Pre-existing condition health coverage

[Irfyg]

Hello all,

My wife has received her COPR (out-land application) and will be moving to Toronto, Ontario, where she will be moving in with me (Canadian Citizen).

We are concerned with regards to the 3 month window of OHIP, as she has a chronic corneal condition and is on numerous daily prescribed eye drops, as well as needs regular (bi-weekly) check-ups with specialist consultants.

As you can imagine, this can very easily break the bank and we're worried that there really is no way around this. I've gone to numerous insurance companies, yet none of them will accept her due to her not meeting the "stable for x amount of days" (her frequency of applying one drop or the other changes almost monthly).

Anybody have any insight to a similar situation or circumstance, that may be able to provide some enlightenment?

 

[scylla]

It's unlikely there is a way around this - apart from paying for all health care costs out of your own pocket for the first three months.

Insurance companies aim to make a profit. So they aren't going to approve a policy which they know out the gate will cost them more than the premiums you pay. It's possible you may be able to find some sort of specialized insurance that will cover this care - however you should expect the premiums will cost you more than the cost of the base care she needs.

 

[Rob_TO]

There is zero chance OHIP will waive 3 month waiting period.

And as mentioned, no insurer will give you a policy on a pre-existing condition where it's guaranteed they will pay out so much in claims.

As i see your only 2 options are:
1. Budget and pay for everything out of pocket for first 3 months until OHIP kicks in.
2. Occasionally return back to her home country for the treatments and checkups if it's cheaper or she's covered there. Just make sure she doesn't leave long enough (30 days cumulative) to void the OHIP waiting period.

 

[Irfyg]

It's unlikely there is a way around this - apart from paying for all health care costs out of your own pocket for the first three months.

Insurance companies aim to make a profit. So they aren't going to approve a policy which they know out the gate will cost them more than the premiums you pay. It's possible you may be able to find some sort of specialized insurance that will cover this care - however you should expect the premiums will cost you more than the cost of the base care she needs.

Yeah, it seems I'm going to have to pay it all out of pocket for the 3 months.

 

[Irfyg]

There is zero chance OHIP will waive 3 month waiting period.

And as mentioned, no insurer will give you a policy on a pre-existing condition where it's guaranteed they will pay out so much in claims.

As i see your only 2 options are:
1. Budget and pay for everything out of pocket for first 3 months until OHIP kicks in.
2. Occasionally return back to her home country for the treatments and checkups if it's cheaper or she's covered there. Just make sure she doesn't leave long enough (30 days cumulative) to void the OHIP waiting period.

You're right, I've combed through the Health Act, as well as contacted Service Ontario - Absolutely no chance of waiving this under the few exemptions they have.

 

[scylla]

You're right, I've combed through the Health Act, as well as contacted Service Ontario - Absolutely no chance of waiving this under the few exemptions they have.

OHIP definitely won't make an exception. That was a non-starter from the beginning.

Your only possible option is to find private insurance. But again, I think you can expect the costs of that insurance to exceed your known expenses.

 

[Rob_TO]

You're right, I've combed through the Health Act, as well as contacted Service Ontario - Absolutely no chance of waiving this under the few exemptions they have.

Alternatively, if you can instead move to a province that doesn't have a waiting period (like Alberta) and commit to staying there at least 6 months, then you would be covered for healthcare immediately upon landing.

 

[lotuslover]

Sort of similar question, if a 27 year old has hypertension (high blood pressure) and is on medication, can he clear the medical test ?

 

[scylla]

Sort of similar question, if a 27 year old has hypertension (high blood pressure) and is on medication, can he clear the medical test ?

Difficult for any of us to judge. It would depend on why the blood pressure meds are needed (i.e. what is the underlying condition causing the high blood pressure).

 

[yodheydhara]

Hi All,
I will be arriving in Ontario later this month. I understand that the OHIP card will take about 3 months to come. So, in the meantime, I am planning to purchase private insurance. Any recommendations on which insurance company to go for?

 

[Steevy]

Hi All,
I will be arriving in Ontario later this month. I understand that the OHIP card will take about 3 months to come. So, in the meantime, I am planning to purchase private insurance. Any recommendations on which insurance company to go for?

Depending on your age, preferences for coverage, deductible and whether or not you have any pre-existing medical issues you should be able to find quite a few options. Private insurance for newcomers to Canada will cover the costs for medical emergency care i.e. treatment of unexpected sicknesses or injuries. It does not cover non-emergency situations i.e. routine check-ups or an ongoing treatment for a medical condition (if you have any).

If you are around 30-35 y.o., then on average prices will range from $150-300 for a policy for around 90 days.

You can take us an online insurance calculator to see what options are available and get a personal quote - Insurance for Newcomers to Canada

 

[yodheydhara]

Depending on your age, preferences for coverage, deductible and whether or not you have any pre-existing medical issues you should be able to find quite a few options. Private insurance for newcomers to Canada will cover the costs for medical emergency care i.e. treatment of unexpected sicknesses or injuries. It does not cover non-emergency situations i.e. routine check-ups or an ongoing treatment for a medical condition (if you have any).

If you are around 30-35 y.o., then on average prices will range from $150-300 for a policy for around 90 days.

You can take us an online insurance calculator to see what options are available and get a personal quote - Insurance for Newcomers to Canada

Thanks Steevy, this is helpful!!

 

[yodheydhara]

Thanks Steevy, this is helpful!!

Is vision included in the health insurance in general or like US, it is separate?

 

[Steevy]

Is vision included in the health insurance in general or like US, it is separate?

Eye care coverage is usually a part of an extend heath benefit plan for Canadian residents with an active provincial insurance coverage.