Family Medical Insurance

Family Medical Insurance

Bridging the gap with Supplemental Family Insurance

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Ontario Medical Insurance

If you live in the Canadian province of Ontario, you will be under OHIP, the Ontario Health Insurance Plan. It helps cover most of the medical expenses for you and your family; however, it may not be adequate in covering all medical needs, especially in the case of dental care and prescription drugs. Moreover, the Ontario medical insurance plan does not cover all specialized treatments; therefore, if you have any pre-existing illnesses in your family that are not covered by basic insurance, you should consider purchasing a private family medical insurance plan.

No Coverage
Ontario Medical Insurance CostsCertain services are considered not medically related and are not covered by Ontario’s medical plan, such as various cosmetic surgeries. For this purpose, additional medical insurance coverage would be necessary. For detailed information, visit the official site of the Ontario Ministry of health and long-term care.

Other medical services are only partially covered by the Ontario provincial insurance plan; individuals are required to take care of the remaining cost. Here are some facts:

  • The costs for medical care in Ontario are consistently outpacing the provincial coverage. The province requires that patients pay the first $100 of prescription drug costs plus an additional $6 per prescription.
  • Allotted nursing home coverage is only $47 per day. Wait times are extensive, adding additional levels of worry and stress to the family.
  • Although Ontario is the second richest province in Canada, it spends less on medical care than any other province, according to the Registered Nurses Association of Ontario. This can leave families needing important medical care lacking coverage. Family medical insurance is designed to bridge that gap and ensure treatment.

Moving In
If you are coming to Ontario from a different province, you need to check if your previous coverage is valid while you apply for the Ontario medical plan. It is important to know about the various medical services covered by OHIP, as it will help you select additional medical insurance if necessary.

Services Partially Paid for by OHIP
Some of the medical services that are partially covered by the Ontario medical insurance plan include:

  • Medical services provided by podiatrists
  • Dental surgery
  • Eye exams provided once a year to children under twenty and seniors 65 and over.

Some medical services that are not partially covered by the Ontario medical insurance plan include:

  • Prescription drugs from pharmacies
  • Home care services
  • Ambulance services
  • Long term care services that are provided in other provinces.

If you are travelling outside Canada, the insurance plan of Ontario will not cover medical expenses incurred during travel; therefore, you are advised to get a supplementary private insurance plan that will help cover potential medical expenses while travelling. Without supplementary travel insurance, you may end up spending a significant amount of money for appropriate treatment. Depending on the length of time you are away, you may need to fulfill the eligibility criteria in order to maintain your medical coverage in Ontario. The guideline dictates that you must be in Ontario for 153 days in any 12-month period; otherwise, you can still be eligible for coverage as a ‘mobile worker’ or ‘mobile student’, given that you have adequate paperwork.

A private family medical insurance plan, in addition to the provincial medical coverage, should help cover all of your family’s medical expenses. There are various insurance plans to choose from and you can make the right choice by comparing the costs and features of each plan.


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