricultural Worker Program;

AND

• you make your primary place of residence in Ontario; and generally speaking,
• you are in Ontario for at least 153 days of the first 183 days immediately following the date you establish residence in Ontario (you cannot be absent for more than 30 days during the first 6 months of residence); and
• you are in Ontario for at least 153 days in any 12-month period.

Tourists, transients or visitors are not eligible for OHIP coverage.

Your eligibility for Ontario health insurance coverage is based solely on :

• you having one of the above OHIP-eligible citizenship or immigration statuses, and
• you making your primary place of residence in Ontario,  and
• meeting the physical presence requirements.

Everyone, including babies and children, must have their own health cards.  Always carry your health card with you. You should be ready to show it every time you need medical services.

Staff can help you determine whether or not you are eligible for Ontario health insurance coverage.

For more details about OHIP eligibility:

• refer to Regulation 552 of Ontario’s Health Insurance Act (viewed online at www.e-laws.gov.on.ca)

The above is only a summary of the OHIP eligibility provisions of Regulation 552 for your reference.  You should consult the actual regulation for the specific requirements applicable to you.  The provisions in Regulation 552 prevail over this summary.

April 2009