Health card for New Immigrant (OHIP) for Ontario

[MapleLeafBride]

O ok.... Thanks for ur reply.... I had no idea that was the case..... cuz they never asked at any time if she had OHIP

If she's just going in for a dental cleaning, would she have to be on OHIP? They don't cover anything that's done in a dental office.

From the Health Services website: "The ministry pays for some dental surgery, when it is done in hospital. You must pay the cost of regular dental services in a dentist's office."

 

[screech339]

O ok.... Thanks for ur reply.... I had no idea that was the case..... cuz they never asked at any time if she had OHIP

Who's they? The insurance company or your work?

My work company told me that my wife couldn't go on company benefits until she is on OHIP. They knew my situation with my wife awaiting PR.

In your case, they probably didn't ask because they assumed she is on OHIP.

 

[screech339]

If she's just going in for a dental cleaning, would she have to be on OHIP? They don't cover anything that's done in a dental office.

From the Health Services website: "The ministry pays for some dental surgery, when it is done in hospital. You must pay the cost of regular dental services in a dentist's office."

Even for dental cleaning, she is required to be on OHIP. Most dental benefits do include coverage for cleaning usually 80-90%. So as long as she will get coverage from work benefits, she has to be on OHIP.

Honestly I never heard of a dental work benefit that doesn't provide coverage for cleaning. What's the point of having dental benefits if it doesn't provide coverage for basic services. If your work dental benefits doesn't cover basic services as cleaning then you got a very sh*tty work dental plan.

 

[MapleLeafBride]

Even for dental cleaning, she is required to be on OHIP. Most dental benefits do include coverage for cleaning usually 80-90%. So as long as she will get coverage from work benefits, she has to be on OHIP.

Honestly I never heard of a dental work benefit that doesn't provide coverage for cleaning. What's the point of having dental benefits if it doesn't provide coverage for basic services. If your work dental benefits doesn't cover basic services as cleaning then you got a very sh*tty work dental plan.

I was just curious how it all works. My quote was from the OHIP page, not any provider. Since OHIP has nothing to do with going to the dentist, I wasn't sure if the work plan would even look into whether or not sure had provincial health insurance (at least in this case). My husband isn't on my plan since he's not in Canada yet, but it's good to know for when he does arrive.

 

[screech339]

I was just curious how it all works. My quote was from the OHIP page, not any provider. Since OHIP has nothing to do with going to the dentist, I wasn't sure if the work plan would even look into whether or not sure had provincial health insurance (at least in this case). My husband isn't on my plan since he's not in Canada yet, but it's good to know for when he does arrive.

Even though dental care are not covered under OHIP, it is covered only under medical emergency if it threatened your life, for example, major surgery needed from an accident (car accident).

Even eye glasses are not covered by OHIP. Hearing aids expenses are not covered by OHIP. These things are covered by work benefits.

 

[Rob_TO]

If she's just going in for a dental cleaning, would she have to be on OHIP? They don't cover anything that's done in a dental office.

Usually the employer insurance company makes it all or nothing. If you have OHIP you are entitled to all benefits, if you don't have OHIP you aren't entitled to anything. Insurance can't pick and choose which benefits are partially covered by OHIP and which aren't, as it would be too difficult to manage. Easier to just say you get nothing.

I had this same issue with my wife. As soon as we became common-law I added her to my work benefits the same day. I had no clue about requiring OHIP, and they never asked for her OHIP number and just added her no questions asked.

I only found out because at one point we were travelling and she claimed an out-of-country medical expense through my work benefits. They payed the claim, but then sent a form asking for her OHIP info (since OHIP will pay partial payment for out-of-country medical costs). So I called in and asked a "hypothetical" question of what would happen if someone didn't have OHIP, and they said they could not be covered at all, period.

It was over a year later before she landed as PR and did the 3 month waiting period, and during that time we made tons of claims. Luckily for us, they never checked.

 

[screech339]

The funny thing about it all was that the insurance company allowed me to get "optional life insurance" for my wife but not dental/vision/ etc benefits. I guess the insurance doesn't care about that since it's me that pays for the benefits not them.

 

[amjad1002]

got it and thanks yes i call OHIP and they told me apply your card on second landing not first landing.

 

[amjad1002]

Ahh i see. I still use the old-fashioned red & white OHIP card that has no photo and never needs to be renewed

but if the person leave out side of Canada for long time he or she have to reapply for new photo card so red and white card will be replace with new one.

 

[MapleLeafBride]

Usually the employer insurance company makes it all or nothing. If you have OHIP you are entitled to all benefits, if you don't have OHIP you aren't entitled to anything. Insurance can't pick and choose which benefits are partially covered by OHIP and which aren't, as it would be too difficult to manage. Easier to just say you get nothing.

I had this same issue with my wife. As soon as we became common-law I added her to my work benefits the same day. I had no clue about requiring OHIP, and they never asked for her OHIP number and just added her no questions asked.

I only found out because at one point we were travelling and she claimed an out-of-country medical expense through my work benefits. They payed the claim, but then sent a form asking for her OHIP info (since OHIP will pay partial payment for out-of-country medical costs). So I called in and asked a "hypothetical" question of what would happen if someone didn't have OHIP, and they said they could not be covered at all, period.

It was over a year later before she landed as PR and did the 3 month waiting period, and during that time we made tons of claims. Luckily for us, they never checked.

Thanks for clarifying this for me, Rob_TO! It's very helpful to hear about people's direct experiences. I will hold off adding the hubby until he gets OHIP. And probably remind him to get a dental cleaning before leaving the US

 

[truesmile]

Even for dental cleaning, she is required to be on OHIP. Most dental benefits do include coverage for cleaning usually 80-90%. So as long as she will get coverage from work benefits, she has to be on OHIP.

Interestingly in my case, my wife has close to $1,000 in dental claims (through my work plan) PRIOR to getting OHIP. Her first couple of appointments (her first in I don't know how many years) were real whoppers!

 

[screech339]

Interestingly in my case, my wife has close to $1,000 in dental claims (through my work plan) PRIOR to getting OHIP. Her first couple of appointments (her first in I don't know how many years) were real whoppers!

Then you got lucky that the insurance company never caught on, otherwise paying back the money would be a real whopper.

 

[truesmile]

Yeah, I'd be sending them up our HR departments ass. I was upfront and explained EVERYTHING to them ahead of time. They even had to follow up with me later to go ask someone else (maybe the insurance company).

 

[sussdawg]

Dear forumites, I applied for health card yesterday but I landed 30th may 2014. So m almost due for waiting period of 3 months. I was also given a paper stating that my coverage starts from the first of July to expire in 2020. however, i might b travelling sometime next month to return in about 6months and then settle finally. I will still remain in my address. They also said my card will b mailed to me.

Now, that I have applied. Do u think I have made the right decision?If No, what do I Do?

I appreciates ur responses.

 

[Rob_TO]

Dear forumites, I applied for health card yesterday but I landed 30th may 2014. So m almost due for waiting period of 3 months. I was also given a paper stating that my coverage starts from the first of July to expire in 2020. however, i might b travelling sometime next month to return in about 6months and then settle finally. I will still remain in my address. They also said my card will b mailed to me.

Now, that I have applied. Do u think I have made the right decision?If No, what do I Do?

You should read here: http://www.health.gov.on.ca/en/public/publications/ohip/ohip_eligibility.aspx
- you make your primary place of residence in Ontario; and generally,
- you are in Ontario for at least 153 days of the first 183 days immediately following the date you establish residence in Ontario (you cannot be absent for more than 30 days during the first 6 months of residence); and
- you are in Ontario for at least 153 days in any 12-month period.

Sounds like you will not be in Ontario for 153 days (5 months) out of first 6 months after you landed. So you should expect that when you come back to Canada 6 months later, you will need to do a waiting period again of 3 months before you have OHIP.