Ontario Health Insurance Plan

INFOBulletin

Ukrainian arrivals may be eligible for OHIP

Patients from Ukraine who present without a health card should be advised they may apply for OHIP at ServiceOntario

To: All providers
Category: Dentist Services, Fertility Clinics, Independent Health Facilities, Midwife Services, Optometrist Services, Physician Services, Physiotherapy Facilities, Podiatrist Services, Primary Health Care Services, Registered Nurse with Extended Class
Written by: Health Insurance Branch; OHIP, Pharmaceuticals and Devices Division
Date issued: April 12, 2022
Bulletin Number: 220407

Individuals from Ukraine may be eligible for OHIP

Regulation 552 under the Health Insurance Act has been amended in order to provide Ontario Health Insurance Plan (OHIP) coverage to persons in Ontario who have been granted an emergency authorization to enter into and remain in Canada for humanitarian reasons for the duration of that authorization or any subsequent authorizations.

This authorization includes individuals arriving under Canada-Ukraine Authorization for Emergency Travel (CUAET).

This change is part of a number of initiatives intended to ensure that individuals with such an authorization have access to the publicly funded provincial health care supports and services they may need, including mental health services.

Patients may be unaware of their eligibility for OHIP. Health care providers are encouraged to advise those who present without a health card to apply at a ServiceOntario office.

Individuals who are eligible and register for OHIP, including those arriving under CUAET, are immediately provided with a transaction record that confirms their OHIP eligibility and contains their health card number and version code.

The transaction record may be presented to health care providers to facilitate the submission of any claims for the payment of insured services pending receipt of the health card.

The health card should arrive within 4 to 6 weeks.

Please note in response to COVID-19, the three-month waiting period for OHIP coverage was removed, resulting in immediate coverage for new registrants.

Patients who present without a health card or transaction record may receive services and be asked to provide their valid health card number and version code to the provider once it has been obtained, which can then be used to submit a claim to OHIP for payment. Alternatively, in the absence of confirmation of OHIP coverage at the time of service, the patient may be billed directly for the services provided. However, if the patient can later demonstrate they were eligible for OHIP coverage on the service date by providing their health number and version code, the service is insured and the full amount paid should be reimbursed to the patient. The claim can then be submitted to OHIP for payment.

Individuals who do not meet OHIP eligibility criteria

Individuals who cannot demonstrate eligibility for OHIP, including individuals arriving from Ukraine without CUAET or other documentation conferring eligibility, have access to some publicly funded health care services in Ontario, as follows:

• Primary care at Ontario's Community Health Centres (75 sites across the province) can be found by visiting: Community Health Centres.
• Midwifery care (funded program; not dependent on OHIP coverage) can be found by visiting: Midwifery.
• Public Health Units (PHUs) may offer certain publicly funded vaccinations, testing for infectious diseases, and community harm reduction programs for uninsured persons. To find a PHU, please visit Public Health Units.
• Physician and Hospital Services for Uninsured Persons (PHSUP) program provides funding for all medically necessary services performed in hospital and limited physician services in the community for those who do not have coverage under OHIP, another provincial or federal health plan or private insurance. PHSUP was implemented in response to COVID-19 and remains temporary in nature.
• Emergency care: The Public Hospitals Act requires hospitals to admit uninsured patients if not doing so would endanger their lives.

Health card validation

For information on health card validation, please refer to INFOBulletin 220201, issued February 18, 2022.

Keywords/Tags

Health card; CUAET; health card validation; HCV; eligibility;

Contact Information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.