OHIP Coverage while Outside Canada - Possible? 

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When I travel outside of Canada, will OHIP pay the same medical expenses that are covered in Ontario?

No. If you are a resident of Ontario and you are insured under OHIP, you are entitled to very limited funding for a certain range of medical services when you are travelling outside of Canada. For this reason, you are strongly advised to purchase additional health insurance every time you leave Canada and ensure that the supplementary insurance you have purchased provides adequate coverage.

What does OHIP cover while I'm out of the country?

OHIP will pay very limited amounts for physician services and hospital/health facility services, and only if certain conditions are satisfied (refer to section below "What is not covered by OHIP?"). Under Ontario's Health Insurance Act and regulations, physician services are subject to different conditions than hospital services.

OHIP will pay only for insured, emergency out-of-country health services that are rendered to an insured person. To qualify as an 'emergency' there are a number of criteria that must be satisfied. These criteria are set by regulation and include the conditions listed below that must be met :

• the treatment must be medically necessary, and
• the treatment must be performed at a licensed hospital or licensed health facility, and
  
  
• the treatment must be rendered in relation to an illness, disease, condition or injury that :
• is acute and unexpected, and
• arose outside of Canada, and
• requires immediate treatment.

These provisions are intended and designed to provide a very limited amount of funding for the medical treatment of insured residents of Ontario if they incur an unexpected illness, disease, condition or injury while they are outside of Canada. If the illness, disease, condition or injury arises before you leave Canada, or if it is not acute or unexpected, no payment can be made.


What is not covered by OHIP?

OHIP does not cover:

• treatment that is medically unnecessary
• health services that are rendered at a facility that is not a licensed hospital or licensed health facility
• treatment that is generally accepted by the medical profession in Ontario, as being experimental, or for research or for part of a study
• treatment rendered for an illness, disease condition or injury that arose inside Canada
• ambulance services or transportation costs
• other services specifically set out in the regulations as uninsured or otherwise not listed as insured.