20
The Canadian Travellers’ Report Card
PRESERVATION OF HEALTH COVERAGE FOR FREQUENT TRAVELLERS
C+
(2006: C)
Ontarians can keep their health benefts and be out of the province for up to 212 days (approximately seven
months) in any 12-month period. While this is one of the longest allowable travel periods in Canada, Ontario does
not have a policy that allows residents to travel the rest of the year without risk of losing their benefts. The govern-
ment does, however, have the discretion to approve continued coverage during a longer vacation absence.
Change since last report:
Efective April 1, 2009, Ontarians may be eligible to maintain their OHIP coverage more
than once for a longer vacation absence. To be eligible, Ontarians must meet the physical presence requirements
in Ontario for at least 153 days in the 12-month periods for 5 consecutive years before each subsequent absence.
Recommendations:
In addition to allowing travellers to be out of the country for 212 days a year, Ontario should
allow for an unlimited number of short-term trips to anywhere in the world, provided that the traveller maintains
his or her principal residence in the province.
ACCESS TO EMERGENCY HEALTH COVERAGE WHEN TRAVELLING
C-
(2006: C-)
Ontario’s practice for reimbursing Canadians for emergency health services while abroad contravenes sub-para-
graph 11(1)(b)(ii) of the Canada Health Act. Emergency in-patient hospital services eligible for OHIP coverage will be
paid up to a maximum of $400 per day for complex hospital care. “Complex” is defned as care that takes place in
coronary care unit, intensive care unit, neonatal or paediatric special care unit or the operating room of an eligible
hospital or health facility. For less intensive emergency in-patient care Ontario reimburses travellers up to $200
per day. Both these rates are well below the rate of $851 provided for in-patient hospital services received within
the province. Emergency out-patient services, with the exception of dialysis, will be paid to a maximum of $50 for
all out-patient services provided on any one day. Out-of-country dialysis treatment will be paid at a rate of $210
per treatment. Fifty dollars per day is below the average paid to residents for similar in-province services in other
jurisdictions. For physician services, OHIP will pay the actual cost billed by the out-of-country physician(s) or the
cost of the same physician service(s) in Ontario, whichever is less.
Change since last report
:
None.
Recommendations
:
Comply with the Canada Health Act by reimbursing emergency in-patient and out-patient
services required by travelling Ontarians at the same rate as that paid for services within the province. The province
should continue to update these rates over time to match change in real costs.
ACCESS TO PRESCRIPTION DRUGS FOR USE DURING TRAVEL
B-
(2006: B-)
Ontario’s Drug Beneft Programwill cover the cost of 200 days worth of prescription drugs, but only in two separate
100-day supplies. In order to obtain the second 100-day supply, the traveller must provide the pharmacist with a
letter (written by the individual) or a copy of travel insurance, in either case confrming the planned departure. In
addition, if an Ontario resident has 30 days or less left on their current prescription, the ministry will allow an early
refll of the next 100-day supply. This allowance enables one to take between a 200 to 230-day supply of medica-
tion with them when travelling, depending on when the request for an early refll and vacation supply is made.
As an alternative, the Ontario government suggests that the patient can make arrangements with the physician
and pharmacist to receive a second supply, while abroad, by registered mail or courier.
The Ontario government does not reimburse the cost of prescriptions purchased while outside of the province.
Change since last report:
Formalization of the policy allowing an early refll on the next 100-day supply if 30 days
or less are left on the current prescription.
Ontario