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Are Canadians covered by provincial health insurance while in the USA?

Region: Ontario Answer # 1099

It is important to check with your provincial health insurance provider to learn if you are covered for any health services when travelling outside Canada. In order to be eligible for any provincial health care coverage that is provided while in the USA, you must meet the residency requirements in your home province.

There are a number of laws governing long term holidays and travelling to the USA as a visitor, student, or to work, often involving Visas and travel permits. To get help, call a lawyer now.

Alberta

You must be physically present in the province for at least 183 days during any 12-month period to qualify for health insurance when out of the province.

Effective April 1, 2020, only the cost of insured emergency physician and/or hospital services received outside of Canada will be eligible for reimbursement under the Alberta Health Care Insurance Plan. Visit AHCIP for more information.

British Columbia

BC must be your permanent home and you must be present for at least 6 months in a calendar year to be covered by health insurance when out of the province.

The province provides some coverage for emergency hospital care when you travel outside Canada. The coverage is limited to a maximum daily payment of $75 in Canadian funds.  Visit British Columbia Medical Services Plan (MSP) for more information.

Manitoba

You must be physically present in the province for at least 183 days in a calendar year to qualify for health insurance when out of the province.

If you are admitted on an emergency basis to a hospital outside of Canada, Manitoba Health, Seniors and Active Living will pay for the services you need based on established daily rates. If you are seen in a hospital outpatient or emergency department, coverage is limited to a maximum of $100 CDN per visit. Physician services are covered at the same rates paid to Manitoba doctors. Visit Manitoba Health Insurance Plan (MHIP) for more information.

Newfoundland and Labrador

If leaving the province for more than 30 days, an Out-of-Province Coverage Certificate for up to twelve months’ coverage should be obtained from Medical Care Plan (MCP). When returning to the province, residents must be physically present for at least 4 consecutive months during any 12-month period to ensure provincial health care benefits are continued.

Coverage is only provided for services that are insured under the Medical Care Plan (MCP). Visit MCP for more information.

New Brunswick

New Brunswick must be your permanent home and you must be physically present for at least 153 days during any 12-month period.

Only emergency medical costs are covered at a maximum cost of $100 per day. More information is available for the New Brunswick Department of Health.

Northwest Territories

NWT must be your permanent home and you must be physically present for at least 153 days in a calendar year to be covered by health insurance when out of the territory.

You must notify the Health Services Administration Office if you plan to be out of the NWT for more than 90 days at a time by providing a completed Temporary Absence Form. Coverage is provided for medically necessary services for emergency or sudden illness. More information is available from the NWT Department of Health and Social Services.

Nova Scotia

You must be physically present in the province for at least 183 days during any 12-month period to qualify for health insurance when out of the province.

If you travel outside of Canada, your medical coverage applies 24 hours a day to a maximum of 60 days per trip. Coverage includes medical reimbursement up-to $1 million. Visit Nova Scotia Health Authority for more information.

Nunavut

The only requirement is that Nunavut must be your primary place of residence.

Nunavut’s Health Care Plan covers limited costs for emergency health services based on the Nunavut physician fee schedule and approved Nunavut hospital rates. For more details, visit the Nunavut Department of Health.

Ontario

You must be a permanent resident of Ontario and be physically present for at least 153 days during any 12-month period to qualify.

As of January 2020, anyone travelling outside Canada is no longer covered by OHIP for emergency health services, such as acute, unexpected conditions, illnesses, diseases, or injuries that require immediate treatment. If recommended by your Ontario doctor, OHIP may cover some medical services in a licensed hospital or facility outside Canada, but you must get written prior approval from the Ministry of Health before you receive the services. Visit the Ministry of Health for more information.

UPDATE:

On September 23, 2020 a court ordered the Ontario government to restore this coverage. The Ontario Divisional Court said the province must reinstate the $200-to-$400-per-day coverage for emergency in-patient services and the as much to $50 per day for emergency outpatient and doctor services.

 

Prince Edward Island

You must be physically present in PEI for at least 6 months plus 1 day in any year to be covered by health insurance when out of the province.

Eligible PEI residents temporarily absent from the province are covered for emergency or sudden illness only. For more details, visit Health PEI.

Quebec

You must be physically present in Quebec for at least 183 days in a calendar year (trips of less than 21 days do not count as non-residency).

Professional services rendered by doctors, dentists and optometrists are covered, as long as the same services are covered in Québec. Hospital services received during a hospital stay or at a hospital outpatient clinic that are insured under the Hospital Insurance Plan are covered. More information is available from the Quebec Régie de l’assurance maladie (RAMQ).

Saskatchewan

Saskatchewan must be your permanent home and you must be present for at least 6 months during any 12-month period.

Saskatchewan Health provides limited coverage for emergency medical care from approved hospitals outside Canada if the same services would be covered in the province. Visit Saskatchewan Health for more information.

Yukon

Yukon must be your permanent home and you must be present for at least 6 months. If you will be away from Yukon for three months or more, you must fill out a Temporary Absence form. Only coverage for emergency, medically necessary hospital and physician services is provided. Visit Yukon Health Care Insurance Plan (YHCIP) for more information.

Under certain circumstances, such as if a written request made by the resident is approved, some provinces may relax the residency requirements.

It is always a good idea to obtain additional private travel health insurance to cover any unexpected medical emergencies.

Get help

A criminal record will prevent you from entering the USA or obtaining your USA immigration status. To erase your Canadian criminal record, call toll-free 1-888-808-3628 or learn more at Pardon Partners. It’s easier than you think.

There are a number of laws governing long term holidays and travelling to the USA as a visitor, student, or to work, often involving Visas and travel permits. To get help, call a lawyer now.


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