OHIP changes out-of-country coverage

In Ontario, the Ontario Health Insurance Plan (OHIP) currently provides limited coverage for residents travelling outside Canada. OHIP provides the following coverage:

Physician services — the lesser of the actual amount a physician bills for services and the rate that would be paid to an Ontario physician for the same services if performed in Ontario Emergency outpatient services — the lesser of the amount the hospital bills and $50 Canadian per day Emergency inpatient services — up to $400 Canadian per day for an operating room, coronary care unit, intensive care unit or pediatric special care unit, as well as up to $200 per day for lower levels of care

The above coverage, which represents approximately four per cent of the total cost of out of country emergency medical bills, is ending Dec. 31, 2019. Effective Jan. 1, 2020, OHIP will no longer provide coverage to Ontario residents travelling outside Canada. Most private travel insurance plans will cover these costs for eligible claims. While these additional costs will have an impact on travel insurance plans, it is expected that the additional costs will not be catastrophic, as they represent such a small amount of the total claim cost.

RTO/ERO’s Extended Health Care plan includes travel insurance. The above services, previously covered by OHIP, are eligible for reimbursement under RTO/ERO’s travel insurance. Please refer to your RTO/ERO Insurance Booklet for details of your travel insurance.

It is important to note that these changes do not affect your OHIP coverage when travelling outside Ontario within Canada. These changes apply to out of Canada travel only.

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