Landing and Birth within the first 90 days

[tender_heart]

Hi,

I am sponsoring my wife (pregnant) to join me in Ottawa, ON. Apparently, my wife will be expected to land 3 months prior to the delivery due date. Upon the OHIP law they will not cover her for the first 90 days. My questions:

1) When land, she needs to submit different types of proof to apply for OHIP; one of those, is the proof of residency (e.g. mailed telephone bill - under her name, ...etc.), this will require a minimum of 30 days to get it mailed to our address. So, would those 30 days be counted or shall they consider only 90 days after providing all required proof documents?

2) Is there a chance to pay for private insurance and cover the birth/delivery expenses?

3) What would be the birth/delivery costs for non covered patients

Finally, what would you advice?

thanks,

[scylla]

1) It's 90 days after you land. If it takes a month proof of residency, that won't matter.
2) Extremely unlikely - pregnancy is classified as a pre-existing condition and is almost always excluded. If you do manage to find an insurerer who will cover the pregnancy/deliver, you should expect the costs of the coverage to be so high that it will be the equivalent of paying the costs yourself.
3) I would budget $10K to be safe. It should be a bit lower - but could also be higher if there are any complications. If you opt for a home birth with a midwife, it should be quite a bit cheaper.

[steaky]

I suggest you move to Alberta and your wife lands there, so that the birth/delivery expenses will be paid by that province  

[tender_heart]

Many thanks scylla and steaky,

My wife should land in Montreal, QC. I am thinking to move with directly to (Ottawa, Mississauga or Toronto), ON. Would that make a difference or affect the 90 days period?

[Leon]

No, it will not matter.  She is sponsored by you and you live in Ottawa and have OHIP.  As long as you stay in Ontario, she will have 90 day wait for health care.  If you immediately move to QC instead, she would be exempted from the waiting period there because she is pregnant but I don't think QC will like it because you did not live in QC when you sponsored your wife so she does not have a CSQ.  However, the charter of rights and freedoms does say that all PR's are free to live anywhere in Canada.

[tender_heart]

Hi Leon,

My wife sponsorship application was through Quebec (I am there) and she has the CSQ as part of the sponsorship process. I was thinking, post to her landing to move directly to ON. Would you recommend that or not?

[Leon]

Hi Leon,

My wife sponsorship application was through Quebec (I am there) and she has the CSQ as part of the sponsorship process. I was thinking, post to her landing to move directly to ON. Would you recommend that or not?

No, because of your situation, I definitely would not recommend moving to ON at this point.  You say she is 6 months pregnant.  She will need check ups and it is possible that she will give birth before 90 days.

If you stay in Quebec, she can apply for RAMQ and they will make an exception during the waiting period for her pregnancy related expenses and child birth.

If you move to ON right after she lands, she will have a 90 day waiting period to get covered under OHIP, no exceptions.  If the baby is born during this time, you pay for it out of pocket.

[tender_heart]

Hi again,

sorry i was searching for Quebec health rules.

1) I didn't find any rule that exempts my wife from the 90 days waiting period! Is it there some where??


2) Exemption for pregnancy related expenses (upon my research is any complications, tests ...etc.) related to the pregnancy period and not the delivery (birth). Is that true?

[Leon]

Look at this:

Healthcare received during the waiting period
 
Generally speaking, if you arrive in Québec from outside Canada, even if you are a Canadian citizen, you will be eligible for the Québec Health Insurance Plan after a waiting period of up to 3 months following your registration.
 
The Régie does not reimburse you for healthcare you receive during the waiting period. To save you from having to pay for any healthcare services that you or your family members may need, the Régie strongly recommends that you take out private insurance within 5 days following your arrival in Québec. Thereafter, coverage is more difficult to obtain. For information about private insurance, contact the OmbudService for Life & Health Insurance (OLHI).
 
Pending receipt of your card, be sure to keep the letter indicating that you are subject to a waiting period, because some healthcare services are available free of charge to persons waiting for their coverage to take effect, such as services:
* needed by victims of conjugal or domestic violence or of sexual assault;
* related to pregnancy, child birth or termination of pregnancy;
* needed by people suffering from infectious diseases that have an impact on public health.

[Andrea838]

Hi sir Leon
Can you give more information or breakdown regarding the $43,000 that was charged to the mom who gave birth at BC? How come that big amount? I am planning to give birth in BC. Thanks

Was this a normal child delivery? Many thanks

[Leon]

She said she did not have complications as far as I recall.  She did not detail the amount.  She asked MSP and they said that when you pay yourself, the hospital charges you less than if MSP pays so if she would have paid herself, it might have been less.  However, MSP paid for her and they expected her to pay back what they had to pay on her behalf.

[Andrea838]

Ok thanks so much.

Is it ok if I ask you something. I am a resident of BC I file income tax yearly however I am abroad most of the time. Can I accept MSP premium assistance as I am unemployed. 

Am I a resident or non resident?

[Leon]

As far as I know, you must live in BC at least 6 months a year in order to keep your MSP coverage.  If you are gone more than that and they find out, you may lose your health care and you may possibly lose it retroactively because that is what happened to the lady with the 43,000$ bill.  She had arrived in BC, did her 3 month waiting time, got her health care but only stayed for 5.5 months total.  She returned to her home country, not knowing about the 6 month rule but continued to pay MSP premiums as she wanted to continue her coverage on her return.  She did not return again within the next 6.5 months, MSP found out that she left and so they decided that she was never eligible for MSP in the first place and back charged her.

[Andrea838]

Ok thanks Sir!!! I wonder how that huge amount came up. Thanks so much for assisting me. So they really do back charge clients.

Once again thank you!