As we await the final ruling on the government of Ontario’s proposed elimination of payments for out-of-country claims, many Ontario travellers have questions as to how this might affect their coverage.
To help, we've outlined the impact that the proposed changes might have on you and your family.
What is the current reimbursement structure of the Out-Of-Country Travellers Program?
Regardless of the actual claims cost paid by the Insurer, OHIP’s inpatient services cover up to $400/day for higher level of care (e.g. Intensive Care Unit, operating room) and up to $200/day for any other level of care while up to $50/day is available for outpatient services and $210 for renal dialysis.
With the proposed amendments to Ontario Regulation 552 made under the Health Insurance Act, the Ontario Health Insurance Plan (OHIP) would no longer cover any portion of emergency medical expenses that occur while travelling outside of Canada.
What does this mean for Travellers?
It is not uncommon for insurers to encounter Ontarians who think that OHIP fully covers them when travelling abroad. In reality, reimbursement typically covers about 5 – 7 % of the actual claim cost. This misunderstanding has led to many Ontario residents travelling out-of-country with insufficient coverage.
Moving forward, it is imperative that Ontarians check the coverage provided (if any) by their workplace benefits, credit card or purchase travel insurance if they are planning a trip outside of the country.
Travel Insurance for Families: Common Questions, Answered. Read More.
When will the proposed changes take effect? How will we be notified?
Contrary to reports, October 1, 2019 has not been confirmed as the official date for these changes to take effect. Responses received through the 6-day public consultation period are still in the process of being reviewed by the provincial government. While the actual decision date is still unknown, the Canadian Life and Health Insurance Association (CLHIA), a voluntary trade association who represents 99 percent of Canada's Travel Health Insurers, is working directly with the Director of Out-of-Country and will communicate the decision to its members, (the Insurers), who will share the information with its distributors as soon as it becomes available.
Will I still receive OHIP coverage out of province? 
The proposed changes are intended to only apply to out-of-country medical expenses, not out-of-province. However, Ontarians planning to travel between provinces are encouraged to purchase travel insurance in order to avoid emergency medical costs that might not be covered by their provincial health plan, such as medical transportation and emergency dental treatment.
What's next?
In anticipation of this new legislation, CAA Niagara encourages you to educate yourself on the potential impact it may have on your travel plans. Ontario travellers are encouraged to secure emergency travel medical coverage before leaving the province. For more information or to purchase travel insurance, visit CAA Travel Insurance online at caaniagara.ca/insurance/travel or visit any CAA Niagara location.
CAA Travel Insurance is underwritten by Orion Travel Insurance Company, a CAA Company. Certain exclusions, limitations and restrictions apply. A Medical Questionnaire may be required. ™You take on the world, we’ll take care of the rest is a trademark of Orion Travel Insurance Company.
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