Changes to OHIP Out-of-Country Coverage Lead to Confusion and Misinformation

OHIP Changes to Out-of-Country Coverage Leads to Confusion and Misinformation

Since the Ontario government announced that OHIP would end all coverage for out-of-country medical expenses in October 2019, there has been a lot of misinformation circulating about how this change will affect travellers.

One of the myths that has been circulating is that OHIP’s decision to end out-of-country medical coverage effectively makes you ineligible for coverage under any supplemental (i.e. private) travel insurance policy you have purchased.

How did this rumour start?

This rumour likely started because supplemental travel medical insurance policies include an eligibility requirement that you must be covered by a Government Health Insurance Plan (GHIP) - such as OHIP - in order to be eligible for coverage under your policy.

For example, policies offered by Snowbird Advisor Insurance include language that says in order to be eligible for coverage, you must “be a resident of Canada and covered under a government health insurance plan for the entire duration of your trip”.

If you get your travel insurance from a different provider, take a look at your policy and you’ll find similar language, as it’s a standard eligibility requirement.

What are the facts?

This eligibility requirement has been incorrectly misinterpreted by some to mean that your GHIP coverage must include out-of-country coverage for you to be eligible for coverage under your policy

However, this is NOT the case. The eligibility requirement is simply that you must have GHIP coverage. So, as long as you have OHIP coverage, you meet this particular eligibility requirement.

Accordingly, the bottom line is that the change in OHIP coverage does not affect your eligibility to be covered under your supplemental travel insurance plan.

It does, however, highlight the importance of maintaining your provincial GHIP coverage by making sure you don’t spend too many days outside your home province, which can result in losing your GHIP coverage. You can learn more about residency requirements to maintain your GHIP coverage here.

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