Get on waiting list before OHIP coverage

[daveoh]

This is probably a bit of an unusual question.

I have dual citizenship with Canada and have been offered work in Toronto for next month. About a few weeks I was put on a waiting list in my home country for a non-emergency, but required surgery. Unfortunately in my home country the waiting list is very long (3-5 months or more). I understand the waiting period for OHIP coverage is 3 months.

So I was wondering whether it is possible for me to pay to see a doctor uninsured when I arrival and get a referral and get on a waiting list in Toronto. Then by the time surgery times come (I have heard waiting times in Ontario for this operation are pretty long too, over 3 months), would I be able to have the surgery covered by OHIP? Or would the fact that I sought treatment uninsured make the subsequent surgery uncovered?

While the condition is very unlikely to cause any emergency situations, it is very uncomfortable therefore I am hesitant to wait 3 months for OHIP then wait another 3+ months when on a waiting list.

Thank you.

 

[scylla]

There's nothing stopping you from going to see a doctor. You'll obviously have to pay out of pocket for the original doctor visit - as well as the visit with the specialist and any test that may be required.

 

[Leon]

As long as you are covered before the operation takes place, it should be covered. There is no such thing as pre-existing conditions with health care in Canada.

 

[daveoh]

Thank you both for the clarification. I was a little worried they wouldn't refer until OHIP coverage starts, but I'll be sure to see a doctor right away when I arrive, don't mind paying for the initial costs. The waiting list should be over 3 months minimum so think I'll be good.

 

[scylla]

Thank you both for the clarification. I was a little worried they wouldn't refer until OHIP coverage starts, but I'll be sure to see a doctor right away when I arrive, don't mind paying for the initial costs. The waiting list should be over 3 months minimum so think I'll be good.

Just to warn you - there may be an additional waiting time you aren't factoring into the calculation.

Typically you would go to a family doctor or walk-in clinic to get the referral to see the specialist. The specialist is the one who then typically puts you on a list for a procedure. (Although this can of course vary depending on the procedure.). If this is the process you're expecting, you may need to factor in a few more months of waiting time for the appointment with the specialist (i.e. once you are referred to the specialist it may take a few months to get an actual appointment). But as Leon said, once you're covered by OHIP then you're covered. Doesn't matter when you were referred or put on any list.

 

[daveoh]

Just to warn you - there may be an additional waiting time you aren't factoring into the calculation.

Typically you would go to a family doctor or walk-in clinic to get the referral to see the specialist. The specialist is the one who then typically puts you on a list for a procedure. (Although this can of course vary depending on the procedure.). If this is the process you're expecting, you may need to factor in a few more months of waiting time for the appointment with the specialist (i.e. once you are referred to the specialist it may take a few months to get an actual appointment). But as Leon said, once you're covered by OHIP then you're covered. Doesn't matter when you were referred or put on any list.

Yeah unfortunately I'm expecting that, because in my home country it did take nearly 2 months to see a specialist so I'm expecting a similar time frame for Canada. As long as I'll be able to get the ball rolling without any problems with OHIP down the line I should be ok waiting 5 months or so. Should things get worse I have considered traveling back to my home country briefly in 3 months when I'll reach the top of the waiting list there.

I'm a little worried about arriving without insurance because from what I've seen most insurers will understandably not cover pre-existing conditions. My doctor has told me the risk of a severe complication is pretty low within a year or two, but if something does go wrong then I will likely need emergency surgery. I guess I will have to weigh the benefits of accepting the job offer and moving to Toronto considering this, because a huge medical bill within the first 3 months would be a nightmare.

 

[Leon]

OHIP requires you to stay 5/6 months in Ontario after you move there in order to be eligible so if you do decide to travel back to your home country because you've reached the top of the waiting list there, make sure you don't stay there more than a month or you could be in trouble with OHIP about your coverage.