November 1, 2019

OHIP Travel Coverage – Important Changes

Effective January 1st, 2020, the Ontario government will cancel emergency travel insurance coverage outside of Canada currently provided by OHIP.
Given the busy travel season that is upon us, this may be a concern for plan members.  Please rest assured and assure your employees that they will not experience any gaps in coverage.  Expenses previously covered by OHIP will simply shift to the insurance company.
OHIP paid up to $400/day for in-patient services and up to $50/day for emergency out-patient and doctor services.  As of January, these costs will be absorbed by the group insurance plan.  Because the costs are minimal, we do not anticipate a significant impact to plan rates but this is still under review by the insurance companies.  Any required changes will likely flow through to your next renewal. 
Out-of-country expenses incurred up to December 31st will still need to be considered by OHIP before the insurance company will review the claim.
Medical expenses while travelling within Canada are not affected by this change. 
While the government is winding down emergency travel coverage, they are providing a new program to be operated by the Ontario Renal Network.  It will allow those with kidney failure to receive dialysis when travelling out of the country up to the current level of coverage.

Tips for Travellers

Pack your travel card – emergency travel contact numbers are usually provided on the back of the drug card but some insurance companies provide a separate travel card.  Both are available for download from the plan member sites if the originals have been misplaced.
Keep documents accessible – keep copies of all travel documents including proof of provincial coverage (ex. health card) in a place that is accessible while traveling.  Some people will scan copies of everything to an email account that they can access on the road.  Emergency travel information is always available through the plan member site – just make sure you know your username and password!
Call your provider – in the event medical attention is required while travelling always call the emergency travel number as soon as possible.  If you are unable to do so, have a travelling companion do it.  This will allow the insurance company to direct you to the most appropriate care provider, advise you as to what expenses are eligible, and/or open a file to coordinate with provincial coverage, if applicable.
Never pay out of pocket unless so directed by the travel provider.  If an expense is small (ex. under $300USD) you may be asked to pay for the expense and submit it for reimbursement upon your return home.  Leave all other expenses to be handled by the insurance company.  Paying out of pocket can delay reimbursement and may leave you responsible for a portion of the total cost.
Know restrictions – Canadians must be resident in their home province for a certain number of days every year in order to be eligible for their provincial plan.  The duration varies by jurisdiction.  For example, in Ontario, it is 212 days. 
If you are expected to be out of Canada for an extended period of time (ex. snowbirds) check with your local government for restrictions and exceptions.  Although OHIP will not cover out of Canada expenses as of January 1st, travel insurance still requires you to have provincial coverage in place.
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