OHIP eliminates coverage for out-of-country emergency care

As of January 1, 2020, OHIP may no longer cover out-of-province emergency medical expenses for Ontario residents. However, out-of-country dialysis coverage will still be available under a new program.  

Changes like this to provincial health coverage are not uncommon. Services and drugs may be added or removed from one year to the next. Provincial travel coverage also varies widely across the country, which can add to the confusion.

So when changes like these happen, consider reviewing them to understand the impact on you and your family. And whether you’re travelling within Canada or abroad, it’s a good idea to check your provincial coverage and top it up with travel insurance.

Here’s a coast-to-coast summary of what’s covered, including out-of-country emergency medical treatment.


What’s covered:

  • Physician services
  • Midwife services
  • Oral surgery, if performed in a hospital
  • Medically necessary eye exams
  • Some orthodontic services
  • Diagnostic services
  • Supplementary services (acupuncture, chiropractic, massage therapy, naturopathy, physical therapy, podiatry) for eligible low-income individuals 

Out-of-country:

  • Emergency hospital care, to a maximum of $75 a day; patients are responsible for expenses above the maximum
  • You can vacation out-of-province a maximum of seven months before losing MSP coverage

For more information, visit MSP.


What’s covered:

  • Physician services, hospital services, surgery
  • Standard ward hospitalization and drugs administered in hospital
  • Private nursing care and nursing services
  • Laboratory and diagnostic services
  • Psychiatric visits
  • Oral surgery in hospital
  • Vision care (eye exams and some treatment) for residents younger than 18 or older than 65 and care for any age if caused by trauma, accident or illness
  • Some podiatry services

Out-of-country:

  • Hospital services that would normally be covered by AHCIP, to a maximum of $100 a day for inpatient care and $50 a day for outpatient; patients are responsible for expenses above the maximum
  • You must be committed to being physically present in Alberta for at least 183 days in any 12-month period in order to be eligible

For more information, visit AHCIP.


What’s covered:

  • All medically necessary services provided by a physician
  • Physiotherapy or occupational therapy
  • Screening mammography for women aged 50 to 69
  • Immunization for children and flu vaccine every year for all residents over the age of 6 months
  • Treatment for sexually transmitted infections
  • Human immunodeficiency virus (HIV) testing
  • Treatment for alcohol and drug abuse and problem gambling
  • Mental health services
  • Supplementary services (dental, prescriptions, medical supplies, optical services, podiatry, emergency medical transportation) for individuals recommended by Social Services and eligible low-income working families

Out-of-country:

  • Emergency medical treatment in the amount that would be covered in Saskatchewan; patients are responsible for paying the difference
  • Extended absences (up to 24 months) may not affect eligibility provided you notify eHealth Saskatchewan in advance

For more information, visit the Government of Saskatchewan.


What’s covered:

  • Physician services, surgery/anaesthesia, x-ray and laboratory services
  • Vision care (one exam every two years) for residents under 19 and over 65
  • Chiropractic care (up to seven visits per calendar year)
  • Dental surgery when hospitalization is required
  • Hospital coverage — ward room accommodation and meals; nursing services; laboratory, x-rays and diagnostics; surgery and related supplies; dietetic counseling
  • Ambulance fees
  • Personal care home services (accommodation, meals, nursing care, assistance with daily living, physiotherapy, prescriptions) for eligible individuals based on assessment by a Manitoba Health, Seniors and Active Living panel

Out-of-country:

  • Emergency medical services, at the same rates as Manitoba; patients are responsible for the difference
  • To maintain eligibility, you must reside physically in Manitoba for at least six months of the calendar year

For more information, visit the Insured Benefits Branch of Manitoba.


What’s covered:

  • Doctors’ visits 
  • Hospital visits and stays (doctor and nursing services, diagnostics, medication administered in hospital, meals, ward accommodation)
  • Abortion services
  • Dental surgery in hospital
  • Vision care (one eye exam every 12 months) for residents 19 and younger or over age 65 or suffering from an eye disorder such as glaucoma
  • Podiatry ($7 to $16 per visit to maximum of $135 per patient per year plus $30 for x-rays)
  • Ambulance services
  • Travel for those living in northern Ontario 

 

Out-of-country:

  • Emergency medical care (up to $400 for inpatient services; $50 a day for out-patient services and $210 per treatment for dialysis) 
  • As of January 2020, coverage for emergency medical treatment will no longer be available; coverage for dialysis treatment will continue at the same level under the new Ontario Renal Network
  • You can be away from the province for up to 212 days in any 12-month period before losing coverage

For more information, visit OHIP.


What’s covered:

  • Medical examinations, consultations, and diagnostic and therapeutic procedures provided by a general practitioner or a specialist
  • Psychiatric treatment 
  • Surgery 
  • Anesthesia 
  • Certain radiology services provided by a doctor

Out-of-country:

  • Medical, dental and optometric services reimbursed only up to the applicable Quebec rate
  • Emergency hospital services reimbursed up to a maximum of $100 a day for inpatient treatment and $50 for outpatient
  • You must be present in Quebec 183 days or more per year to maintain eligibility

For more information, visit RAMQ.


What’s covered:

  • Medical services provided at a physician's office, in hospital or at the patient’s residence
  • Surgical, diagnostic and therapeutic procedures, including anaesthesia
  • Pre- and post-operative care
  • Complete maternity care
  • Radiology interpretive services
  • Dental procedures that are considered medically necessary and performed in hospital by a dentist or oral surgeon

Out-of-country

  • Medical services obtained outside Canada paid at MCP rates; any difference is the patient's responsibility
  • If you’ll be absent from the province for more than 30 days, obtain an Out-of-Province Coverage Certificate from MCP to ensure coverage stays intact

For more information, visit MCP.


What’s covered:

  • Most medically required services provided by a physician in-office or in an approved hospital
  • Surgical dental procedures when medically required and provided in an approved hospital
  • Standard hospital accommodation and meals
  • Necessary nursing service 
  • Drugs administered while in hospital 
  • Operating room, delivery room and anesthetic facilities 
  • Laboratory, X-ray and other diagnostic services as deemed necessary 
  • Physiotherapy, occupational therapy, speech therapy and audiology 
  • Radiotherapy
  • Routine surgical supplies

Out-of-country

  • Emergency out-of-country physician and hospital services or services for which you have received prior approval to a maximum $100.00 a day for inpatient treatment and $50 a day for outpatient
  • You can be absent from the province up to 182 days in a 12-month period before losing coverage

For more information, visit New Brunswick Medicare.


What’s covered:

  • Physician services
  • Hospital services
  • Optometry services for residents under nine years of age or over age 65
  • Addiction treatment
  • Continuing care (nursing, home support, etc.)
  • Ambulance fees
  • Dental surgery when performed in hospital
  • Infection prevention
  • Mental health services

Out-of-country:

  • Inpatient hospitalization as the result of an accident or sudden illness; up to $525 a day plus 50% of ancillary fees
  • You can vacation out-of-province for up to seven months in any calendar year and maintain eligibility

For more information, visit Nova Scotia Health.


What’s covered:

  • Physician and hospital services
  • Eligible prescription medications, certain medical supplies and pharmacy services; fully or partially covered depending on patient income
  • Home care, palliative care and long-term care; coverage may be full or partial
  • Addiction and mental health services
  • Dental public health services
  • Chronic disease prevention and management
  • Public health nursing
  • Diabetes program, community nutrition, cancer screening programs, speech language pathology services
  • Ambulance services may be subsidized for Island residents in certain situations

Out-of-country:

  • Emergency and sudden-illness coverage reimbursed at PEI rates; the patient is responsible for the rest
  • To maintain eligibility, PEI must be your primary residence for at least six months plus one day every year

For more information, visit Health PEI.


What’s covered:

  • Physicians’ services provided in an office, clinic or hospital, at the scene of an accident or in a patient’s home
  • Care and treatment by a physician before, during and after an operation, including anesthesia
  • Physicians’ care during pregnancy
  • Certain dental-surgical procedures that have to be performed in an approved hospital
  • Hospital accommodation and meals at standard ward rates
  • Necessary nursing services, laboratory, radiological and other diagnostic procedures
  • Drugs, biologicals and related preparations when administered in hospital
  • Use of operating room, case room and anesthetic facilities including equipment and supplies
  • Radiotherapy and physiotherapy services where available
  • Emergency and non-emergency out-patient services
  • Medical travel subsidy for costs such as accommodation, meals and taxis while receiving outpatient medical services outside of Yukon ($75 a day starting on Day 2; maximum 90 days)

Out-of-country:

  • Physician services and hospital charges covered at Yukon rates; the patient is responsible for the difference
  • Medevac and ambulance fees not covered outside of territory
  • To maintain eligibility, you must not be physically absent for more than six months

For more information, visit YHCIP.


What’s covered

  • Physician diagnosis and treatment of illness and injury
  • Surgery, including anesthetic services and surgical assistance where necessary
  • Obstetrical care, including prenatal and postnatal care
  • Eye examinations, treatment and operations provided by an ophthalmologist
  • Hospital accommodation and meals at standard ward care
  • Nursing services, when provided in hospital 
  • X-ray and diagnostic procedures and interpretation
  • Drugs prescribed by a physician and administered in hospital
  • Use of the operating room, case room, and anaesthetic facilities required for diagnosis and treatment, including necessary equipment and supplies
  • Radiotherapy treatment, occupational therapy, and physiotherapy when provided by an insured facility
  • Detoxification services in an approved health facility and medical treatment

Out-of-country:

  • Medically necessary services provided in the case of emergency or sudden illness provided at NWT rates only; the patient is responsible for the rest
  • To maintain eligibility, you must be physically present in the NWT for at least 153 days in a calendar year

For more information, visit NWT Health Care Plan.


What’s covered:

  • Physician diagnosis and treatment of illness and injury
  • Surgery, including anesthetic services and surgical assistance, where necessary
  • Obstetrical care, including prenatal and postnatal care
  • Eye examinations, treatment and operations provided by an ophthalmologist
  • Standard ICU (Intensive Care Unit) ward rate
  • Nursing services, when provided in hospital
  • Laboratory, x-ray and diagnostic procedures and interpretation
  • Drugs prescribed by a physician and administered in hospital
  • Use of the operating room, case room, and anesthetic facilities required for diagnosis and treatment, including necessary equipment and supplies
  • Radiotherapy treatment, occupational therapy, and physiotherapy when provided by an insured facility
  • Medical travel (less a $250 deductible) to the nearest centre if advised by a doctor, nurse, dentist or other healthcare professional 

Out-of-country:

  • Emergency health services based on the Nunavut physician fee schedule and approved Nunavut hospital reciprocal rates; the patient is responsible for any difference
  • To maintain eligibility, Nunavut must be your primary place of residenc

For more information, visit Nunavut Health Care Plan.