OHIP Maternity Coverage

[Aim high]

Hi ,

I have done a lot of research but I would like to know from new immigrants who are already in Ontario. I will land on 3/05/2019 and I know the waiting period will be from the day I have landed. So, let's assume my waiting period gets over by 3/08/2019.

Once I am eligible to avail OHIP services can my wife conceive within the first month of coverage or should we wait for a month or so to get the maternity coverage completely. Moreover, I have heard that the medical system is a disappointment with regards to any consultation (for eg - if we are injured the doctors do not attend us immediately the appointment can be given to us after few hours/weeks or maybe a month.

My concern is do they treat pregnant ladies in this manner as well? If yes, so should I get private health insurance for my wife?

Looking forward to genuine suggestions mates.

Thank you

 

[Copingwithlife]

Hi ,

I have done a lot of research but I would like to know from new immigrants who are already in Ontario. I will land on 3/05/2019 and I know the waiting period will be from the day I have landed. So, let's assume my waiting period gets over by 3/08/2019.

Once I am eligible to avail OHIP services can my wife conceive within the first month of coverage or should we wait for a month or so to get the maternity coverage completely. Moreover, I have heard that the medical system is a disappointment with regards to any consultation (for eg - if we are injured the doctors do not attend us immediately the appointment can be given to us after few hours/weeks or maybe a month.

My concern is do they treat pregnant ladies in this manner as well? If yes, so should I get private health insurance for my wife?

Looking forward to genuine suggestions mates.

Thank you

You’d purchase private insurance for the period you’re not covered by OHIP, which typically covers emergencies, not routine visits , then after the waiting period OHIP kicks in.
Don’t understand the question re purchasing private insurance thereafter. The medical system isn’t set up that way . OHIP covered versus private . If you need to see a specialist typically the primary caregiver will refer you , you then get an appointment. But if you’re expecting an appointment with a specialist same day , tomorrow, you’ll be sorely mistaken

 

[Aim high]

You’d purchase private insurance for the period you’re not covered by OHIP, which typically covers emergencies, not routine visits , then after the waiting period OHIP kicks in.
Don’t understand the question re purchasing private insurance thereafter. The medical system isn’t set up that way . OHIP covered versus private . If you need to see a specialist typically the primary caregiver will refer you , you then get an appointment. But if you’re expecting an appointment with a specialist same day , tomorrow, you’ll be sorely mistaken

Thank you so much @Copingwithlife , God bless you

 

[APPNOV2014NY]

You won't get any private insurance to cover pregnancies. Try to get good family doctor who refers your wife to gynecologist ( once she is pregnant) after 3 months ( standard). Few family doctors don't refer to gynecologist until 5th-6th month.

 

[kprs_ind]

There's one insurance which covers for pregnancy, but it has its own conditions.
From your message it does not look that your wife is currently pregnant. Why are you looking specifically to cover pregnancy?

 

[21Goose]

I have very recent personal experience of this entire process!

My wife and I moved in October 2017, and we learned she was pregnant in February '18. We had already qualified for OHIP in January, but we didn't have a doctor yet - a GP, not a specialist.

Finding a doctor was pretty easy. The Government of Ontario helps find a doc if you're pregnant - they have a helpline you can call, and a registered nurse will give you various options in your neighborhood. In addition, most clinics and physicians will accept you even if they are not currently accepting patients.

We went with a good clinic that was pretty close to where we lived. We found it on our own. We had a list of other clinics that the nurse had given us, but we didn't need those in the end. It took us just a week of looking.

Once we'd registered, everything else went very smoothly. The doctor was very nice and he started the ball rolling by scheduling the first set of blood tests. He told us that he would be monitoring us for the first few weeks, and at the same time reaching out to various maternity hospitals to get us a specialist. Again, this was a collaborative process. He made a few recommendations, and also asked us which hospital we'd prefer.

We wanted to go to Sunnybrook as our first choice, followed by Mt.Sinai, and then Michael Garron. We knew that Mt.Sinai only really took high risk pregnancies, but we really wanted to go to Sunnybrook.

He took our preferences and added one more, and then faxed the hospitals. A week later we had our answer - we would be delivering at Sunnybrook.

Our first appointment with the Ob-gyn was in early May. Through March and April we met with our GP a few times (I think it was once every three weeks) and he monitored things like weight, answered any questions, and generally was very supportive. We never felt like we didn't have great care.

Once we went to Sunnybrook (early May), our care shifted to our Ob-gyn. We had a great doctor at Sunnybrook who really took care of my wife through the whole process. The pregnancy was relatively uneventful and we had to do the usual set of check-ups, sonograms, etc.

The only slight hitch was at the time of delivery where we had to have an emergency C-section. Everything went well and our son was born in Oct. 18.

All through this process, we only had to pay for :

1. Parking at Sunnybrook - buy the multiple pass. Parking is expensive ($20 or so for a few hours).
2. Prescription Medicines - Thyroxine, and some pills to help with morning sickness. Total cost was less than $300. We had insurance that paid 80% of this.
3. Non-prescription - vitamins, tums, etc. Just over the counter stuff, cost less than $200 in total. Insurance didn't cover this.
4. Private Room at Sunnybrook: Cost was $400, insurance paid half of that.

We didn't have to pay for anything else. The total cost of the pregnancy was less than $1000, and at no point did we feel that we weren't getting world-class care.

 

[APPNOV2014NY]

4. Private Room at Sunnybrook: Cost was $400, insurance paid half of that.

Was this insurance through your employer?

 

[21Goose]

Was this insurance through your employer?

Yes. Even without the insurance, though, it was eminently affordable.

 

[canuck78]

All depends where you live. For example the hospitals in Peel region are usually full. When going for OB appointments you may have to wait for an hour. That is because one doctor in the practice can be called to deal with deliveries at the hospital. In general Canada does maternity care and cancer well. But all depends on the area. If you expect no wait times throughout the system it’s not going to happen. Wait times may be from a month to a year. If you go to an ER you will likely be there for at a minimum 6 hours so only go if it’s an emergency. As @21Goose has mentioned not everything is free. If you think you will be getting a job with benefits wait until then to get pregnant. You will have coverage for medication, semi-private or private hospital rooms, etc. If your wife wants to receive maternity payments she must work 600 hours this year to qualify. In general getting hired when already pregnant is more difficult. You also can get really sick especially at the beginning of a pregnancy so best to start a job and get past the probationary period in my opinion. No point in getting private insurance because it doesn’t give you faster access, Ontarians will get priority.

 

[canuck78]

Yes. Even without the insurance, though, it was eminently affordable.

Glad you mentioned there are some expenses because many think that everything is covered.

 

[canuck78]

One more suggestion. When planning for a pregnancy you should focus less about when you have coverage and more about when you have full-time jobs with decent pay, have secured accommodations, saved a bit in case you have to take time off during the pregnancy and to prepare for the costs of having a child in Canada (even the basics like diapers). It is better to get a feel for your new home before jumping into a pregnancy. Some people get lucky and have a very easy pregnancy but others have tons of medical problems and even get hospitalized. It is very hard to take time off when you first start a new job for either of the spouses. Maternity benefits are only a fraction of your normal salary (in most cases) so most need to save to prepare for maternity leave.

 

[Buletruck]

I think that there is a bit of a misconception that because there are situations where patients in Canada don't get immediate attention (and whine to the press) when they feel they need it, that those who are in critical need may have to wait. This isn't the case. Based on personal experience in situations where care was needed for life threatening or critical illness, the response from the health care system is nearly immediate. If you have a cold and show up in emergency, expect to wait an extended period....if you have life threatening cancer or are suffering a heart attack, they treat you NOW! The guy with the cold can wait.

 

[canuck78]

I think that there is a bit of a misconception that because there are situations where patients in Canada don't get immediate attention (and whine to the press) when they feel they need it, that those who are in critical need may have to wait. This isn't the case. Based on personal experience in situations where care was needed for life threatening or critical illness, the response from the health care system is nearly immediate. If you have a cold and show up in emergency, expect to wait an extended period....if you have life threatening cancer or are suffering a heart attack, they treat you NOW! The guy with the cold can wait.

Our system deals well with acute illnesses and cancer well. Basic health issues as well including maternity care. If you have a chronic condition or something complicated it can take a while. I have been waiting since October to see a GI specialist with no appointment in sight. That doctor isn’t accepting new patients but made an exception for me. Waited 6 months for my other GI specialist. I would be on the serious side of issues and my doctors tried to push to get me into see GI specialists faster. I am not complaining I am thankful but I am also the one directing my own care. Luckily I am competent enough to do it. There is also the issue of finding a bed. In many hospitals that is the biggest issue and it is only getting worse. Seniors or those who are medically fragile get stuck in hospital unable to be discharged with no rooms available in long term care. It is only getting worse as the population ages. When I hear PGP numbers increasing dramatically I wonder how the areas will be able to absorb even more seniors.