OHIP Eligibility if planning to leave Ontario


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immi2grate   
Member since: Jan 09
Posts: 10
Location:

Post ID: #PID Posted on: 02-08-13 16:03:55

I have been a PR since 5 years, but my life landed on March 1st and got her OHIP on 1st June, 2013.

She is pregnant and we wanted to go to Pakistan for at least 3 months before returning. I called the OHIP helpline to make sure that she will still be eligible as per the requirements of 153 days residence in Ontario out of the first 183 days.

According to the website it says:

- be physically present in Ontario for 153 days in any 12-month period; and
- be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and make your primary place of residence in Ontario.

Now she got her residency on 1st March, so according to that she has fulfilled the 153 days out of 183 days requirements. But the operator told me that the date starts from when she got her OHIP, that is, June 1st. If that is the case, then the official website has got it wrong, they should list 153 from the first day of OHIP eligiblity and not establishing residency in the province.

Who is in the wrong here? Was it an illinformed operator or the website is wrong? Or Am I reading it wrong?



Full House   
Member since: Oct 12
Posts: 2677
Location:

Post ID: #PID Posted on: 03-08-13 10:52:29

Quote:
Originally posted by immi2grate

I have been a PR since 5 years, but my life landed on March 1st and got her OHIP on 1st June, 2013.

She is pregnant and we wanted to go to Pakistan for at least 3 months before returning. I called the OHIP helpline to make sure that she will still be eligible as per the requirements of 153 days residence in Ontario out of the first 183 days.

According to the website it says:

- be physically present in Ontario for 153 days in any 12-month period; and
- be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and make your primary place of residence in Ontario.

Now she got her residency on 1st March, so according to that she has fulfilled the 153 days out of 183 days requirements. But the operator told me that the date starts from when she got her OHIP, that is, June 1st. If that is the case, then the official website has got it wrong, they should list 153 from the first day of OHIP eligiblity and not establishing residency in the province.

Who is in the wrong here? Was it an illinformed operator or the website is wrong? Or Am I reading it wrong?


-------------

Without having access to their internal operations, it is very hard to interpret the guide lines provided on their website. So, please be guided by the info you got.

Now for my ruling, the operator who gave you the information is WRONG. Here is the reason why?

"It is 153 days after establishing a residence within Ontario" That is the first qualifying factor.
The 153 days is not to be used in conjunction with after qualifying for the OHIP coverage.
No where does it say that. So, the opertor was dead WRONG.

From their Q & A section....

"Am I still eligible for OHIP if I temporarily leave Ontario?

You may be out of the province for up to 212 days in any 12-month period and still maintain your Ontario health insurance coverage provided that you continue to make Ontario your primary place of residence.

To maintain eligibility for OHIP coverage you must be an eligible resident of Ontario. This means that you must :
•have an OHIP-eligible citizenship/immigration status; and
•be physically present in Ontario for 153 days in any 12-month period; and
•be physically present in Ontario for at least 153 days of the first 183 days immediately after establishing residency in the province; and
•make your primary place of residence in Ontario.

If you will be out of the province for more than 212 days in any 12-month period, please refer to the Longer Absences from Ontario fact sheet."

I am quoting the same as you have written in your posting, to provide you with the complete quote and not a fragmented one.

Once it is written in their books, which is as quoted, they canot change the rules. Next thing is, no one is going to ask you for your Passport and the entries there in, when you go for your wife's delivery. It is an honour system and you just carry on as normally as you can and take your trip to your native country and return. But it is a risk that you will have to be prepared and willing to undertake with such a long trip back and forth with a return at a extremely advanced state of pregnancy. Are you sure you both are ready for it? You both know the dates and there is not sufficient information in your post about it. It will be better to consult your physician once before you book your travels. So, just a note of caution, that is all.


Happy holidays.


FH.




adamthorat   
Member since: Aug 11
Posts: 1041
Location:

Post ID: #PID Posted on: 08-09-14 17:21:18

Don't bother informing them anything. They don't know when she left or when she came back or how long she was out.

They don't call immigration for that.



chandresh   
Member since: Mar 03
Posts: 2606
Location: Toronto

Post ID: #PID Posted on: 09-09-14 12:48:10

Quote:
Originally posted by adamthorat

Don't bother informing them anything. They don't know when she left or when she came back or how long she was out.

They don't call immigration for that.



You really are doing a service to the nation and its residents!!


-----------------------------------------------------------------
Chandresh

Advice is free – lessons I charge for!!


sudesingh   
Member since: Jul 04
Posts: 2085
Location: Toronto

Post ID: #PID Posted on: 09-09-14 12:52:29

Quote:
Originally posted by adamthorat

Don't bother informing them anything. They don't know when she left or when she came back or how long she was out.

They don't call immigration for that.



She's probably delivered the baby by now. :)


-----------------------------------------------------------------
SS
Reiki Grand Master


Fido   
Member since: Aug 06
Posts: 5286
Location: Canada

Post ID: #PID Posted on: 09-09-14 23:36:46

Quote:
Originally posted by adamthorat

Don't bother informing them anything. They don't know when she left or when she came back or how long she was out.

They don't call immigration for that.



Good to know and yes they may not share information on that ... customs / immigration etc.

Wonder how they implement the eligibility other wise .... while visiting docs / hospitals I have never been asked for residence in Ontario ..How do they implement their own criterion ?


-----------------------------------------------------------------
Fido.




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