Ontario Health Insurance Plan covers many emergencies and preventative medical care costs. While many people are aware of the basics covered by OHIP, such as doctor visits and emergency health care, costs that are not covered can sometimes cause misunderstanding.
What’s Covered (Partially or Fully)
- Doctor visits
- Hospital visits and stays
- Medical or surgical abortions
- Eligible dental surgery
- Eligible eye-health/optometry services
- Ambulance services
- Travel for health services if you live in Northern Ontario
What’s Not Covered
- Prescription drugs are provided in non-hospital settings for individuals under the age of 65
- Alternative medicine consultation treatments, including Chinese medicine, homeopathy and Reiki
- Chiropractic services
- Dental services provided in a dentist’s office
- Eyeglasses, contact lenses
- Laser eye surgery
- Cosmetic procedures
- Immunizations for travel (Hepatitis A, Hepatitis B, Twinrix, HPV)
OHIP Plus (+)
OHIP+ provides drug products for patients 24 years and under who are not covered by a private plan at no cost. Those who are eligible for OHIP Plus do not need to enroll. All they need is a health card number and a valid prescription for an eligible medication.
Medication Covered under OHIP Plus
- Antibiotics to treat infections
- Inhalers for asthma
- Medications for diabetics such as insulin and diabetes test strips
- Medications to treat arthritis, epilepsy and other chronic conditions
- Medication/drugs for attention deficit disorder (ADHD)
- Medications/drugs to treat childhood cancers or other rare conditions
- Epinephrine injectable products
- Medications/drugs to treat mental health conditions
- Help to quit smoking: This can include up to a year of pharmacist-assisted counselling and medication for those who are 18 years or older.
OHIP For Seniors
All OHIP-insured seniors aged 65 years and over automatically qualify for the Ontario Drug Benefit Program, commonly referred to as the ODB program. This program provides seniors with expanded coverage to ensure they have access to the healthcare they need.
Additional benefits for seniors include:
- Coverage for visits to the optometrist every two years
- Coverage for most prescription medications
Home care, massage, physiotherapy and dental services are not covered.
Eligibility Requirement (Any One of The Following)
- You are a Canadian citizen, permanent resident, or registered as an Indian under the Indian Act.
- You have submitted an application for permanent residence in Canada, and Citizenship and immigration in Canada have confirmed that you meet the eligibility requirements to apply for permanent residence.
- You are a “protected person,” such as a refugee or a person in need of protection.
Additionally, you must be in Ontario for at least 153 days of the first 183 days immediately following the date you established residence in Ontario. You also need to be sure you are in Ontario for at least 153 days in any 12-month period.
How To Apply
Book an Appointment at Service Ontario Centre
Proof of ID and residency in Ontario will be required.