Canadian Provincial Healthcare: Ontario Is Cutting Out-of-Country Medical Insurance

Thousands gather in Queen's Park to protest against the Ford's government changes to Public Healthcare in the province of Ontario, Canada.

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Canadian Provincial Healthcare – Catching Up: 

Canadians are certainly not rarities abroad. In Mexico, there are sizeable communities in Puerto Vallarta and Lake Chapala. If you’re reading this in other tropical countries, it’s likely they have a community of Canadian expats as well. Many Canadians simply leave Canada during the winter months to avoid the colder months. These so-called “snowbirds” will generally return to Canada once the snows thaw and the harsh winters pass. 

The Canadian provincial healthcare system is a form of socialized medicine that is broken down into provincial plans. That means whichever province that you reside in will have its own healthcare plan for you—and some provinces are richer than others. Canadian provincial healthcare coverage often only covers some scenarios to a varying degree. 

Canadian provincial plans generally have some form of out-of-country coverage. This means that when you are abroad, your province will cover you for a certain amount—occasionally based on the price of the procedure in Canada. Canadian provincial plans rarely cover everything in expensive countries like the United States. However, in inexpensive countries like Mexico, these plans have often been enough for snowbirds to feel relatively secure in their wellbeing when they travel abroad. 

Furthermore, the Canadian provincial healthcare system has attempted to cater to these individuals by offering out-of-country provincial coverage to Canadians living abroad for roughly 6 to 7 months. As long as you return to your home province within the allotted time period, you have healthcare coverage abroad which is typically done on a reimbursement model. The Canadian citizen fronts the medical expenses out-of-pocket, and then the province reimburses them. Occasionally, what the province pays out is enough to cover the costs of medical expenses abroad—though this is quite rare. 

If you should happen to overstay abroad beyond the allotted time period, then your Canadian provincial plan will expire and it may be a process to get your provincial coverage back.

Canadian Provincial Healthcare – Changes in Ontario: 

As all things, Canadian provincial healthcare is subject to change. Nowhere is this more obvious than in Ontario where their provincial plan has decided to scrap out-of-country coverage altogether. On May 1st of 2019, the government of Ontario announced that it will remove the government-funded program which offers basic out-of-country travel insurance from Ontario’s provincial plan. 

After a 6-day public consultation, Health Minister Christine Elliott and her progressive conservative government decided to eliminate the program. She said, “We know that it’s not good value for Ontarians. People should be making their own plans to obtain coverage, which can be obtained quite inexpensively and provide them with full compensation if they sustain any health problems while out of the country.” 

The Ontario Health Insurance Plan (OHIP) provincial out-of-country plan currently covers inpatient services up to $400 CAD per day—which is intended to secure a higher level of care—and $200 CAD for other care. In addition, it also covers up to $50 CAD a day for doctor services and emergency outpatient services.

Overall, the province of Ontario spends $9M CAD in claim payments through this program every year. However, one huge factor in justifying cutting the program is that it costs $2.8M CAD to administer the program as well. 

The change is scheduled to come into effect on October 1st, 2019. 

Of course, this change will come right before most “snowbirds” leave Canada for warmer pastures. A public outreach campaign will be put forth to remind travelers to purchase health insurance before leaving Canada. Elliott went on to say, “I think many people didn’t even know there was any level of coverage before, but it is important and we will have a public campaign to advise people because we don’t want people to have that unfortunate shock if they have a health problem while out of country, to have those costs which can be quite extraordinarily high.”

Seniors belonging to the 'Ottawa Raging Nannies' hold signs protesting changes to Ontario's out-of-country healthcare.

Canadian Provincial Healthcare – Criticism of Changes: 

These changes to Ontario’s provincial healthcare are not without their critics, however. Much of the criticism is directed at the fact that older snowbirds will be hurt the most by cutting this OHIP program. In 2018, 11 million Canadians traveled abroad at least for one night. Of those 11 million, 56% were over 45 years of age—roughly 6 million people. According to the Ontario government, 40,000 people require health services abroad each year. 

Several prominent organizations have joined in objecting to Ontario’s cutting out-of-country coverage. Among them, the Canadian Association of Retired Persons (CARP), the Canadian Federation of Pensioners, and the Canadian Snowbird Association have both objected to the changes. 

Part of CARP’s objections is that any expat health insurance and travel insurance must take into account that these snowbirds have lost their OHIP out-of-country provincial coverage. As CARP’s Chief Policy Officer Laura Tamblyn Watts put it, “CARP is very concerned about these recent cuts. Our members, and all older Canadians, may now be more vulnerable to health care costs out of country. Canadians will also need to ensure that any extended coverage is not predicated on OHIP coverage.”

The Canadian Snowbirds Association also objects to the changes in Ontario’s out-of-country provincial plan. Their main objection is that premiums could increase up to %7.5 without a Canadian provincial healthcare plan to back it up. The Canadian Federation of Pensioners also objects to cutting the out-of-country provincial plan on the grounds that many snowbirds have preexisting conditions which would make private insurance extremely expensive or even unavailable. 

President of the Canadian Federation of Pensioners Michael Powell said, “The Canadian Federation of Pensioners is against these cuts. By the age of retirement, the majority of older adults have pre-existing conditions, which make private insurance unaffordable or ineligible. Many of those people are currently covered by extended benefits from their previous employer, and often to get a claim paid, OHIP coverage is required.”

Another conscientious objector is NDP legislator Marit Stiles who felt that the Ontario provincial government was attempting to pass the changes in OHIP’s out-of-country provincial coverage “without having a coversation with the folks who will be affected, who travel overseas or to the south during the winter months. . . I don’t know how this government can be making this decision at all.”

Canadian Provincial Healthcare – Defense of Changes: 

Those who defend the new changes in OHIP’s Canadian provincial healthcare plan has been defended by several government officials. Most point out that OHIP covers only 5% of the cost of a typical medical emergency abroad that Canadians have been known to face. Because of this low amount of coverage, the government of Ontario states that purchasing travel insurance is already a necessity—especially if you are traveling to a country like the United States without socialized medicine. 

In addition, they hope these measures will help to address the $11.7B CAD deficit that the Ontario provincial government has acquired. Cutting out-of-country insurance helps to cut 10% of the province’s deficit. Plus, over 90% of out-of-country travelers obtain private travel health insurance already. 

Unfortunately, it seems as though Ontario’s provincial government has come under fire for the job losses that these changes to Canadian provincial healthcare will have on the job market of Ontario. Canadian Health Minister Christine Elliott says that the new healthcare legislation was not aimed at cutting healthcare. In a statement released earlier this year, Elliott said, “What we are looking at is improving patient efficiency. We are restructuring the system in many respects, moving people into different positions within the structure, because the way things are operating. . . it’s not working right now.”

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