Health care in Ontario

OHIP is Ontario’s health care plan. Through OHIP, the province pays for many of the health services you may need. You need to apply and, once you’re approved, you’ll get an Ontario health card. Your health card proves you’re covered by OHIP – that’s why you’ll need to show it every time you see your doctor, visit an emergency room, have a medical test or go for surgery.

What’s covered

OHIP covers many health services you may need, such as:

• appointments with your family doctor
• visits to walk-in clinics and some other health care providers
• visits to an emergency room
• medical tests and surgeries

To be covered by OHIP, you must have a medical reason to receive a service or treatment. Cosmetic surgery, for example, is not covered.

Learn more about OHIP-covered services and products.

Who qualifies

To qualify for OHIP, you must meet all of the minimum qualifications listed below plus at least one of the additional requirements.

To meet the minimum qualifications you must:

• be physically in Ontario for 153 days in any 12‑month period
• be physically in Ontario for at least 153 days of the first 183 days immediately after you began living in the province
• make Ontario your primary home

You must also meet at least one of the following additional requirements. You:

• are a Canadian citizen
• are an Indigenous person (registered under the federal Indian Act)
• are a permanent resident (formerly called a “landed immigrant”)
• have applied for permanent residence, and Immigration, Refugees and Citizenship Canada has confirmed that:
  • you meet the eligibility requirements to apply
  • you have not yet been denied
• are in Ontario on a valid work permit and are working full-time in Ontario, for an Ontario employer, for at least six months
  • your spouse and any dependents also qualify if you do
• are in Ontario on a valid work permit under the federal Live-in Caregiver Program
• are a convention refugee or other protected person (as defined by Immigration and Refugee Board of Canada)
• have a Temporary Resident Permit (only certain case types, e.g. 86 through 95)
• are a clergy member who can legally stay in Canada and is ministering full time in Ontario for at least six months
  • your spouse and any dependents also qualify if you do

How to apply

You must apply for OHIP in person at a ServiceOntario centre. You can drop in, or book an appointment.

You will need to bring these documents with you:

• a completed Registration for Ontario Health Insurance Coverage form
• three separate, original (not photocopies or printouts of electronic documents) identification documents:
  • one that proves your Canadian citizenship or OHIP-eligible immigration status (e.g. Canadian birth certificate, Permanent Resident Card )
  • one that proves you live in Ontario (e.g. Ontario Driver’s Licence, income tax assessment)
  • one that supports your identity (e.g. credit card, passport from any country)

Children who are:

• under 16 years old do not need a photo or signature on their card so a parent/guardian can register for them
  • if you need another record of your child’s health card information (e.g.when parents/guardians do not live in the same home), please ask for a transaction record in person at a ServiceOntario centre
• older than 16 years need a photo and signature on their card so must apply in person at a ServiceOntario centre

See the complete list of qualifying identification documents

New Eligibility Requirements for The Low-Income Seniors Co-Payment Drug Program

Starting August 1, 2016, more than 170,000 seniors will be newly eligible for the low-income Seniors Co-Payment program under the Ontario Drug Benefit (ODB) Program.

You might be eligible to enrol in the Seniors Co-Payment Program if you are:

• A single senior with an income of less than or equal to $19,300; or
• A senior couple with a combined income of less than or equal to $32,300.

Seniors enrolled in the Seniors Co-Payment Program pay no annual deductible and a co-payment of up to $2 for each prescription. As a result, they will save approximately $130 on average per year in out-of-pocket drug costs.

How to Apply for the Seniors Co-Payment Program

Complete a Co-payment Application for Seniors form and send it to the Ministry of Health and Long-Term Care. There are four ways for seniors to access an application for the Seniors Co-Payment Program:

• At most Ontario pharmacies and all MPP Offices
• Co-payment Application for Seniors
• Call the Seniors Co-Payment Program at:
  • 1-888-405-0405 or 416-503-4586 in Toronto
• Call ServiceOntario Infoline at:
  • 1-866-532-3161; or 416-314-5518 in Toronto
  • TTY 1-800-387-5559
  • In Toronto, TTY 416-327-4282