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OHIP Changes In 2020

Happy New Year everyone! It’s a new year and its important for Ontarians to be aware of key provincial changes to the Ontario Health Insurance Plan (OHIP) including one that has implications for Ontario travellers travelling outside Canada – as of January 1, 2020, the OHIP no longer covers any portion of out-of-country medical expenses.

Some of the changes to OHIP include:

  • De-listing imaging for most sinus problems
  • Loop recorders used for the monitoring of heart disorders will no longer be covered as the physician-led group claims the devices are an outdated form of technology
  • OHIP will continue to fund more effective testing to diagnose infertility, but post-coital testing of cervical mucous will no longer be covered
  • Patients who ask their doctor to remove ear wax when it’s not medically necessary may be required to pay
  • Dipstick urine pregnancy tests performed in a physician’s office will only be covered by OHIP when its imperative to determine pregnancy to prevent patient harm
  • Physician premiums for house calls will be only be covered for frail and housebound individuals
  • As of January 1st, 2020 Ontario residents will no longer be eligible for up to $400 per day for out-of-country hospital care.

The Changes are adirect result of recommendations from a physician-led group reviewed coverage for OHIP insured services. In August, 2019, the group delivered 11 recommendations regarding tests and procedures to the Ontario Health Minister. The decision to cut OHIP for Ontario travellers outside Canada was made independently by the provincial government and was not part of the recommended changes by the physician-led group.

For additional details please review the following Porvincial Government websites:

OHIP for Travellers: http://www.health.gov.on.ca/en/public/programs/ohip/outofcountry/travellers.aspx

OHIP when temporarily outside Canada : https://www.ontario.ca/page/ohip-coverage-while-outside-canada

OHIP Out of Country Prior Approval Program: http://www.health.gov.on.ca/en/public/programs/ohip/outofcountry/prior_approval.aspx

Regulation 552 of Health Insurance Act – https://www.ontario.ca/laws/regulation/900552

Travel insurance protects from unexpected and costly emergencies and it’s important to evaluate available coverage, based on your individual personal needs, to determine how to best safeguard yourself and your family. This is even more important now that there is no coverage through OHIP.

When purchasing emergency travel medical insurance the insurer may require you to complete a health questionnaire. It’s important to be honest, as it will determine your premium – not the actual coverage.Thus, you shouldn’t base your insurance decisions on price alone, but rather look at what coverage is most important for your circumstances. Speak with a knowledgeable travel insurance advisor that understands your needs.

Read more about this topic in the news at the following links:

https://www.cbc.ca/news/canada/toronto/feds-criticize-ontario-for-eliminating-out-of-country-health-insurance-1.5223941

https://www.cbc.ca/news/canada/toronto/ohip-change-1.5400012

https://www.cbc.ca/news/canada/ottawa/ohip-out-of-country-insurance-scraped-1.5411253