Medical Insurance in Toronto

Toronto, Canada's economic hub and largest city, offers its residents a comprehensive health insurance system. This system, typical for the entire province of Ontario, is a unique blend of public and private options, ensuring a high level of medical care. This guide will help you understand the nuances of health insurance in Toronto so you can make an informed decision about your healthcare.

Ontario Health Insurance Plan (OHIP)

The Ontario Health Insurance Plan, known as OHIP, is the cornerstone of the healthcare system not only in Toronto but throughout Ontario. This public health insurance plan provides residents access to a wide range of essential medical services.

Who is eligible for OHIP?

To qualify for OHIP, you must meet the following basic requirements:

• Physical presence in Ontario. You must be physically present in the province for at least 153 days in any 12-month period. This requirement ensures that OHIP covers only permanent Ontario residents.
• Physical presence in the first months of residence. During the first six months after arriving in Ontario, you must be in the province for at least 153 days out of the first 183 days.
• Primary residence. Ontario must be your primary place of residence. This means you must have a permanent address in the province and spend most of your time here.

In addition to the minimum requirements, you must meet at least one of the additional conditions to receive OHIP. Those eligible for OHIP include:

• Canadian citizens, registered Indigenous people under the federal Indian Act, and permanent residents.
• Those in the process of obtaining permanent residency may also be eligible for OHIP if their application for permanent residence has been submitted and is being reviewed by Immigration, Refugees and Citizenship Canada (IRCC).
• Individuals with a valid work permit who have been working full-time for an Ontario employer for at least six months.
• Participants in federal programs such as the Live-in Caregiver Program and the Seasonal Agricultural Worker Program.
• Refugees and other protected persons, as well as temporary residents with permission to stay in Canada for specific cases.
• Clergy members who are legally in Ontario to serve for at least six months are also eligible for OHIP along with their families.

It's worth noting that in 2020, Ontario eliminated the waiting period for OHIP coverage, allowing newcomers to apply immediately upon arrival.

How to apply for OHIP

Obtaining OHIP requires in-person application and submission of several documents. Here's a step-by-step guide:

• Visit a ServiceOntario center in person. These centers are located throughout Toronto and provide various government services.
• Provide a completed registration form. You can get this form at a ServiceOntario center or download it from the official Ontario government website.
• Bring three identification documents: proof of citizenship or immigration status, proof of Ontario residency (e.g., lease agreement, utility bill), and photo ID (e.g., driver's license).

After your application is processed, you'll receive an OHIP card, which you'll need to present when receiving medical services.

ServiceOntario locations in Toronto:

• 777 Bay Street, Lower Level;
• 33 Victoria Street;
• 839 Yonge Street;
• 2700 Dufferin Street;
• 3300 Bloor Street West.

What does OHIP cover?

OHIP provides a wide range of medical services, but it doesn't cover all medical needs. Here are the main services covered by OHIP:

• Family doctor visits, including regular check-ups, diagnosis, and treatment of common illnesses;
• Walk-in clinic visits;
• Emergency care in hospital departments;
• Medical tests and most surgical procedures, including blood tests, X-rays, and MRIs.

OHIP also covers specialist services referred by a family doctor (e.g., cardiologists, dermatologists, orthopedists).

Additional private insurance

Despite

• International students must have health insurance provided by their educational institutions. Public universities usually offer health insurance through the University Health Insurance Plan (UHIP), while colleges and private institutions may offer insurance through other providers. Health insurance plans for international students are not free services. Their cost is typically added to the student's tuition fees.
• Temporary workers may become eligible for OHIP if they reside in Ontario for a certain period. Others must purchase private insurance or rely on employer-provided coverage.
• Tourists from other Canadian provinces or from abroad are not eligible for OHIP. Therefore, it's recommended to purchase private health insurance for your trip as an extra precaution. This will help cover medical expenses in case of emergencies during your stay in Ontario.

Innovations in Health Insurance

Health insurance in Toronto is constantly evolving. One of the key trends in recent years has been the development of telemedicine, which allows patients to receive consultations remotely. Many insurance companies now include virtual consultations in their plans.

Insurance Costs and Choices

OHIP is funded through provincial taxes, so Ontario residents don't pay additional premiums for this insurance.

The cost of private health insurance in Toronto varies depending on your age, health condition, and the level of coverage you choose. For most residents, basic plans cost roughly between $70 CAD to $140 CAD per month.

You can also find more information in our articles about the healthcare system in Canada and medical insurance in Canada.