As of January 1, 2020, Ontarians have lost the majority of their out-of-country (OOC) insurance coverage through OHIP. All OOC coverage for medical emergencies, with an exception for dialysis services, have been scrapped because this coverage was deemed “irresponsible use of taxpayer money” as highlighted by Health Minister Christine Elliot. She adds that the program did "little in the way of providing meaningful travel coverage," since it only covered a daily maximum of $400 for inpatient treatments, with an additional $50 per day for emergency outpatient services.

Impact on Premiums

There has been a lot of speculation about how this would affect existing travel benefit premiums. Luckily, Beneplan is happy to note that this out-of-country change will not affect premiums for plan sponsors (or at most, change will be negligible).

Claims Submission Moving Forward

Submitting claims for emergency services incurred out of country will work as follows:

• The ministry will reimburse eligible claims incurred up to and including December 31, 2019. Claims for emergency services incurred up to December 31, 2019 must be submitted no later than December 31, 2020.
• Any OOC emergency services that are incurred on or after January 1, 2020 will not be eligible for reimbursement by OHIP. Instead moving forward they will now be submitted to your insurer (Greenshield/Co-operators) under your Group Benefits plan.

To learn more about this change, please contact us or speak with your plan advisor.