First 90 Days: Health Insurance For Newcomers

“Do you need Health Insurance for the first 90 days?”

“Absolutely, Yes.”

“But I do have my Travel Insurance, which says it will cover for 60 days.”

“Yes, that you do have.”

“Why do I need insurance then?”

“Dear friend, as they taught me in Alcatraz, the devil lies in the details.

Your travel insurance only covers a visit to the hospital under ‘Emergencies’. As vague as legal mumbo jumbo goes, Emergencies have a pretty forward definition. It covers incidents occurring under an Emergency, not your regular fever and antibiotic shots.

There are two main benefits: Emergency Medical and Medical Evacuation.

Emergency Medical coverage can reimburse you for the costs associated with medical treatment for an illness or injury during your trip. This can include coverage for physician services, ambulance services, and hospital charges, among other expenses.

Medical Evacuation is included alongside Emergency Medical coverage. This benefit can arrange for your transportation to the nearest hospital in the event of a medical emergency and can bring you home if the hospital determines it’s necessary for your situation.

Simply put, your travel insurance is what it is. Your travel insurance and NOT A SUBSTITUTE FOR A HEALTH INSURANCE.

Travel Insurance promises to make good the losses while travelling, including baggage loss, cancellation of trips, passport loss and among other things, your emergency medical care.”

“Bro, I have moved my application for the Ontario Health Insurance Plan. So, relax, I have got it all under control.”

“If you have filed an application for the same and are waiting for approval, you leave yourself at risk of having to pay for any medical expenses or accidents that may occur until you receive your coverage, which may take up to 3 months if not more. Here is an advice from OHIP on waiting for the card.

Also, under OHIP, essential coverage is available to everyone, but even OHIP does not cover everything.

Make sure you know what is and what is and what is not covered by OHIP, and protect yourself from the expenses that are not covered. Without insurance, you are liable to pay any expenses incurred as a result of an injury, accident or unexpected illness, until your OHIP coverage is confirmed.

Also, if you are someone who travels in and out of Canada a lot, many health services outside Canada cost much more than OHIP will cover. You are then responsible for any difference in cost. Also, some health services are not insured by the OHIP and you will have to pay the full costs for these services.

Here is a list of services that are typically not covered:

  • Prescription drugs for individuals if you are under the age of 65 (although medication, while hospitalized, is covered)
  • Smoking cessation drugs
  • Physiotherapy treatments for people 20 to 64 years of age, is usually not covered
  • Dental care (unless you are on social assistance)
  • Chiropractic services
  • Items such casts, crutches and splints
  • Eye care is covered only under certain circumstances, for people between the ages of 20 and 65.
  • Glasses and contact lenses.
  • Laser eye surgery.
  • Ambulance transportation services if not deemed medically necessary (maximum cost of $240).
  • Out of province ambulance costs are not covered.
  • Any dental services performed in a dental office.
  • Most paramedics such as chiropractors, massage therapists, naturopaths, acupuncturists and osteopaths.
  • Necessary emergency medical treatment obtained outside of Canada (e.g. while travelling) is only covered on a very limited basis;
  • Any cosmetic surgery.
  • Semi-private and private rooms in a hospital.
  • Birth control pills and other contraceptives UNLESS you are 24 or younger OR you qualify for a specialty drug program (e.g. low-income family).

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