What Is OHIP? A Complete Guide to Ontario’s Health Insurance Plan
- Murat Koçak
- Oct 14
- 7 min read
Ontario, Canada’s most populous province, stands out for its strong economy and comprehensive public health system. Access to essential healthcare in this province is provided through the Ontario Health Insurance Plan (OHIP), a government-funded program built on the principle of accessible healthcare for everyone. OHIP directly covers the cost of many medically necessary services, removing the financial burden from individuals.
This guide explains the scope of OHIP, who is eligible, how to apply, waiting periods, exceptional cases for students, services not covered, and available private insurance alternatives. It also helps clarify OHIP’s role within Canada’s overall healthcare structure.
Which Services Are Covered by OHIP?
OHIP covers only medically necessary healthcare services for diagnosis or treatment that directly affect a patient’s health.
Generally, OHIP covers the following:
Family doctor and specialist consultations
In-hospital tests, laboratory work, and diagnostic imaging
Emergency room visits and urgent care services
Medically required surgeries
Ambulance services are provided when medically necessary (for example, transfers to the hospital)
Update (2025): Ambulance transportation is not always entirely free. OHIP covers part of the cost, while patients are usually required to pay a flat co-payment between CAD 45 and 240, depending on travel distance and the level of urgency.
The main goal of OHIP is to ensure fair and universal access to healthcare. However, cosmetic surgery, elective dental, or non-medical treatments are excluded. Some age-specific exceptions also apply; for instance, eye exams are free only for people under 20 and over 65, while those between these ages must pay out of pocket.
Practical Tip:Before scheduling an appointment, ask, “Does OHIP cover this service?” This simple step helps avoid unexpected costs. Some services may only be partially covered or require a co-payment, especially in dental, podiatry, or physiotherapy areas.
Who Is Eligible for OHIP?
Being in Canada alone does not qualify someone for OHIP. You must meet both residency and legal status requirements.
Residency Requirements
Your primary residence must be in Ontario.
You must be physically present in Ontario for at least 153 days within your first six months, and 153 days each 12 months thereafter.
These rules ensure that the system truly serves Ontario residents. For example, individuals in Canada on short-term visitor visas are not eligible.
Status Requirements
The following people are generally eligible to apply for OHIP:
Canadian citizens
Permanent residents (PR holders)
Refugees or protected persons
Individuals registered under the Federal Indian Act
Persons with “approval-in-principle” PR applications
Holders of valid work permits of at least six months who are employed full-time in Ontario
Some cases are more complex. For example, the spouses of work-permit holders or open-work-permit applicants may need individual assessment. Contacting a ServiceOntario center before applying is the best way to confirm eligibility and document requirements.
Tip:Prepare both your status documents (e.g., work permit or PR card) and proof of Ontario residency (such as a lease or utility bill) in advance to speed up the process.
How to Apply for Ontario Health Insurance (OHIP)
Applying for OHIP is a detail-oriented but straightforward process. It usually requires one in-person visit, and renewals or address updates can later be completed online or by mail.
1. Prepare Your Documents
You must present three different types of documents:
● Proof of identity (passport, driver’s license, birth certificate, etc.)
● Proof of legal status (PR card, work or study permit, refugee document, etc.)
● Proof of residence in Ontario (lease, utility bill, bank statement, etc.)
All documents must be original and current; photocopies are generally not accepted.
2. Visit a ServiceOntario Centre
Once your documents are ready, visit the nearest ServiceOntario office in person. An officer will verify your documents and ask you to complete a short form. Ensure your address is correct, and your Health Card will be mailed to this address.
Update (2025):Many ServiceOntario centers now use an online appointment-booking system. You can book a time slot in advance to avoid long waiting lines.
3. Receive Your OHIP Card
After approval, your OHIP card usually arrives by mail within two to four weeks. It shows your name, date of birth, and personal health number. You must present this card every time you receive medical care.
Notes:
Applying for OHIP is free of charge.
You can update your address or renew your card through ServiceOntario or its online portal.
Lost cards can be replaced by submitting a Replacement Card request.
Waiting Period Before OHIP Coverage Starts
For many newcomers, OHIP coverage does not begin immediately. Most new permanent residents must wait up to three months before their coverage becomes active, a rule designed to verify legal residency.
Update (2025):During the COVID-19 pandemic, this waiting period was temporarily waived, but it was reinstated in 2024. Therefore, newcomers should always obtain private health insurance for the first three months after arrival.
The waiting period may be adjusted during health emergencies, but official updates should always be checked on the ServiceOntario website.
Example:
A family that moves to Ontario and needs emergency care before their OHIP starts could receive a hospital bill of CAD 1,000–2,000. Short-term “gap insurance” policies are recommended to bridge this waiting period safely.
Can Students Get OHIP?
OHIP applies to Canadian citizens and permanent residents who study in Ontario. However, international students are generally not eligible. Instead, most Ontario universities require them to join the University Health Insurance Plan (UHIP), a private group health insurance program that covers medically necessary services during the student’s study period.
Some institutions include UHIP costs directly in tuition fees, usually around CAD 600–700 per year.
Update (2025):
In 2025, annual UHIP fees vary by university, ranging between CAD 600 and 750. Students should check the exact amount and coverage details provided by their institution.
Tips:
For expenses not covered by UHIP, such as dental, vision, or prescription drugs, students can purchase extended health plans (often offered through student unions).
After graduation, you may qualify for OHIP once you obtain a Post-Graduation Work Permit (PGWP). Notify ServiceOntario when your status changes.
Services Not Covered by OHIP
OHIP does not pay for every type of medical expense. It only covers medically necessary treatments. The following are either partially covered or excluded:
Prescription drugs (except those given in hospitals)
Dental care (only medically required hospital-based procedures are covered)
Eye exams and eyewear for individuals between 20 and 65 years old
Laser eye surgery and cosmetic procedures
Alternative therapies (acupuncture, osteopathy, chiropractic care, etc.), unless included in special plans
Some clinics offer these as “uninsured services,” sometimes under annual packages called “block fees,” which may cover medical forms or prescription renewals.
Private Health Insurance Options in Canada
While OHIP covers essential needs, many people choose private or employer-based plans to expand their protection. These are especially helpful for dental, vision, prescription, and physiotherapy services.
Common Types of Coverage
Drug coverage: For prescription medicines used outside hospitals.
Dental and vision care: Routine checkups, fillings, glasses, and contact lenses.
Paramedical services: Physiotherapy, psychotherapy, massage therapy, chiropractic, etc.
Travel health insurance: Coverage for medical costs outside Canada.
Who Might Need It
OHIP does not cover international students.
Short-term workers or visitors
Frequent travelers
People with regular dental or vision needs
Employees without group plans
When selecting a policy, always review the limits, waiting periods, exclusions, and the insurer’s direct-billing network. Companies like Manulife, Sun Life, and Canada Life offer digital tools for easy claim submission and reimbursements.
Frequently Asked Questions
Is OHIP valid throughout Canada?No. OHIP coverage is limited to Ontario. You can receive emergency care in other provinces, but reimbursement is limited. For more extended travel, it’s advisable to purchase travel health insurance.
Is Canada’s healthcare system sound?Yes. Canada’s publicly funded healthcare system is known for its high standards. Essential medical services are free but long wait times and limited dental or vision care coverage are common concerns. In Ontario, OHIP forms the backbone of this system, complemented by private plans.
Taking Informed Steps in Your Healthcare Journey
OHIP is one of the most important guarantees of life in Ontario. However, its coverage extends only to medically necessary services. For Canadian citizens, permanent residents, or individuals with valid work permits, OHIP represents the first step toward full access to the healthcare system.
For newcomers, applying as soon as possible and purchasing private insurance for the three-month waiting period is essential. In addition, evaluating extended plans that include dental, vision, or prescriptions can be beneficial in the long term.
Ontario’s healthcare system is generally safe, accessible, and well-organized. Once your OHIP card becomes active, you can receive emergency medical services without financial worry.
Refer to ServiceOntario’s official website for the latest policies, required documents, and updates.
At C&C Canada Education, Visa and Immigration, we help our clients take informed steps in navigating the Canadian healthcare and insurance system. From OHIP applications to UHIP and private plan guidance, we aim to ensure that students and newcomers understand each stage clearly and confidently start their new lives.
Accurate information is your most excellent safeguard in every stage of your Canadian journey. C&C Canada Education, Visa, and Immigration is here to help you begin your healthcare journey with clarity and confidence.
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