# OHIP questions



## shilo (Jun 7, 2012)

hi, I am new here. I have a few questions with regard to OHIP. 

My mom is a Canadian citizen, and has been living outside of Canada to care for her mom the last two years. My grandma's health has improved, so my mom will be returning to Ontario to live, and re-apply for a new OHIP which has expired two years ago. Questions are as follow:

1. Can she apply for OHIP as soon as she lands? My mom still has a home and bank accounts in Ontario, so she will have no problem to proof residency. 
2. I know that there will be a 3-month waiting period for coverage, will they mail her the new card after the 3-month period?
3. In case my mom has to leave again to care for her mom, will it affect her OHIP coverage?

Thanks in advance!


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## Auld Yin (Mar 10, 2009)

shilo said:


> hi, I am new here. I have a few questions with regard to OHIP.
> 
> My mom is a Canadian citizen, and has been living outside of Canada to care for her mom the last two years. My grandma's health has improved, so my mom will be returning to Ontario to live, and re-apply for a new OHIP which has expired two years ago. Questions are as follow:
> 
> ...


Our pleasure.


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## shilo (Jun 7, 2012)

hi Auld Yin, thanks for the quick reply!
"Undisturbed" means she might be denied for coverage? Let's say she will be out of the province more than 6 months, will the Ministry of Health find out if my mom doesn't disclose it?


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## Auld Yin (Mar 10, 2009)

Yes, they have methods to detect fraud.


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## shilo (Jun 7, 2012)

thanks again! Appreciate it!


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## WestCoastCanadianGirl (Mar 17, 2012)

She may be able to get her old OHIP number back.

I know that in the province of British Columbia, I was able to reactivate my MSP account after a 2 year absence from Canada. Heck, MSP was kind enough to send me a NEW CARD for free (I had sent them the 10$ card replacement fee and they refunded that back).

I would recommend that your Mom print out the OHIP registration application form before she returns to Canada and pop it into the mail box at Pearson Airport as soon as she lands... that way, she can get the paperwork machine working towards her 90 day probation period and her card issued while reducing the possibility of a lack of coverage.


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## EVHB (Feb 11, 2008)

If she returns to Ontario, but leaves the province again within a couple of months, she will loose her OHIP again.
Eligibility

Ontario residents are eligible for provincially funded health coverage (OHIP). Generally, to be eligible for Ontario health coverage you must :


> •be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups who are eligible for OHIP as set out in Ontario’s Health Insurance Act ; and
> •be physically present in Ontario for 153 days in any 12-month period; and
> •be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and
> • make your primary place of residence in Ontario.


Ontario Health Insurance (OHIP) - Ministry Programs - Public Information - MOHLTC
(and there's a phone number on that page, so she can call them if she wants)

If she travels out of the province or out of the country, she will need private insurance (even if it's for 2 weeks), OHIP doesn't cover your (vacation) trips.


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## rhornal (Jun 12, 2012)

Hi Shilo, 

Here are a few more comments:

2. I know that there will be a 3-month waiting period for coverage, will they mail her the new card after the 3-month period?

During the 3 month time that she is waiting to be insured under the OHIP again, I would recommend that she obtain 'returning Canadian' insurance (visitors to Canada) from a Canadian insurance company. To do so, the best bet is to use a website that will let you compare many different plans like the one from BestQuote Travel Insurance Agency

3. In case my mom has to leave again to care for her mom, will it affect her OHIP coverage?

After the three months waiting period, and after she has been accepted on OHIP again if she needs to leave the country for a period longer than 212 days (not '6 months' like earlier post), she will automatically lose her OHIP coverage. However, if she knows she is going away for a longer period of time, and wishes to stay on OHIP, she can apply to OHIP for a special temporary absence and obtain permission (once), for an extended absence. 

Why would she want to do that? Well, the cost of being on OHIP is fairly cheap compared to obtaining international (expatriate) health insurance. Of course OHIP won't pay for emergency illness or accidental injury out of the province, so she may want to buy travel insurance (for Canadians travelling abroad, Canadian insurance companies require the person to be on provincial health care - otherwise they'd have to buy an expatriate policy that can cost $100's more each month).

And, if she came down with a major illness overseas while she was away, and wasn't on OHIP at the time, it's possible that she wouldn't be covered by her expatriate plan - and that to return home, she would have to wait another three months before OHIP would cover costs - never a good thing when you need immediate treatment, or shouldn't delay in getting attention.

Hope this helps.


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## rhornal (Jun 12, 2012)

I ran across this more exact info the other day about waiting period's, leaving the country after going back on OHIP etc.:

If this cut and paste doesn't work you can find the full article on the OHIP website:

OHIP Coverage Waiting Period

Generally speaking, there is a three-month waiting period for Ontario Health Insurance Plan (OHIP) coverage. It applies to most new applicants for coverage and former residents returning to Canada after living in other countries for long periods. Please note that on April 1, 2009, changes were made to the OHIP eligibility rules under Regulation 552 of the Health Insurance Act. 

Is anyone exempt from the waiting period?
Several groups are exempt from the waiting period. These include, but are not limited to :

newborn babies born in Ontario;
OHIP-eligible adopted children under the age of 16;
protected persons (Convention Refugees and persons in need of protection); and
people from another province/territory who move directly into a long-term care facility in Ontario, or who require admittance into a long-term care facility within 3 months of arrival in Ontario.

As a result of the April 1, 2009 changes, individuals who hold a valid Temporary Resident Permit (issued by Citizenship and Immigration Canada (CIC)) are now subject to the three-month waiting period. Note: this does not apply to Temporary Resident Permit holders who have been determined by CIC to be a Convention Refugee or person in need of protection. 

Staff at your local ServiceOntario Centre – Health Card Services will help you determine if you are exempt from the waiting period. You must show that you meet the requirements both for OHIP, and for the waiting period exemption. For more information about exemptions to the three-month waiting period :

refer to Regulation 552 of Ontario's Health Insurance Act (can be viewed online at www.e-laws.gov.on.ca)
or visit your local ServiceOntario Centre – Health Card Services

Please note : The waiting period does not apply to insured residents who travel outside Ontario for less than 212 days in each 12-month period. All insured Ontario residents can spend up to 212 days a year outside the country without losing their OHIP eligibility.

In addition, insured Ontario residents who are eligible for continuous OHIP eligibility while out of the country during a longer absence are not affected by the three-month waiting period. Please refer to the fact sheet, ‘Longer Absences From Ontario’ for more information.

With the waiting period, when am I eligible for OHIP coverage?

a) If you move to Ontario from another country :

The waiting period begins on the date you establish or re-establish residence in Ontario. If you are an eligible temporary resident, such as a foreign worker or clergy member who meets the citizenship and residence requirements described in Ontario's Health Insurance Act, the waiting period begins on the date you establish residence in Ontario.

Your coverage begins when the waiting period ends - after three calendar months.

For example :
Date Residence is Established in Ontario	Coverage Begins
January 15 April 15
May 3 August 3
November 30 February 28

b) If you move to Ontario from another province or territory where you had provincial/territorial health insurance coverage :

If you move to Ontario directly from another province and apply for coverage, your OHIP coverage will begin on the first day of the third month after establishing residence in Ontario, provided you were insured in your previous province or territory.

Your valid health card from your former province will continue to provide you with health insurance coverage in accordance with that province/territory’s plan during this three-month waiting period.

For example :
Date Residence is Established in Ontario	Coverage Begins
January 15 April 1
May 3 August 1
November 30 February 1

c) If you move to Ontario from another province or territory where you did not have provincial/territorial health insurance coverage:

If you are an uninsured person moving to Ontario from another Canadian province or territory, you will be subject to a waiting period lasting three full months. Your Ontario health insurance coverage would become effective three full months after establishing permanent residence in Ontario.

Please Note :

Leaving Ontario for more than 30 days in the first six months immediately after establishing residence in Ontario can impact your OHIP coverage by affecting the start date of your three-month waiting period.
It can result in a new three-month waiting period being applied as most new and returning residents to Ontario are required to be physically present in Ontario for 153 days in the first 183 days after residence is established in Ontario in order to maintain Ontario health insurance coverage.
The requirement to be physically present in Ontario for 153 days in the first 183 days after residence is established in Ontario only applies to new or returning residents:
Who move to Ontario from another country or
Who move to Ontario from another province/territory where they were not covered by the health insurance of that province/territory

How can I get coverage during the waiting period?

During the waiting period, you may be able to purchase private health insurance through a private insurance company if you meet the company's eligibility requirements.

Contact a private insurance company or... (get a comparable quote from one like BestQuote Travel Insurance Agency so you can conveniently see a range of policy options from Canada's top travel insurance companies side by side) - My link reference!


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