Ontario’s Out-of-Country Emergency Medical Coverage Is Officially No More

As of January 1, 2020, the Ontario Health Insurance Plan (OHIP) no longer covers Ontario residents when they're travelling abroad. If you want coverage while you're outside the country, you'll need to ensure you have your own travel insurance coverage in place.

Why Did Ontario End Out-of-Country Coverage?

In its 2018 annual report, Ontario's Auditor General stated the Ministry of Health and Long-Term Care spent $2.8 million to administer $9 million in claims for emergency services outside of Canada. On average, payouts amounted to only $127 per claim. The high administration costs and low payouts made the program seem unattractive and inefficient. In the annual report, the Auditor General suggested simplifying the administration of out-of-country claims. The government responded by eliminating the claims process entirely.

When announcing the change, the Ontario government claimed the “change will have no impact on 99.5% of Ontarians. OHIP data suggest of those 40,000 Ontarians who do travel outside of Canada each year and require health services, over 90% obtain private travel health insurance."

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The Canadian Snowbird Association Challenges Decision in Court

In response to the new regulations, the Canadian Snowbird Association (CSA) has filed a legal challenge to Ontario's new health insurance restrictions. The CSA argues the new rules are an "egregious violation" of the Canada Health Act's portability requirement, which holds that the government must continue to cover Canadians who are temporarily outside their home province. These new restrictions wouldn't only affect people flying across the world for vacation, but also people shopping or visiting family across the border in the United States. The CSA notes that Ontario is the only Canadian jurisdiction to terminate all emergency funding for travelling residents.

Exception: Some Dialysis Costs are Still Covered

In response to criticism from residents with kidney disease who claimed finding independent coverage would make travelling too expensive, the government introduced a new program that helps travellers requiring dialysis. The government will cover up to $210 of kidney dialysis costs incurred abroad—the same amount originally covered under OHIP’s now defunct out-of-country coverage. Ontario's government will provide $700,000 per year to the Ontario Renal Network to administer the reimbursement program.

Why You Need Travel Insurance

The new OHIP rules make purchasing your own travel insurance more important than ever. Out-of-country emergency health care costs can run into the thousands of dollars even for something as simple as a broken arm.

According to David Jensen, the Ministry of Health and Long-Term Care spokesperson, "The government has always strongly encouraged individuals to purchase additional travel health insurance so they are adequately covered every time they leave Ontario to travel abroad."

Travel insurance is also a great way to guard against travel problems that aren't health-related. Depending on your plan, travel insurance can reimburse you for lost baggage, delayed flights, and even cancelled trips. Compare the best travel insurance policies in Canada to find a plan that works for you.

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