1. Am I eligible for Ontario Health Insurance ?

You must have Ontario health insurance to use Ministry of Health and Long-Term Care funded health care services. You are 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, convention refugee, or are registered as an Indian under the Indian Act
• you have submitted an Application for Permanent Residence or an Application for Landing and have been confirmed by Citizenship and Immigration Canada as having satisfied the medical requirements for landing
• you are a foreign worker who holds a valid work permit or employment authorization which names a Canadian employer situated in Ontario and your prospective occupation and is valid for at least six months
• you are a foreign clergy member who will be providing services to a religious congregation in Ontario for at least six months
• you hold a Temporary Resident Permit or Minister's Permit with a case type 80 (for adoption only), 86, 87, 88 or 89
• you are the spouse, same sex partner, or dependent child (under 19 years of age) of a foreign clergy member or eligible foreign worker who is to be employed in Ontario for a period of at least three consecutive years
• you hold a work permit or employment authorization under the Live-In Caregivers in Canada Program or the Foreign Domestic Movement
• you have been issued a work permit or employment authorization under the Caribbean Commonwealth and Mexican Season Agricultural Workers Program administered by the federal department of Citizenship and Immigration
• and you make your permanent and principal home in Ontario
• and you are in Ontario for at least 153 days of the first 183 days immediately following the date you establish residency in Ontario (you cannot be absent for more than 30 days during the first 6 months of residency)
• 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.

• See OHIP Eligibility Fact Sheet
• Refer to the question "What documents should I bring when I register ? or to the Ontario Health Coverage Document List for a complete listing of approved documents.

Your eligibility for Ontario health coverage is not determined by whether you have a job or are unemployed, or where you pay your income tax. It is based solely on your meeting one of the above citizenship or immigration categories and on you making your permanent and principal home in Ontario.

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.

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2. Am I eligible for OHIP right away or do I have to wait ?

There may be a three-month waiting period for your OHIP coverage.

If you are a newcomer to Ontario, or a former resident returning here to live after being out of the country for more than seven months, the waiting period begins on the date you establish or re-establish residence in Ontario. You are also required to be present in Ontario for 153 days of the first 183 days immediately following the date residency is established in Ontario (you cannot be absent for more than 30 days during the first 6 months of residency).

If you are an eligible resident moving to Ontario from another part of Canada, the health insurance of your former province/territory will cover you for up to three months.

If you are not covered by another the health insurance of another province/territory, it is important to buy private health insurance to cover you until you receive your Ontario health coverage.

For more information  :
Contact a private insurance company directly or call the Canadian Life and Health Insurance Association Inc. at 1 800-268-8099. In Toronto, call 416-777-2344.

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3. How do I get an Ontario health card?
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4. What documents should I bring when I register ?

When applying for a new health card, you must bring three original documents to prove citizenship/immigration status, residency in Ontario and identity.

• See health card Fact Sheet
• See Ontario Health Coverage Document List (PDF)

You may be asked for additional documents. For example, if your name has changed you may need to provide a marriage certificate or a change of name certificate.

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5. How do I register my children?

If your children are 15 ½ years or younger, you need to apply for their health coverage. For your convenience, you can apply for their health coverage at the same time you apply for your own. The children do not have to go with you because they will not have a photo or signature on their card.

If you are not eligible for OHIP but your children may be because they were born in a Canadian hospital and are therefore Canadian citizens, and if your children are 15 ½ years or younger, you will need to apply for their health coverage.

You will need three original documents for each child. Refer to the question "What documents should I bring when I register?" or to the Ontario Health Coverage Document List for a complete listing of approved documents.

The document from list 1 showing their citizenship status must be in their name. The documents from lists 2 and 3 can be in the name of the parent who is registering them.

Children older than 15 ½ years must register in person because they will have a photo and signature on their card. They will need three original documents in their name - one each from lists 1, 2, and 3.

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6. How do I change my name on my health card to my married name?
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7. How do I change my name on my health card upon dissolution of my marriage?
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8. If I have had my name legally changed, how do I have my new name put on my health card?
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9. What if my red and white health card is lost, stolen or damaged?

During business hours you should immediately call the ministry INFOline at 1-800-664-8988. For TTY service, call 1 800 387-5559.

After business hours, report your lost, stolen or damaged health card to the ministry health card Ontario inquiry system at 1 800 664-8988.

To replace your red and white health card, you will have to register for a photo health card. To register :
1. Go in person to your local ministry office.
2. Complete a Registration for Ontario Health Coverage (form 0265-82).
3. Provide three original documents to prove citizenship/immigration status, residency in Ontario and identity. You may be asked for additional documents, for example, if your name has changed you may need to provide a marriage certificate or a change of name certificate.
• See Health Card fact sheet
• See Ontario Health Coverage Document List

If there is no ministry office in your area, you may require information about temporary Outreach Registration sites. For this information, call the ministry INFOline at 1-800-664-8988.

If you find your health card, keep it only until your new photo health card arrives and then destroy it because it will no longer be valid. Make sure you have your new photo health card before destroying the old health card.

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10. What if my photo health card is lost, stolen or damaged?

During business hours you should immediately call the ministry INFOline at 1-800-664-8988. For TTY service, call 1 800 387-5559.

After business hours, report your lost, stolen or damaged health card to the ministry health card Ontario inquiry system at 1 800 664-8988.

If the card is a photo health card you will be sent a new one right away but if there are additional changes to your information, like an address change or name change, then you will need to visit a ministry office or Outreach site.

If there is no ministry office in your area, you may require information about temporary Outreach registration sites. For this information, call the ministry INFOline at 1-800-664-8988.

If you find your health card, keep it only until your new photo health card arrives and then destroy it because it will no longer be valid. Make sure you have your new photo health card before destroying the old health card.

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11. My photo health card has expired. How do I renew my health card?

Your photo health card has an expiry date that is linked to your date of birth. The first time you apply for a photo health card, the expiry date can be anywhere from two to seven years in the future. When your photo health card is renewed, the renewal date will always be five years in the future and linked to your date of birth.

Renewal notices for photo health cards are mailed approximately two months prior to the expiry date shown on the front of the photo health card; however, if it is more convenient, you can renew up to six months prior to the date of expiry.

To learn more about renewing your Ontario photo health card, refer to the fact sheet Renewing Your Photo Health Card.

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12. How do I renew my child's health card?

Children under the age of 15 ½ years have health cards that are exempt from both photo and signature.

Your child’s renewal notice will be mailed approximately two months prior to the expiry date shown on the front of his or her photo health card. In most cases, children under 15 ½ years of age can have their health card renewed by the custodial parent/guardian completing and signing the back of the child’s renewal notice and returning it to the ministry in the pre-addressed envelope. You will receive your child’s renewed health card in the mail within approximately six weeks following the receipt of the completed application. Your child’s existing health card should be shown when receiving insured health services until the new card arrives.

The child’s renewal notice will advise the parent/guardian if they must visit an OHIP office or Outreach site to provide their own proof of residency and identity to support the renewal of their child’s health card.

If your child’s health card is expiring around the time of his or her 16th birthday, he or she must visit a ministry office in person to have their photo and signature captured. Your child must bring acceptable original documents as listed on the Ontario Health Coverage document List (form 9998E-82).

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13. I have a red and white health card. Do I need a photo health card?

A red-and-white card or a photo health card are both accepted as long as they are valid and belong to you.

If you register and receive a photo health card, you should destroy your red-and-white card if you still have it.

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14. What if I forget to bring my health card when I go for health care?

You may be charged for a health service if you do not have a health card. The ministry requests that the provider reimburse you for the service if it was an OHIP insured service and you can later show that you were covered by OHIP at the time of the service.

Your health care provider may ask you to fill out a Health Number Release (form 1265-84) to indicate your consent to the ministry providing your health number to them.

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15. What should I do if I move?
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16. Why is it important for me to notify the ministry when I move?
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17. What if I know of someone using a health card that is not theirs ?

It is against the law to receive insured health care when you are not an insured person.

If you know someone who is using a health card :

• which is not theirs, or
• after moving away permanently from Ontario.

You should inform the Ministry of Health and Long-Term Care Fraud Line at 1-888-781-5556.

You may make your report anonymously if you wish.

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18. What services does OHIP cover?

OHIP covers a wide range of health services; however, it does not pay for services that are not medically necessary, such as cosmetic surgery. A brief description of insured services follows below. For more details, please contact your nearest ministry office.

Services in Ontario

An eye examination is covered by OHIP for persons under 20 and for those 65 and over once a year. OHIP also covers a major eye examination once every 12 months for persons aged 20 - 64 who have medical conditions requiring regular eye examinations.

For more information refer to OHIP Bulletin 8089, fact sheets Changes to OHIP Coverage for Eye Care Services and Health Services.

Northern Health Travel Grant :

You may be eligible for a Northern Health Travel Grant to help pay transportation costs if you live in northern Ontario and must travel long distances for specialty medical care.

Services in Other Canadian Provinces and Territories :

Most of your Ontario health coverage benefits can be used across Canada. The province or territory you are visiting will usually bill Ontario directly. If you have to pay for health services you receive in another part of Canada, you can submit your receipts to your local ministry office to be considered for reimbursement. Prescription drugs from pharmacies, home care services, ambulance services and long-term care services provided in other provinces and territories are not covered.

Services Outside Canada :

For people travelling outside Canada, the ministry pays a set rate for emergency health services. Emergency health services are those given in connection with an acute, unexpected condition, illness, disease or injury that arises outside Canada and requires immediate treatment. Ambulance services are not covered. Ontario residents are encouraged to purchase supplementary insurance when traveling outside Canada as many emergency health services provided outside the country cost much more than OHIP may pay.

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19. How do I submit my medical bills?

If you have purchased supplementary insurance, check with your insurance carrier about how you should submit your bills. Otherwise, it is required that you send your itemized bill to your nearest OHIP office within 12 months of receiving treatment. With your bill, send :

• an original, detailed statement, itemized on a fee-for-service basis
• your original receipt for payment
• your name and current Ontario address
• your health number
• a completed Out of Province/Out of Country Claims Submission (form 0951-84)

To avoid delays, do not hold your bills and receipts until you return to Ontario. Mail them to your insurance carrier or the ministry as soon as you receive them.

For more information : Travelling Outside Canada

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20. My baby was born in hospital or at home attended by a registered midwife. How do I get a health card for my baby when he or she is born?

The Ministry of Health and Long-Term Care has a special registration process for babies born in Ontario birthing hospitals (hospitals which have labour and delivery facilities) and for babies born at home attended by a registered midwife.

Immediately after the birth of your baby, hospital staff or a registered midwife will give you an Ontario Health Coverage Infant Registration to complete. Babies born in an Ontario birthing hospital or at home and attended by a registered midwife will be provided with an infant registration form. Tourists, transients or visitors are not eligible for OHIP coverage.

This form requests information regarding your baby such as the baby’s name, birth date and mailing address. Information is also requested regarding the parent/guardian who is completing the form. You will be asked to confirm that :

• The child has a permanent and principal home in Ontario.
• The child will be physically present in Ontario for at least 153 days in any twelve-month period to retain health coverage.

The bottom of the form is detachable and should be retained by you. It is pre-printed with a health number assigned to your baby. You should keep this record and use it until you receive the baby’s plastic Ontario health card.

A custodial parent may complete and sign the infant registration form. The completed form, minus the tear-off portion containing your baby’s Ontario health number, should be given back to the hospital or midwife before discharge. The midwife will forward the form to the hospital and the hospital will submit the completed top portion of the form to the ministry for processing.

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21. What if my baby wasn’t born in hospital or attended at home by a registered midwife?

You will need to visit a ministry office to register your child for Ontario health coverage.

If you visit a ministry office within 90 days of the birth of your child you need to bring :

• confirmation of the baby’s birth, through either a letter from the hospital or attending physician, or a Certified Statement of Live Birth from a provincial office of the Registrar-General
• a completed Registration for Ontario Health Coverage (form 0265-82)
• your residency document
• your identity document

If you visit a ministry office more than 90 days after the birth of your child you need to bring :

• your child's citizenship document
• your residency document
• your identity document

Refer to the question "What documents should I bring when I register?" or to the Ontario Health Coverage Document List for a complete listing of approved documents.

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22. My baby was born in an Ontario hospital but we are only visiting Ontario for a short period. Can we use the Ontario Health Coverage Infant Registration form to register our baby for Ontario health coverage while we are here?

No. Tourists, transients or visitors are not eligible for OHIP coverage. For a child born in Ontario to be eligible for Ontario health coverage they must make their permanent and principal home in Ontario, and be physically present in Ontario for at least 153 days in any 12-month period to retain OHIP coverage.

If you are visiting Ontario from another province or territory in Canada, contact your home province/territory regarding health coverage for your baby and any insured services received while visiting Ontario.

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23. I don’t live in Ontario. Can my newborn/baby be registered through this process?

No. Only residents who have a permanent and principal home in Ontario can register using this process.

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24. What should I do if I need to take my baby to the doctor but haven't received his or her health card ?

The infant registration form contains a convenient tear-off record of your baby's Ontario health number. Keep and present this record for any required medical services until you receive your child's plastic Ontario health card.

If you do not have the tear-off record and you have paid for medical services for your child while awaiting his or her health card, your health care provider can reimburse you in full when you show the health card as proof of your child's eligibility.

It usually takes 6 weeks from registration for the ministry to process and mail your child's health card.

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25. Do I need to notify the ministry if my baby and I are leaving the province?

You should contact the Ministry of Health and Long-Term Care with any change of address for both you and your baby. If you move to a location outside Ontario, you should inform the ministry of your new address and the date of the move as soon as possible. To inform the ministry of your move, you can either :

• Obtain a Change of Information (form 0280-82) for you and your baby. Complete and sign the form and return it by mail. Forms are available from your local OHIP office or from Forms Online.

or

• Send a letter to your local ministry office. You must include your names, health numbers, telephone number, current address, new address including postal code, and the effective date of the move for yourself and child(ren).




26. Do I need to cancel my OHIP coverage if I plan to move to a location outside Ontario?

You should contact the Ministry of Health and Long-Term Care with any change of address. If you move to a location outside Ontario, you should inform the ministry of your new address and the date of your move as soon as possible. To inform the ministry of your move, you can either :

• Obtain a "Change of Information" form and return it by mail. Forms are available from your local OHIP office or from the Forms Online

or

• Send a letter to your local OHIP office. You must include your name, health card number, telephone number, current address and new address including postal code.

The ministry will end your OHIP coverage based on the information that you provide.

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27. Do I need to do anything with a deceased person's health card or health coverage ?

The health card of a deceased person must be returned to the Ministry of Health and Long-Term Care. You will need to complete a Change of Information (form 280-82) and then mail it with the health card of the deceased person to the ministry. You should include a copy of the death certificate. Copies of this form are available by :

• Contacting your local ministry office and requesting that one be forwarded to you.
• Printing a copy of the form through Forms Online.

Alternately, you can send a letter to your local ministry office providing the deceased person's name, date of birth, sex and health number. Enclose a photocopy of the death certificate and the actual health card.

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28. Doesn't the government already know about this death ?   A death certificate has been issued.

It is important to notify the ministry as soon as possible when an insured person dies. The attending physician forwards this information to the ministry but this may take some time and the doctor is not responsible for the collection and return of the health card. The person who is looking after the affairs of the deceased must return the health card to the ministry.

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29. Can I just throw a deceased person's health card away ?

No. The health card is actually the property of the government. It should be returned to the ministry for proper action and disposal.

Here is a list of local ministry offices.

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30. Should I tell a deceased person's health care providers about the death (e.g., family doctor, specialists, optometrist, dentist) ?

As a courtesy, you could advise the deceased person's various health providers but you are under no obligation to do so.

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31. What should I do if I have a question or concern about extra billing or queue jumping?

You may call the Ministry of Health and Long-Term Care at any of the following numbers :

OHIP Extra Billing : 613 536-3103 (Collect calls are accepted) INFOline : 1 800 268-1153 OHIP Fraud : 1 888 781-5556

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