Leon Help me..regarding health coverage suspended and PR expiring before 720 day

[ranjitbuttar]

Hi Leon
I read through this topic and really appreciate you helping people.
I am also in need of your suggestion regarding my parents situation:
My parents came to Canada on 2008. That time I was studying and could not support them. So they used to travel to here in between in order to complete the 2 years out of 5 years. Last year, I got job and from beginning of this year they have been staying with me. However, they will not be able to complete 730 days before their PR card expires. They need another 3 months before they can apply for PR renewal. Another thing is during these years they were not able to complete 153 days each year (requirement for eligibility to OHIP). They used their OHIP card sometimes in this time. Only last year, they received letter from Ontario that their health cards have been suspended and they need to prove that they stayed 153 days out of 1 year. We still cannot figure out how they got to know about this as i know people who hardly lived in canada but still their OHIP cards are valid. However, luckily, I got job in Quebec last year and they moved with me. There they got quebec health card. But this year i moved back to Ontario. We talked with Kingston center responsible for my parents health case and they asked us to bring all documents of their stay. Only thing we had was passport stamps and we gave them the record of visits. Now its been 3 months my parents have been staying in ontario with me but when we talked with them, they again refused to provide health coverage saying that theres no adequate proof that they resided here for 3 months and asked us to go to review committee (who have more access to information and can give us health coverage) to fight against the OHIP kingstton guys decision. We are trying to get documents proving that they stayed here last 3 months which they actually stayed. only documents we have is phone bills on my dad name, my mom's visits to doctor using quebec card (as quebec covers for 3 months when u leave the state). I have been cautious now and have started building proofs (bank accounts, doctors visits, appointments, phone bills) so that after 3 months they dont refuse me again. Now, I am worried that since health guys know the record of my parents visits, can they report my parents to CBSA and tip them about my parents. I am very worried that they might ask my parents to leave. After much effort, i have been able to secure my job and now can support my parents. We see our future in this country which can be shattered by this. Do you think we need to pursue review committee. Basically my two concerns:
1. How to get health coverage again. do we need to wait another 3 months period. Can we apply from scratch again or have to go through those guys to get OHIP coverage again. I will be getting private insurance for them for the time we dont have OHIP coverage, which is quite costly.
2. Is there any danger to the PR of my parents. If we keep silent and dont push OHIP for OHIP coverage they might not go to that extent where they can report my parents to CBSA.
Please suggest us the way out.
Thanks in advance

 

[Leon]

I do not think OHIP will report them to CIC.

OHIP is however one of the most difficult health cares to get coverage from and of course it doesn't help that your parents used their OHIP in the past when they should not have. The OHIP card is surely valid for several years but it comes with conditions like living in Ontario for 153 days in your first 6 months and 183 days a year after that. If you don't meet those conditions, you lose your OHIP. Same is true for every other province as well. You lose your health care if you do not live in the province 6 months a year. You may still have a valid card but you do not have the right to use it. You should continue talking to OHIP to prove their stays in Ontario. That's all you can do.

You can order the CBSA exit/entry records to show that they did not leave or enter Canada. Maybe that will help.

They should not apply to renew their PR cards until they have at least 730 days in the past 5 years, even if they have to let their cards expire.

 

[ranjitbuttar]

Thanks Leon!
By above you mean my parents wont get OHIP ever if they failed to complete 153 days out of 1 year in the past? Like now they have been living here for 3 months and will be living here forever as I have job to support them. Can we go from scratch again and apply health card instead of review committee. We can wait 3 more months.

 

[Leon]

Thanks Leon!
By above you mean my parents wont get OHIP ever if they failed to complete 153 days out of 1 year in the past? Like now they have been living here for 3 months and will be living here forever as I have job to support them. Can we go from scratch again and apply health card instead of review committee. We can wait 3 more months.

They should be able to get an OHIP card if they truly live in ON but you may have to make good with OHIP and work out when they were inside and when they were outside Canada and when they actually lost their OHIP or should have and when they should have gotten it again. They may be back charged for what OHIP paid for them when they should not have been covered. Just tell the review committee that this was not done with any ill will. They truly did not know or realize that they should stay for a certain number of days per year to keep their OHIP, they just looked at the validity of the card.

 

[ranjitbuttar]

But like I said they were in quebec with me and had health card there.. That time we didnt know we would be returning to Ontario..but i got my job transferred here..We dont want to mess up with them in order not to lose permanent residency..Can we apply as a returning residents? My mom did go to doctor couple of times when they were in Ontario. And even she went to doctor one time when she was in quebec. I just spoke with OHIP and told them that they were in quebec and asked them if we can apply as returning residents. They were not happy with that and said now i have a different story. What if committee denies them health card too. Can they check with CIC as well?
Again is there a fear of losing the health card again. My parents dont have money to payback for health services they used or might have used. I am hardly supporting them. My dad did job for some time in quebec but he lost as we moved to ontario. Should i disclose to committee that we had been living there in Quebec. That way committee can say that my parents will be returning residents?

 

[Msafiri]

There seems to be 3 issues here:

1. PR Card renewal - wait till 730 days. You need to document your parents residence in Canada. They should apply for CBSA records but only at the 730 day mark.

2. Historic OHIP issues - Ministry of Health can follow this up and get your parents to pay back for 'non eligibility' periods.

3. Current OHIP issues - when you moved back to ON from Quebec then the Quebec provincial health card should have covered you for 3 months. Your parents should have applied for their OHIP cards submitting required documents as proof of status and ON residence. Did they do this and what did they submit? I know most health professionals outside Quebec don't accept Quebec health cards - they want you to pay and then claim the funds yourself...its hard getting their cash from La Belle Province I gather.

 

[ranjitbuttar]

Thanks alot Msafri..you are bang on target..thanks for refining the whole load of lines and put them in a nice way.
Exactly we have this situation. For sure, we will apply PR after we know we have 2 years of stay out of 5 years before the time of application.

We didnt know we would come back to Ontario so never replied to their letter sent out to my parents last year when they were in ontario. Yes they had health cards there in Quebec which covered my parents in ontario for these last 3 months. Now when we came back 3 months ago we talked with OHIP about those letters and didnt tell them about quebec. That time they asked us to provide documents to prove 153 months of stay. We said we dont have sufficient proofs and will come up after 3 months. That time they asked us to go to review committtee which we didnt. We thought by proving them that my parents stayed here atleast 3 months they can be eligible again for OHIP. Now after 3 months, we went back to them and they still said we dont have sufficient proofs and they reffered us to committee. Since its hard to prove my parents stay. We now thinking that we dont go to committe and stay here for about 3 months more and then apply. I have started building documents for that as well. My parents will be staying here now forever so we just want to have proofs for their long stay and then apply again. I dont wnat to escalate things to committe etc. who can probe into entry/exits and tip cic....My parents just went once or twice to doctor for medicine. we are still wondering who give OHIP the information. I know hundreds who have lived more than a year continuously and still their health cards are not suspended.

 

[on-hold]

If there use was so minimal, why not pay it back right away and clear the air?

 

[ranjitbuttar]

Addition to my above comment: It seems like we have the option of going to OHIP service center and reapply when we have 3 months stay proofs. Are they going to refer to that ongoing case with ministry? is 3 months wait period valid for my parents whose health cards have been cancelled and they have been asked to go to committee to fight against it. We chose to reapply after some time and not go to committee.

Regarding health services used, even with a fever here going to walk-in clinic one time visit costs 500 $ easily..my parents rather go to their back country for most of checks up as its very fast there and less expensive...here they had to go couple of times...they need OHIp insurance to be on safe side..no body uses OHIP for any ill will or play with it..

 

[on-hold]

I'm just pointing out that you are arguing both sides:

1) your parents only went a couple of times, no big deal

2) but they're not going to pay it back

Government programs are contracts between society and its citizens, they come with conditions. If the conditions aren't fulfilled, either side can appeal; that's what's happened here, your parents broke a contract. It's unlikely OHIP actually cares about the theft of services; but I suspect they will keep a record and require payment before enrolling your parents again. Meanwhile, if your parents are over 50 and living without health insurance, you are risking a much large financial calamity by delaying while you try to figure out how to avoid the bill.

 

[ranjitbuttar]

Thanks for your replies and time...like i said if the bill is around 5K for both it wont be possible for us to pay them back..I am the only earning hand and i guess in canada I am not supposed to pay for my parents services...they are dependent on me though my father got some jobs in between and is actively searching one....can they seize their bank account ...what can they do in order to get money from them...my parents are healthy..unless they paid them back for the used health services, they cannot again get OHIP coverage?

 

[on-hold]

Thanks for your replies and time...like i said if the bill is around 5K for both it wont be possible for us to pay them back..I am the only earning hand and i guess in canada I am not supposed to pay for my parents services...they are dependent on me though my father got some jobs in between and is actively searching one....can they seize their bank account ...what can they do in order to get money from them...my parents are healthy..unless they paid them back for the used health services, they cannot again get OHIP coverage?

I really have no idea, you'd have to ask a lawyer. But simplest of all would be to ask OHIP -- after all, they are aware of the situation. Ask them what they're going to do. As for you not being supposed to pay for your parents, that is not true; you don't have to if you don't want to, but OHIP doesn't care who pays.

As for seizing bank accounts, I don't know if they would do that, but I'm sure they can; government programs in Alberta often check bank accounts to audit eligibility, and they look backwards some distance. People who remove resources to become eligible are discontinued, and required to pay back what they've received already.

 

[Leon]

OHIP historical issues is something they have to deal with no matter where they are living. If OHIP sent them a letter last year wanting to clarify things, you should not have ignored that.

It needs to be cleared up when they were living in ON, when they should have lost their OHIP and possibly when they would have gotten OHIP again if they had done everything by the book. OHIP may then ask that they pay for visits that happened when they should not have been covered. If you say your mother went to the doctor only a couple of times, she will not be asked to pay anywhere near 5k for that. However, in order to find out, you must talk to OHIP. There is no avoiding that. Ignoring the issue may result in OHIP denying them coverage because they have not dealt with these issues, accusing them of having purposely tried to defraud OHIP by not informing them about leaving ON and/or single handedly deciding that they were never covered in the past and should pay back for all the services they have received.

You should make sure you tell them that they had no ill will or fraud in mind. That you were all simply naive and that you had no idea that they had to stay 153 days in their first month and 183 days a year after that and you also had no idea that you had to inform them to cancel the OHIP when they left Canada for extended periods of time and when you moved to Quebec. OHIP may or may not believe you. After all, you did ignore their letter last year. However, if you wish to get coverage in the future for them, you need to clear things up for the past.

Even if they (and you) move to Quebec again and get coverage there again, it will not protect you from potentially getting a back charge from OHIP.

 

[ranjitbuttar]

Hi Again

In the letter received from OHIP, they said "you health card and eligibility have been cancelled". They gave us the option to request review of this decision to OHIP eligibiltiy review committee. Please address following:
1. They have not talked about payback of services used. Are they going to look into my parents case again for payback.
2. Can we rather go to Ontario service center and apply from begining? Are they going tp process our request or they will say that my parents wont be able to apply from here as long ?
3. Should we go to review committee and tell them that they had been quebec for some time. This way can they tell us to apply from begieining here?
Thanks!

 

[on-hold]

Hi Again

In the letter received from OHIP, they said "you health card and eligibility have been cancelled". They gave us the option to request review of this decision to OHIP eligibiltiy review committee. Please address following:
1. They have not talked about payback of services used. Are they going to look into my parents case again for payback.
2. Can we rather go to Ontario service center and apply from begining? Are they going tp process our request or they will say that my parents wont be able to apply from here as long ?
3. Should we go to review committee and tell them that they had been quebec for some time. This way can they tell us to apply from begieining here?
Thanks!

Well, I'm not a legal or administrative expert, but I would guess the following:

1) They might still be pursuing payback. Time will tell, you could settle this by asking them.

2) I don't think you could apply from the beginning -- according to the letter you received, your parents' eligibility for OHIP has been permanently revoked.

3) I don't think Quebec has anything to do with it -- to get OHIP, you are going to have to go through OHIP, and they have a file on your parents that says they are not eligible for OHIP.

4) You should appeal this decision. Request a hearing, ask if you pay back the services that you used illegally, will they reinstate your parents' eligibility? This would be very desirable -- it's the only way they are going to get government health insurance in Ontario again.

At least, that's how I read it. My apologies if what I've written here is incorrect.