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Newborn OHIP - Residency- 153 of 183 days Question 

salzafar
salzafar
Posts: 1


Posted On: 7/15/2019
salzafar
salzafar
Posts: 1
Currently, the application form for newborn child at the hospital states that, the child must be present in Ontario for 153 days in the first 183 days. i.e the absence cannot be greater than 30 days in the first 183 days. While the legislation states 1.5 (1).(1) (iii), that the child is exempt.


Can you kindly provide comment ?


Excerpt taken from
Reg. 552: GENERAL
https://www.ontario.ca/laws/regulation/900552#BK3



1.5 (1) The following requirements must be met for a person to be continued to be recognized as a resident:
1. The person must be in Ontario for at least 153 of the first 183 days after becoming a resident, except for,
i. a person who has moved to Ontario directly from another province or territory of Canada where he or she was insured under a publicly funded health care insurance plan,
ii. a mobile student or a mobile worker,
iii. a child to whom section 6 applies, or
iv. a person who is exempt from the waiting period under subsection 11 (2.1) of the Act.
2. Except for those persons listed in subsection 1.3 (2), the person must continue to maintain his or her primary place of residence in Ontario.
3. Subject to sections 1.6 to 1.14, the person must be physically present in Ontario for at least 153 days in any given 12-month period.
4. The person must continue to hold an eligible status as listed in section 1.4. However, in order to maintain their eligible status as a resident, a person referred to in paragraph 13 of section 1.4 must be legally entitled to remain in Canada and will only maintain their eligible status under that paragraph as long as reasonable efforts are being made for the person to obtain one of the other eligible statuses under section 1.4. O. Reg. 133/09, s. 2.
6. (1) A newborn, who, on the date of his or her birth, meets the requirements to be a resident is exempt from the three-month waiting period for the three months immediately following the date of birth.
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Moderator
Moderator
Moderator
Posts: 4063


Posted On: 8/10/2019
Moderator
Moderator
Moderator
Posts: 4063
Hello,

Thank you for pointing this out. Sharing the legislation information is useful.

We have been hearing about this type of inconsistent information regarding newborn babies and OHIP.

You can find some additional information on the Ontario.ca website in the OHIP coverage - Who gets immediate coverage section.

Here is an excerpt,

Who gets immediate coverage

OHIP coverage starts immediately for:
  • babies born in Ontario who are Canadian citizens
  • some internationally adopted children under 16 who are adopted by Ontario residents
  • convention refugees and other protected persons as defined by the Immigration and Refugee Board of Canada
  • people who move from another Canadian province or territory into a long‑term care home in Ontario within the first three months of their arrival
  • military family members with accepted documentation



We hope this additional information is helpful.

Please let us know if you have further questions and if there is any follow up to your question/situation.

=====
Anna
Settlement.Org Content and Information/Referral Specialist, CRS, CRS-DC

Settlement.Org
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Pharinet
Pharinet
Posts: 1


Posted On: 4/6/2020
Pharinet
Pharinet
Posts: 1
Hello,

Babies born in Ontario but their parents are not Canadian Citizen nor Permanent resident are eligible to apply for OHIP coverage?

Thank you.
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Moderator
Moderator
Moderator
Posts: 4063


Posted On: 5/8/2020
Moderator
Moderator
Moderator
Posts: 4063
Hello There,

Thank you for sharing your situation and question with us.

The Ministry of Health is also taking measures to ensure access to medically necessary services to uninsured individuals to address the COVID-19 outbreak. According to this notice on the Association for Ontario Midwives website,
the Ministry [of Health] requests hospitals provide all medically necessary services to all persons who present at a hospital, regardless of whether the person presents a valid OHIP card, or does not have health insurance under OHIP or another provincial health insurance plan.


This means that everyone, insured and uninsured, will receive medically necessary care.

Tourists, transients or visitors are not eligible for OHIP coverage. For a child born in Ontario to be eligible for Ontario health insurance coverage they must make their primary place of residence in Ontario, and be physically present in Ontario for at least 153 days in any 12-month period to retain OHIP coverage.

Babies born in Ontario are immediately eligible for OHIP coverage if you live in Ontario. However, tourists, transients or visitors are not eligible for OHIP coverage. For a child born in Ontario to be eligible for Ontario health insurance coverage they must make their primary place of residence 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 insurance coverage for your baby and any insured services received while visiting Ontario.

If you reside in Ontario, you may find helpful information in the Settlement.org article, How do I register my child for OHIP?. This article will provide information on how to register your child for OHIP if your child was born in a hospital, a midwife's care, or elsewhere in Ontario. You may also find helpful information in the Settlement.Org article What documents do I need to apply for my child's Health Card (OHIP)?

As a person without OHIP, you have other options for healthcare. For more information on the types of programs you may be eligible for, please read I am pregnant and don't have OHIP. What health care can I get?.

We hope this information is helpful. If you have any additional questions, please feel free to post them here.

Sincerely,

Your Settlement.Org Team
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