Toronto residents are fortunate in that they have access to what is often referred to as the best health care system in the world. A big part of that system is the Ontario Health Insurance Plan (OHIP). 

Ontario Health Insurance Plan coverage means that Torontonians do not have to pay for a long list of health related services. Without OHIP, many people would not be able to afford the care they need.

This does not mean that if you are visiting Toronto you have free access to everything health related. Normally you have health coverage if you are a Canadian citizen, permanent resident, landed immigrant or a person registered as an Indian under the Indian Act. If you are visiting the city on vacation, you do not have access to OHIP cards. 

Someone using an OHIP card that is not theirs can be charged with fraud. The province’s Ministry of Health and long term care is constantly investigating potential cases of fraud so it is almost impossible to fool the system. 

Health care fraud is taken very seriously here. If you are convicted of health care fraud you could face up to 10 years in prison.

Torontonians appreciate and value the significance of OHIP. Most residents carry their OHIP card with them wherever they go. They require the cards for doctor’s appointments or any scheduled tests they might have. 

Although they hope they don’t face any sudden emergencies, they are comforted in knowing that the card is always with them should the need arise. If you do forget to take your health card with you to an appointment or just don’t have it when there is an emergency situation, you may be charged for the service.

You can be reimbursed for the service at a later date if you can prove that you were covered by OHIP at the time the service was provided. In many cases like this, the health care provider will ask that you fill out special paperwork called a Health Number Release Form. 

This gives the Ministry of Health your permission to provide the health care provider with your OHIP number. This is one of many safety measures put in place to protect your privacy, as well as the proper use of each and every OHIP card.

OHIP coverage becomes effective approximately 3 months after you start living in Ontario. For this reason new residents should purchase private health insurance just in case they become ill during the time they are waiting for their OHIP to come into effect. As the saying goes, “better safe, than sorry”.

Getting OHIP

If you have recently moved to Toronto or are planning to make a move to the city, here is how you get an OHIP card: go to an accredited OHIP office, fill out a registration form, and provide documents such as proof of citizenship, proof of residency and proof of identity. To find a registration office call ServiceOntario INFOline. You can find more information if you click here.

OHIP Changes

If your name changes due to marriage or divorce, it is your responsibility to make sure your health card is updated. You can address these changes through the OHIP registration office if you have the proper documents with you. 

For example, if you are recently divorced then you have to have the divorce certificate with you and fill out an information form to have the name on your card changed.

If you move from one residence to another, the Ministry of Health and long term care must be informed. In this case you can change your address online or send a letter to your local OHIP office.

From time to time the provincial government makes adjustments to OHIP so it is a good idea to review the rules and regulations at least once a year. 

What OHIP Pays

OHIP pays for a wide range of health related services, including most of the basic medical and emergency services. It can pay for all of a particular service or procedure, or part of it. Below are some examples.

  • General Practitioners 
  • Podiatrists
  • Chiropractors
  • General Emergency visits
  • Dental services in hospitals

The best advice is to talk to health care professionals first to find out if their procedure or treatment is covered by OHIP. Keep in mind that services that are not needed from a medical perspective, such as cosmetic surgery, are not covered by OHIP.

For more information on OHIP and the health care system in general, visit www.health.gov.on.ca.

For more information on Canada Healthcare, browse more of Totally Toronto.