How to Apply for OHIP: A Complete Guide to Ontario Health Coverage for Newcomers

What Is OHIP and Why It Matters

The Ontario Health Insurance Plan, commonly known as OHIP, is the province's publicly funded health insurance program. It covers most medically necessary services provided by physicians and hospitals in Ontario. For newcomers arriving in the province, obtaining OHIP coverage is one of the most important administrative steps to take. Without it, a single visit to the emergency room or a routine doctor's appointment can result in bills totalling thousands of dollars.

Ontario is home to nearly half of all newcomers arriving in Canada each year. The province's healthcare system is administered by the Ontario Ministry of Health, and OHIP is the mechanism through which residents access insured health services. Understanding how to apply, what documents you need, and what the waiting period entails will help you avoid costly surprises and ensure you and your family are protected.

Who Is Eligible for OHIP

Not everyone living in Ontario qualifies for OHIP. To be eligible, you must meet two main criteria: you must be a resident of Ontario (meaning you live in Ontario and are physically present in the province for at least 153 days in any 12-month period), and you must have an eligible immigration status. The following groups are generally eligible:

• Canadian citizens living in Ontario
• Permanent residents (landed immigrants) who have made Ontario their primary home
• Convention refugees and protected persons
• Holders of valid work permits (with certain conditions)
• Holders of valid study permits from designated institutions in some cases
• Individuals who have applied for permanent residence from within Canada and hold a valid work or study permit

Temporary visitors, tourist visa holders, and individuals without valid immigration status are not eligible for OHIP. If you hold a work permit, it generally must be valid for at least six months and you must be working for an Ontario-based employer. Certain work permit categories, such as those under the Atlantic Immigration Program or Temporary Foreign Worker Program, have specific provisions. Always check with ServiceOntario if you are unsure about your eligibility.

The Three-Month Waiting Period

One of the most important things newcomers to Ontario need to understand is the three-month waiting period. Even if you are fully eligible for OHIP, your coverage does not begin immediately. There is a mandatory waiting period that starts on the date you establish residency in Ontario. Coverage begins on the first day of the third month after you establish residency.

For example, if you arrive and establish residency in Ontario on February 15, your OHIP coverage would begin on May 1. During this waiting period, you are responsible for paying for any medical services out of pocket unless you have private health insurance.

How to Get Coverage During the Waiting Period

Several private insurance companies in Canada offer temporary health insurance plans specifically designed for newcomers during the OHIP waiting period. These plans typically cost between $1.50 and $5.00 per day depending on your age and the level of coverage. Some employers also provide health benefits that begin on your first day of work, which may cover this gap. Additionally, if you are a refugee claimant, you may be covered by the Interim Federal Health Program (IFHP), which provides temporary health coverage.

Organizations such as settlement agencies can help you find affordable interim coverage. WelcomeAide's AI Newcomer Navigator can also provide personalized guidance on finding private insurance options during this period.

How to Apply for OHIP at ServiceOntario

Applying for OHIP requires an in-person visit to a ServiceOntario location. You cannot apply online or by mail. When you visit, you will need to bring the following documents:

Required Documents

• Proof of citizenship or immigration status: This includes your Canadian citizenship card, permanent resident card (PR card), Confirmation of Permanent Residence (COPR) document, valid work permit, or refugee claim documentation.
• Proof of Ontario residency: Documents that show you live in Ontario, such as a lease agreement, utility bill, bank statement, or a letter from your employer with your Ontario address.
• Proof of identity: A valid passport or other government-issued photo identification.
• Proof of residency date: Documentation showing the date you became a resident of Ontario, such as your entry stamp, flight itinerary, or COPR with your landing date.

ServiceOntario staff will review your documents, take your photograph, and issue you a temporary document. Your permanent Ontario health card with your photo will be mailed to you within four to six weeks. The health card is a green card with your photo, name, date of birth, and a unique health number.

What OHIP Covers

OHIP provides coverage for a wide range of medically necessary services. Understanding what is and is not covered will help you plan your healthcare needs and budget accordingly.

Services Covered by OHIP

• Visits to family doctors and specialists
• Hospital stays, surgeries, and emergency room visits
• Diagnostic tests including blood work, X-rays, and MRIs when ordered by a physician
• Maternity and newborn care
• Mental health services provided by physicians (psychiatrists)
• Certain preventive services including flu shots and some cancer screenings
• Optometrist visits for children under 20 and adults over 65
• Some dental surgery performed in a hospital

Services Not Covered by OHIP

• Prescription medications (unless administered in a hospital)
• Dental care (routine cleanings, fillings, and extractions)
• Vision care for adults aged 20 to 64 (eye exams, glasses, contact lenses)
• Physiotherapy (except in hospitals)
• Cosmetic surgery
• Ambulance services (a co-payment of $45 to $240 may apply)
• Private or semi-private hospital rooms

For services not covered by OHIP, many Ontario residents rely on supplementary private insurance, often provided through their employer. Ontario also has specific programs for prescription drug coverage, including the Ontario Drug Benefit (ODB) program for seniors, social assistance recipients, and residents of long-term care homes, as well as the Trillium Drug Program for those with high prescription costs relative to their income.

UHIP: Health Coverage for International Students

International students studying at Ontario universities and colleges are generally not eligible for OHIP. Instead, they are typically required to enroll in the University Health Insurance Plan (UHIP) or a similar institutional plan. UHIP is mandatory for most international students at publicly funded universities in Ontario and provides coverage similar to OHIP, including doctor visits, hospital stays, and emergency care.

The cost of UHIP varies by institution but typically ranges from $600 to $900 per year. Some universities include UHIP in tuition fees, while others bill it separately. International students with valid work permits who are also working in Ontario may be eligible for OHIP instead of or in addition to UHIP. It is important to check with your university's international student office and with ServiceOntario to determine which coverage applies to you.

When International Students Become OHIP Eligible

If an international student transitions from a study permit to a post-graduation work permit (PGWP) and begins working for an Ontario employer, they may become eligible for OHIP. Similarly, students who apply for permanent residence from within Canada and receive a work permit may qualify. The transition from UHIP to OHIP should be coordinated carefully to avoid gaps in coverage.

Renewing Your Ontario Health Card

Ontario health cards are valid for five years and must be renewed before they expire. ServiceOntario sends renewal notices by mail approximately two months before the card's expiry date. You can renew online through the ServiceOntario website, by mail, or in person at a ServiceOntario location.

To renew, you need to provide updated identification and confirm that you are still an Ontario resident. If your immigration status has changed (for example, you received your permanent resident card after initially applying with a work permit), you should bring your updated documents. If your health card has already expired, you must renew in person and may need to provide additional documentation.

Finding a Family Doctor in Ontario

Having a family doctor is important for ongoing healthcare. In Ontario, you can register with Health Care Connect if you need help finding a doctor or nurse practitioner who is accepting new patients. Wait times for placement can vary depending on your location, with larger cities sometimes having longer waits due to higher demand.

In the meantime, walk-in clinics are available throughout the province and accept OHIP. You can also access healthcare through community health centres, which offer a range of services including primary care, mental health support, and health promotion. Many of these centres have staff who speak multiple languages, which can be particularly helpful for newcomers.

Final Thoughts on OHIP for Newcomers

Applying for OHIP is a critical step in settling into life in Ontario. While the three-month waiting period can be a challenge, planning ahead with private insurance ensures you are never without coverage. Make your trip to ServiceOntario a priority in your first week, gather all required documents in advance, and consider using settlement agencies and community health centres for additional support during your transition.

WelcomeAide is here to help you navigate healthcare and every other aspect of settling in Canada. Use our AI Newcomer Navigator for instant, personalized guidance on OHIP and healthcare in Ontario. Explore our blog for more health guides and newcomer resources, learn about our mission, or discover how to get involved in supporting newcomer communities across Canada.