Travel Coverage: OHIP Outside Ontario and Canada

When you travel outside Ontario and Canada, your Ontario Health Insurance Plan (OHIP) provides limited coverage for emergency medical services—but it isn’t designed to be your primary insurance while abroad. This guide explains what OHIP covers when you’re traveling internationally, the importance of supplemental travel insurance, and how to navigate the reimbursement process. Whether you’re traveling for business, leisure, or study, understanding your healthcare coverage abroad will help you prepare for unexpected medical needs.

OHIP Coverage Limits When Traveling

OHIP is primarily designed to cover healthcare within Ontario and, to some extent, within Canada. Outside these regions, coverage is very limited:

• Emergency Medical Services Only:
  OHIP may cover emergency care for life-threatening injuries or illnesses, but only in very limited circumstances. Routine care or non-emergency treatments are generally not covered.
• Short-Term Coverage:
  There is no comprehensive coverage for prolonged treatment abroad. OHIP typically only reimburses for short-term emergency services, and even then, the amounts are capped.
• No Coverage for Follow-Up Care:
  Follow-up treatment, medications, or non-urgent medical services provided abroad are not covered by OHIP.

Important: Always verify the specific limitations of OHIP travel coverage by reviewing the latest guidelines on the Ontario Ministry of Health website.

The Role of Travel Insurance

Given the limited nature of OHIP’s international coverage, it is highly recommended that you secure additional travel insurance:

• Comprehensive Medical Coverage:
  Travel insurance policies can cover a wide range of services including emergency care, hospitalization, evacuation, and even routine medical expenses if you become ill or injured abroad.
• Prescription Coverage:
  Many travel insurance plans include coverage for prescription medications and follow-up care, which OHIP does not provide.
• Peace of Mind:
  With the right travel insurance, you can travel knowing that you are financially protected in case of a medical emergency.

Tip: Compare multiple travel insurance options to ensure you get a policy that matches your travel plans and duration. Look for policies that offer high limits on emergency medical expenses and evacuation coverage.

Emergency Care Abroad

In an emergency while traveling, here’s what you need to know:

• Seek Immediate Medical Attention:
  If you encounter a life-threatening situation, go to the nearest hospital or call emergency services immediately.
• Keep Detailed Records:
  Save all receipts, invoices, and medical reports. These documents will be essential when filing for reimbursement through OHIP or your travel insurance provider.
• Contact Your Insurance Provider:
  If you have travel insurance, contact them as soon as possible for guidance on accessing emergency care and understanding the documentation required for claims.

Prior Approval and Reimbursement Process

For OHIP to reimburse any costs incurred while traveling, certain procedures must be followed:

• Prior Approval Requirements:
  In some cases, OHIP may require prior approval for emergency treatment abroad. Although this is rare, it is advisable to contact ServiceOntario or check the OHIP guidelines before you travel if you anticipate needing medical services.
• Reimbursement Process:
  1. Collect Documentation:
     • Obtain detailed invoices and receipts for all medical services.
     • Get a copy of the medical report detailing the treatment provided.
  2. Submit a Claim:
     • Complete the OHIP overseas reimbursement claim form (available on the Ontario Ministry of Health website).
     • Attach all supporting documentation.
  3. Follow Up:
     • Keep copies of your submission.
     • Follow up with ServiceOntario if you do not receive a response within the expected timeframe.

Note: The reimbursement process can be time-consuming, and there is no guarantee that all expenses will be covered. This is another reason why travel insurance is essential.

Final Tips for Travelers

• Plan Ahead:
  Before traveling, review your OHIP benefits and obtain supplemental travel insurance to cover potential medical expenses abroad.
• Emergency Contacts:
  Save the contact information for your travel insurance provider, local emergency services, and the nearest Canadian embassy or consulate.
• Stay Informed:
  Healthcare policies and reimbursement procedures can change. Regularly check the latest information on the Ontario Ministry of Health and ServiceOntario websites before your trip.

Conclusion

While OHIP provides limited emergency coverage outside Ontario and Canada, it is not a substitute for comprehensive travel insurance. By understanding the coverage limits, securing additional insurance, and familiarizing yourself with the emergency and reimbursement processes, you can ensure that you are well-prepared for any medical emergencies abroad. Whether you’re traveling for work, study, or leisure, being proactive about your healthcare coverage is essential for peace of mind.

For more travel health tips and personalized advice, visit doktr.ca or contact us today.