The Ontario Health Insurance Plan ( French: ''Assurance-Santé de l'Ontario''), commonly known in both official languages by the acronym OHIP (pronounced ), is the

government A government is the system or group of people governing an organized community, generally a state. In the case of its broad associative definition, government normally consists of legislature, executive, and judiciary. Government is ...

- run health insurance plan for the Canadian province of

Ontario Ontario ( ; ) is one of the thirteen provinces and territories of Canada.Ontario is located in the geographic eastern half of Canada, but it has historically and politically been considered to be part of Central Canada. Located in Central C ...

. OHIP is funded by a payroll deduction tax by residents who are gainfully employed, by businesses in the province of

, and by transfer payments from the

Government of Canada The government of Canada (french: gouvernement du Canada) is the body responsible for the federal administration of Canada. A constitutional monarchy, the Crown is the corporation sole, assuming distinct roles: the executive, as the ''Crown ...

Summary of Covered Services

Every Ontario resident with his or her primary and permanent home in Ontario is entitled to access emergency and preventive care under OHIP free of charge. Ontario residents may go to a participating doctor—essentially every doctor practising in the province—any time they wish (subject to the consent of the doctor) and the services are billed through OHIP to the government. In 2018, the Ontario Health Insurance Plan announced a new program designed to assist individuals struggling with

food addiction A food or eating addiction is any behavioral addiction that is primarily characterized by the compulsive consumption of palatable (e.g., high fat and high sugar) food items which markedly activate the reward system in humans and other anim ...

Prescription drug

OHIP does not generally cover prescription drugs outside of hospitals or dental care. However, * the Ontario Drug Benefit program pays for prescription drugs for seniors covered by OHIP. * the Trillium Drug Program covers households with high prescription drug costs. *as of 1 January 2018, prescription drugs for those under 25 years of age are covered by OHIP through OHIP+. As of 1 April 2019, the Ontario government will no longer offer free prescriptions to children and young adults with private coverage.

Physiotherapy

OHIP coverage for physiotherapy was restricted to those 65 years of age and over, those 19 years of age and under, residents of long-term care homes (regardless of age), individuals who had been hospitalized (regardless of age) and individuals on the Ontario Disability Support Program, Family Benefits and Ontario Works (regardless of age).

Optometry (eye-health services)

OHIP covers the cost of one major eye exam (for vision and general eye health) every 12 months, plus any minor assessments you need, but only if you are 19 years and younger, or 65 years and older. If you are 20 to 64 years old, and you have a specific medical condition affecting your eyes that requires regular monitoring, OHIP will cover a major eye exam for you once every 12 months and any follow-up appointments related to the condition.

Dental care for low-income seniors

It provides free, routine dental services for low-income seniors who are 65 years of age or older, with the income requirements of an annual net income of $22,200 or less for a single senior, or a combined annual net income of $37,100 or less for a couple (for year 2022).

OHIP Out of Country Travel Insurance

OHIP will only cover a very limited amount of the costs if you receive emergency health services while you’re travelling outside Canada, including the following OOC emergency services: doctor services (e.g. medical assessments, emergency surgery), emergency outpatient services (e.g. MRIs, CT scans), emergency inpatient services (e.g. hospital stays, nursing services).

Funding

While Ontario receives transfer payments from the

to partially fund health care, OHIP is also supported by general provincial tax revenues and premiums (taxes) paid by employers and individuals. Employers are charged a payroll health care tax (with an exemption for small businesses), and residents of the province pay a health premium (introduced in 2004) as part of their income taxes. Similarly, Ontario publicly funds hospitals. The Ontario Health Premium (OHP) is a component of Ontario's Personal Income Tax system. The OHP is based on taxable income for a taxation year. As of May 2010, an Ontario resident with taxable income (i.e., income after subtracting allowable deductions) of $21,000 pays $60 per year. With a taxable income of $22,000, the premium doubles to $120. With a taxable income of $23,000, the premium is $180. With a taxable income of $24,000, the premium is $240. The premium increases at a decreasing rate thereafter for taxable incomes up to $200,600 at which point the maximum premium of $900 is reached.Ontario Health Premium Rate Chart
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Delisted care

Until 2004, OHIP also paid for an

eye examination An eye examination is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations pertaining to the eyes. Eye examinations are primarily performed by an optometrist, ...

every two years and limited

chiropractic Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudosci ...

and physical therapy/ physiotherapy services. The May 2004 budget, however, announced that most eye exams and all chiropractic and physical therapy would be "delisted" (removed) from coverage, by the

Liberal Liberal or liberalism may refer to: Politics * a supporter of liberalism ** Liberalism by country * an adherent of a Liberal Party * Liberalism (international relations) * Sexually liberal feminism * Social liberalism Arts, entertainment and m ...

government of

Dalton McGuinty Dalton James Patrick McGuinty Jr. (born July 19, 1955) is a former Canadian politician who served as the 24th premier of Ontario from 2003 to 2013. He was the first Liberal leader to win two majority governments since Mitchell Hepburn nea ...

. Physiotherapy ended up never being delisted from OHIP. Instead, effective April 1, 2005, OHIP coverage for physiotherapy was restricted to those 65 years of age and over, those 19 years of age and under, residents of long-term care homes (regardless of age), individuals who had been hospitalized (regardless of age) and individuals on the Ontario Disability Support Program, Family Benefits and Ontario Works (regardless of age). OHIP covers up to 50 visits per year post-hospitalization and up to 100 visits per year for residents of long-term care homes. The McGuinty government at the time promised to expand OHIP coverage for residents of long-term care homes and for residents of rural and remote areas. The provision continues to be made for free coverage to minors. Annual eye examinations are free for children (19 or younger), seniors (65 or older), adults ages 20–64 with certain ocular health conditions (including

glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...

cataracts A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble w ...

, and

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

), as well as those receiving ODSP or Ontario Works (every two years).

Eligibility

In order to be eligible for coverage under OHIP, a person must normally be a

Canadian citizen Canadian nationality law details the conditions in which a person is a national of Canada. With few exceptions, almost all individuals born in the country are automatically citizens at birth. Foreign nationals may naturalize after living in C ...

permanent resident Permanent residency is a person's legal resident status in a country or territory of which such person is not a citizen but where they have the right to reside on a permanent basis. This is usually for a permanent period; a person with suc ...

or a holder of a work permit as set out in Ontario's Health Insurance Act, must have a permanent and principal home in Ontario, and must be physically present in Ontario 153 days in any 12-month period. Canadian citizens or permanent residents returning to Canada from another country are not normally covered by OHIP until they have been resident in Ontario for three months. In 2009, applicants for permanent residence from within Canada were added to the plan, following the "Approval In Principle" (AIP) stage of the process. Applicants from outside Canada continue to be ineligible for OHIP until they have completed the landing process and have actually become permanent residents, when the usual three-month waiting period begins. It is recommended to obtain private health insurance to cover the waiting period. For Canadian citizens or permanent residents moving to Ontario from another province, the province of the previous residency continues to cover them during the three-month waiting period.

Waiting period

*Transfer from another province, territory, or country: the waiting period used to be three months, but as of March 19, 2020, that has been temporarily removed because of the

COVID pandemic The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identifie ...

. *Military spouses: immediate regardless of origin. *Applicants for permanent residence from inside Canada: obtaining of permanent residence *Applicants for permanent residence from outside Canada: obtaining of permanent residence (15–24 months as of April 2014)

Precursors

Ontario's first government-run health plan, known as OMSIP (Ontario Medical Services Insurance Plan), was established and enacted on 1 July 1966. On 1 October 1969, it was replaced by OHSIP, the Ontario Health Services Insurance Plan, as a provincially-run and federally-assisted plan under the federal Medical Care Insurance Act for the establishment of a national medical plan. In 1972, its name was shortened to simply OHIP.Official website history
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References

{{Reflist

External links

Official website
1969 establishments in Ontario Government agencies established in 1969 Ontario government departments and agencies Health in Ontario Health insurance in Canada