OHIP - Ontario Health Insurance Plan - centralwesthealthline.ca
OHIP - Ontario Health Insurance Plan - centralwesthealthline.ca
OHIP - Ontario Health Insurance Plan - centralwesthealthline.ca
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>OHIP</strong> – <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
Eligibility<br />
<strong>Ontario</strong> residents are eligible for provincially funded health coverage (<strong>OHIP</strong>). Generally, to be eligible for<br />
<strong>Ontario</strong> <strong>Health</strong> coverage you must:<br />
<br />
<br />
<br />
<br />
be a Canadian citizen, permanent resident or among one of the newcomer to Canada groups<br />
who are eligible for <strong>OHIP</strong> as set out in <strong>Ontario</strong>’s <strong>Health</strong> <strong>Insurance</strong> Act ; and<br />
make <strong>Ontario</strong> your primary place of residence<br />
be physi<strong>ca</strong>lly present in <strong>Ontario</strong> for 153 days in any 12-month period; and<br />
be physi<strong>ca</strong>lly present in <strong>Ontario</strong> for at least 153 days of the first 183 days immediately after<br />
establishing residency in the province; and<br />
<strong>OHIP</strong> coverage normally becomes effective three months after the date you establish residency in<br />
<strong>Ontario</strong>. The ministry strongly encourages new and returning residents to purchase private health<br />
insurance in <strong>ca</strong>se you become ill during the <strong>OHIP</strong> waiting period<br />
What’s Covered under <strong>OHIP</strong><br />
A resident of <strong>Ontario</strong> must have a health <strong>ca</strong>rd to show that he or she is entitled to health <strong>ca</strong>re services<br />
paid for by <strong>OHIP</strong>. The Ministry of <strong>Health</strong> and Long-Term Care pays for a wide range of services,<br />
however, it does not pay for services that are not medi<strong>ca</strong>lly necessary, such as cosmetic surgery.<br />
Most of your <strong>Ontario</strong> health benefits are covered across Canada. The province or territory you are<br />
visiting will usually bill the <strong>Ontario</strong> Ministry of <strong>Health</strong> and Long-Term Care directly for hospital and<br />
physician services. In Quebec, you may have to pay for physician services and then submit your receipt<br />
to your lo<strong>ca</strong>l ministry office for payment.<br />
<strong>OHIP</strong> covers a wide range of health services. A brief description of insured services follows below. For<br />
more details, please contact your nearest ministry office.<br />
June 27, 2011<br />
1
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
Services in <strong>Ontario</strong><br />
Physician:<br />
The ministry covers all insured medi<strong>ca</strong>lly necessary services provided by physicians. Physicians may bill<br />
you for uninsured services or if you miss an appointment or your health <strong>ca</strong>rd is not valid. You may<br />
contact the ministry if you have questions about charges for uninsured services.<br />
Other <strong>Health</strong> Care Providers:<br />
Services provided by podiatrists are partially covered under <strong>OHIP</strong>. The ministry pays part while you must<br />
pay for the extra costs. You may need to pay the full or partial cost of services provided by other health<br />
<strong>ca</strong>re providers, such as physiotherapists. You may contact the ministry if you have questions about<br />
services provided by other health <strong>ca</strong>re providers.<br />
Dental Services in Hospital:<br />
The ministry pays for some dental surgery, when it is done in hospital. You must pay the cost of regular<br />
dental services in a dentist's office.<br />
Eye Care:<br />
An eye examination is covered by <strong>OHIP</strong> once a year for persons under 20 and those 65 and over. <strong>OHIP</strong><br />
also covers a major eye exam once every 12 months for persons aged 20 - 64 who have medi<strong>ca</strong>l<br />
conditions requiring regular eye examinations (refer to <strong>OHIP</strong> Bulletin 8089 or to Changes to <strong>OHIP</strong><br />
Coverage for Eye Care Services).<br />
Northern <strong>Health</strong> Travel Grant:<br />
You may be eligible for a Northern <strong>Health</strong> Travel Grant to help pay transportation costs if you live in<br />
northern <strong>Ontario</strong> and must travel long distances for specialty medi<strong>ca</strong>l <strong>ca</strong>re.<br />
For more information on the Northern <strong>Health</strong> Travel Grant program, <strong>ca</strong>ll 1 800 461-4006 (for service in<br />
English) or 1 800 461-1149 (for service in French).<br />
June 27, 2011<br />
2
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
Services in Other Canadian Provinces and Territories<br />
Most of your <strong>Ontario</strong> health coverage benefits <strong>ca</strong>n be used across Canada. The province or territory you<br />
are visiting will usually bill <strong>Ontario</strong> directly. If you have to pay for health services you receive in another<br />
part of Canada, you <strong>ca</strong>n submit your receipts to your lo<strong>ca</strong>l ministry office to be considered for<br />
reimbursement.<br />
Prescription drugs from pharmacies, home <strong>ca</strong>re services, ambulance services and long-term <strong>ca</strong>re<br />
services provided in other provinces and territories are not covered<br />
http://www.health.gov.on.<strong>ca</strong>/english/public/pub/ohip/<strong>ca</strong>nada.html<br />
Services Outside Canada<br />
For people travelling outside Canada, the ministry pays a set rate for emergency health services.<br />
Emergency health services are those given in connection with an acute, unexpected condition, illness,<br />
disease or injury that arises outside Canada and requires immediate treatment. Ambulance services are<br />
not covered.<br />
<strong>Ontario</strong> residents are encouraged to purchase supplementary insurance when traveling outside Canada<br />
as many emergency health services provided outside the country cost much more than <strong>OHIP</strong> may pay<br />
http://www.health.gov.on.<strong>ca</strong>/en/public/publi<strong>ca</strong>tions/ohip/travel.aspx<br />
Services partially covered by <strong>OHIP</strong><br />
<strong>OHIP</strong> covers numerous health services and is available for all people who meet the residential eligibility<br />
requirements. <strong>OHIP</strong> does not/partially cover the total cost of services such as:<br />
<br />
Ambulance services<br />
Eye exams - routine eye examinations are no longer covered by <strong>OHIP</strong> for people aged 19-64;<br />
those under 18 and 65 and older are still covered for an eye examination once every 12 months.<br />
Individuals aged 20 to 64 years with medi<strong>ca</strong>l conditions affecting the eye receive an eye<br />
examination once every 12 months<br />
Physiotherapy – available to persons who qualify<br />
Some dental surgery that is done in a hospital will be covered<br />
Podiatrists are only partially covered by <strong>OHIP</strong><br />
June 27, 2011<br />
3
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
<br />
Chiropractic Service – no longer covered by <strong>OHIP</strong><br />
Necessary emergency medi<strong>ca</strong>l treatment obtained outside of Canada is only covered on a very<br />
limited basis; it is highly recommended to have travel insurance coverage if traveling outside<br />
of Canada<br />
For more information visit: http://www.health.gov.on.<strong>ca</strong>/en/public/publi<strong>ca</strong>tions/pub_ohip.aspx<br />
As health service providers validate the health numbers of people they treat, it is important to <strong>ca</strong>rry<br />
your health <strong>ca</strong>rd at all times. If you have a red and white health <strong>ca</strong>rd OR the newer photo health <strong>ca</strong>rd,<br />
please <strong>ca</strong>rry it. Either <strong>ca</strong>rd must be validated by your provider.<br />
For More Information on the health <strong>ca</strong>re system in <strong>Ontario</strong> contact:<br />
Service<strong>Ontario</strong>, Infoline at 1-866-532-3161<br />
TTY 1-800-387-5559<br />
In Toronto, TTY 416-327-4282<br />
Hours of operation: 8:30am - 5:00pm<br />
June 27, 2011<br />
4
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
<strong>OHIP</strong> Offices<br />
BRAMPTON<br />
1. 1st Floor, 7765 Hurontario Street<br />
Brampton, ONL6W 4S8<br />
General Inquiry: 1-800-267-8097<br />
Hours of Operation:<br />
Mon-Fri, 8:30 am to 5:00 pm<br />
2. Unit 8, 4 McLaughlin Road<br />
Brampton, ON L6Y 3B2<br />
General Inquiry: 905-452-1132<br />
Hours of Operation:<br />
Mon- Wed. & Fri. 9:00 am – 5:00 pm<br />
Thu 9:00 am – 7:00 pm<br />
Sat 9:00 am-12:00 pm<br />
3. Unit 2, 2150 Steeles Avenue East<br />
Brampton, ON. L6T 1A7<br />
General Inquiry: 905-792-0081<br />
Hours of operation:<br />
Mon- Wed. & Fri. 9:00 am – 5:00 pm<br />
Thu 9:00 am – 7:00 pm<br />
4. Unit 15, 1 Wexford Road<br />
Brampton, ON L6Z 2W1<br />
General Inquiry: 905-840-7433<br />
Hours of Operation:<br />
Mon- Wed. & Fri. 9:00 am – 5:00 pm<br />
Thu 9:00 am – 7:00 pm<br />
Sat 9:00 am-12:00 pm<br />
MISSISSAUGA<br />
June 27, 2011<br />
5
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
1. Unit I-214, 100 City Centre Drive<br />
Mississauga, ON L5B 2C9<br />
General Inquiry: 905-276-4357<br />
Hours of operation:<br />
Mon-Thu 9:00 am-6:00 pm<br />
Fri 9:00 am-8:00 pm<br />
Sat 10:00 am-5:00 pm<br />
2. Unit 101, 6295 Mississauga Road North<br />
Mississauga, ON L5N 1A5<br />
General Inquiry: 905-826-6151<br />
Hours of Operation:<br />
Mon-Fri 8:30 am-5:00 pm<br />
3. Unit 2, 1425 Dundas Street East<br />
Mississauga, ON L4X 2W4<br />
General Inquiry:905-629-1364<br />
Hours of operation:<br />
Mon-Wed & Fri 9:00 am- 5:00 pm<br />
Thu 9:00 Am-7:00 pm<br />
Sat 9:00 am-12:00 pm<br />
4. Unit 14, 1151 Dundas Street West<br />
Mississauga, ON L5C 1C6<br />
General Inquiry: 1-800-267-8097<br />
Hours of Operation:<br />
Mon-Thu 8:30 am- 7:00 pm<br />
Fri 8:30 am- 5:00 pm<br />
5. Unit 24, 2225 Erin Mills Parkway<br />
Mississauga, ON L5K 1T9<br />
General Inquiry: 905-855-0082<br />
Hours of Operation:<br />
Mon-Wed & Fri 9:00 am- 5:00 pm<br />
Thu 9:00 Am-7:00 pm<br />
Sat 9:00 am-12:00 pm<br />
June 27, 2011<br />
6
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
ETOBICOKE<br />
1. Unit 193, 250 The East Mall<br />
Toronto, ON M9B 3Y8<br />
General Inquiry: 416-236-3039<br />
Hours of Operation:<br />
Mon, Tue & Fri 9:00 am-5:00 pm<br />
Wed & Thu 9:00 am-7:00 pm<br />
Sat 9:00 am-1:00 pm<br />
2. 988 Albion Road<br />
Toronto, ON M9V 1A7<br />
General Inquiry: 416-742-1901<br />
Hours of Operation:<br />
Mon-Wed & Fri 8:30 am – 4:30 pm<br />
Thu 8:30 am-7:00 pm<br />
Sat 9:00 am- 12:00 pm<br />
3. Unit 19B, 250 Wincott Drive<br />
Toronto, ON M9R 2R5<br />
General Inquiry: 416-244-0911<br />
Hours of Operation:<br />
Mon-Wed & Fri 9:00 am – 4:30 pm<br />
Thu 9:00 am-7:00 pm<br />
4. Unit 142, 3300 Bloor Street West<br />
Toronto, ON, M8X 2W8<br />
General Inquiry: 1-800-267-8097<br />
Hours of Operation:<br />
Mon-Wed & Fri 8:30 am – 5:00 pm<br />
Thu 8:30 am-7:00 pm<br />
5. Unit 16B, 1255 The Queensway<br />
Toronto, ON M8Z 1S1<br />
General Inquiry: 416-251-4941<br />
Hours of Operation:<br />
Mon-Wed & Fri 8:30 am – 4:30 pm<br />
Thu 8:30 am-7:00 pm<br />
Sat 9:00 am- 12:00 pm<br />
June 27, 2011<br />
7
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
DUFFERIN COUNTY & SURROUNDING AREA<br />
1. Unit 7, 41 Broadway Avenue<br />
Orangeville, ON, L9W 1J7<br />
General Inquiry: 1-800-267-8097<br />
Hours of Operation:<br />
Mon- Fri 8:30 am -5:00 pm<br />
2. 109 Adeline Street<br />
Shelburne, ON, L0N 1S0<br />
General Inquiry: 519-925-3741<br />
Hours of Operation:<br />
Mon- Fri 9:00 am -5:00 pm<br />
Sat 9:00 am-12:00 pm<br />
3. 18 King Street East<br />
Bolton, ON, L7E 5T3<br />
General Inquiry: 905-857-3314<br />
Hours of Operation:<br />
Mon 11:00 am-7:00 pm<br />
Tue-Fri 9:00 am -5:00 pm<br />
4. Unit 1, 180 Parsons Road<br />
Alliston, ON, L9R 1E8<br />
General Inquiry: 705-435-7661<br />
Hours of Operation:<br />
Mon 9:00 am-4:00 pm<br />
Tue-Fri 9:00 am -5:00 pm<br />
Sat 9:00 am-12:0 pm<br />
WOODBRIDGE<br />
June 27, 2011<br />
8
<strong>OHIP</strong> - <strong>Ontario</strong> <strong>Health</strong> <strong>Insurance</strong> <strong>Plan</strong><br />
1. 97 Woodbridge Avenue<br />
Woodbridge, ON L4L 2S6<br />
General Inquiry: 905-851-0777<br />
Hours of Operation:<br />
Mon-Wed & Fri 9:00 am- 5:00 pm<br />
Thu 9:00 am-7:00 pm<br />
2. Unit 12, 7880 Keele Street<br />
Concord, ON L4K 4G7<br />
General Inquiry: 905-660-6626<br />
Hours of Operation:<br />
Mon-Fri 9:00 am- 5:00 pm<br />
Sat 9:00 am-12:00 pm<br />
3. Unit 7, 1150 Sheppard Avenue West<br />
Toronto, ON M3K 2B5<br />
General Inquiry: 416-781-1398<br />
Hours of Operation:<br />
Mon-Wed & Fri 9:00 am- 5:00 pm<br />
Thu 9:00 am – 7:00 pm<br />
Sat 9:00 am-12:00 pm<br />
June 27, 2011<br />
9
Change language