OHIP in Toronto: health cover for Australians

Ontario's public health plan is generous once you're in it. Getting in, and covering what it leaves out, is the hard part.

The short version

Australia and Canada have no reciprocal health care agreement. Your Medicare card does nothing in Toronto [1].
OHIP, the Ontario Health Insurance Plan, covers work permit holders only if they work full-time for an Ontario employer for at least six months and meet the residence rules [2]. Many working holiday makers won't qualify.
There's no longer a three-month waiting period. If you qualify, cover starts straight away [2].
You apply in person at a ServiceOntario centre with three original documents [2].
OHIP doesn't cover prescriptions outside hospital, dentists, glasses or most physio for working-age adults [3][5]. Plan on private or workplace cover for those.

No Medicare, no reciprocal deal

Australia has reciprocal health care agreements with the UK, Ireland, New Zealand and a handful of European countries. Canada isn't one of them. Smartraveller says it plainly: there's no reciprocal agreement, public health care may not be available unless you're a provincial resident, and you should expect to pay upfront [1].

That changes the maths for a new arrival. In Sydney or Melbourne, a GP visit is bulk-billed or close to it. In Toronto, if you're not on OHIP, you pay the clinic's private rate for a walk-in visit, and the bill for an emergency department visit or an ambulance can run into the thousands. Smartraveller warns uninsured travellers may face bills of "many thousands of dollars" [1].

On the Australian side, Medicare is built for people who live in Australia. Once you move overseas for good, your eligibility changes, so read our guide to Medicare when you live abroad before you cancel anything.

Who qualifies for OHIP

Every applicant must meet some minimum rules and at least one extra requirement tied to their status [2].

The minimum rules

Make Ontario your primary place of residence.
Be physically in Ontario for at least 153 days in any 12-month period [2].

The extra requirement for most Australians

Most Aussies in Toronto hold a work permit, and the test there is specific. You must hold a valid work permit and be working full-time in Ontario, for an Ontario employer, for at least six months [2]. If you qualify, your spouse and dependants may qualify too [2]. If your permit has expired but you're on maintained status because you applied to extend it in time, you may still be covered. ServiceOntario decides [2].

Your situation	Likely OHIP status	What to do
Permanent resident	Eligible once you meet the residence rules [2]	Apply at ServiceOntario as soon as you land
Work permit, full-time job, Ontario employer, 6+ months ahead	Usually eligible [2]	Bring your permit and an employer letter
IEC working holiday, casual or short-term work	Often not eligible	Keep the private insurance IEC required
IEC Young Professional with a full-time offer	May be eligible if the job meets the test [2]	Ask ServiceOntario before dropping private cover
Remote worker paid by an Australian company	Not under the work permit test (the employer must be in Ontario) [2]	Private international cover
Visitor	Not eligible	Travel insurance

The working holiday problem

Ontario's OHIP page doesn't mention International Experience Canada at all [2]. So the work permit test is the one that applies. A working holiday permit is open, which is fine, but the job behind it has to be full-time and with an Ontario employer, and you need to be working that job for six months. Bar shifts across three venues usually won't cut it. A full-time contract on a 12-month offer often will.

That's why IEC makes you hold health insurance for your whole stay, including repatriation [6]. Don't treat that policy as a box to tick at the airport. For many Aussies on a working holiday, it's the only cover they'll ever have in Canada.

How to apply at ServiceOntario

You can't apply online. You go in person to a ServiceOntario centre [2], and there are centres spread across Toronto, from downtown to the suburbs. Not every centre handles health cards, so check the location finder before you go.

Check your eligibility against Ontario's page, especially the full-time and six-month rules [2].
Get an employer letter confirming your role, that it's full-time, and the expected length of employment. ServiceOntario's document list sets out what's accepted.
Gather three original documents: one proving your immigration status (your work permit or PR confirmation), one proving Ontario residency (a lease, utility bill or bank statement with your Toronto address) and one proving identity (your Australian passport) [2]. Photocopies aren't accepted [2].
Fill in the Registration for Ontario Health Insurance Coverage form before you go [2].
Book or turn up at a ServiceOntario centre. They take a photo for the card.
Keep the paper receipt. Your card arrives by post, and coverage starts from the date you're found eligible.

If you can't prove something on the day, you'll be asked to come back with more documents [2]. For tricky cases, call ServiceOntario on 1-866-532-3161 [2].

Finding a family doctor (and what to do meanwhile)

In Australia you can usually pick a GP and book online. In Ontario, "family doctors" take on patients, and many lists are full. Smartraveller notes that many Canadian doctors aren't taking new patients [1].

Health Care Connect

Once you have an OHIP number, register with Health Care Connect, Ontario's free matching service. A Care Connector looks for a family doctor or nurse practitioner taking new patients near you, with urgent cases matched first [4]. You need a valid health card number, contact details and the mailing address on your card. You can register online or by calling 811, 24/7 [4]. Registering doesn't guarantee a quick match [4], so ask colleagues and neighbours too. A doctor who's taking patients is often found by word of mouth.

While you wait

Walk-in clinics. Toronto has plenty, from the downtown core to the suburbs. With OHIP, visits are covered. Without it, you pay the clinic's private rate.
Health811. Free phone and online health advice from a registered nurse, at health811.ontario.ca or by dialling 811 [4].
Pharmacists. Ontario pharmacists can assess and prescribe for a range of minor conditions, which saves a clinic visit.
Emergency departments. For real emergencies only, and expect long waits for anything that isn't life-threatening. Call 911 for an ambulance.

What OHIP doesn't cover

This is where Aussies get caught. OHIP covers medically necessary doctor visits, hospital care and most lab tests in full [3]. Everything around them is a different story.

Service	OHIP covers it?	Notes
Family doctor and specialist visits	Yes, if medically necessary [3]	Includes phone and video visits
Hospital stay and tests	Yes [3]	Private or semi-private rooms cost extra
Prescriptions from a pharmacy	No, for most adults [3]	OHIP+ covers people 24 and under without a private plan [5]
Dentist	No [3]	Only certain hospital dental surgery
Eye exam	Under 20 yearly; 20–64 only with conditions like diabetes [3]	Glasses and contacts aren't covered [3]
Physiotherapy	Only for some groups [7]	Under 19, 65+, after a hospital stay or surgery, or on social assistance
Podiatry	Partly: CA$7–16 a visit, up to CA$135 a year [3]	Surgery isn't covered
Ambulance	Partly [3]	Depends on the circumstances

Filling the gaps

Workplace benefits. Most full-time salaried jobs in Toronto come with an extended health plan covering prescriptions, dental, vision and paramedical (physio, massage, psychology). Ask about it at offer stage. It's as much a part of the package as salary.
Private extended health insurance. If your employer doesn't offer a plan, you can buy one yourself. Read the waiting periods and pre-existing condition clauses.
Travel or international cover for anyone not on OHIP. Make sure it covers you while living in Canada, not just a short holiday.
OHIP+ for under-25s. If you're 24 or younger, on OHIP and not on a private drug plan, more than 5,900 prescription drugs are covered automatically [5].

One more point. OHIP's cover outside Canada is limited, so your trip home to Australia at Christmas needs its own travel insurance. Our guide to private health insurance when you move overseas covers what to keep at home.

Your first-month health checklist

Keep your IEC or travel insurance active from the day you land.
Book ServiceOntario once you have a full-time Ontario job, a lease and your permit.
Enrol in your employer's benefits plan within its deadline.
Register with Health Care Connect as soon as your OHIP number arrives [4].
Save 811 and 911 in your phone, and find your nearest walk-in clinic.
Bring a supply of regular medication from Australia with a doctor's letter, and plan how to refill it here.

Want to know which walk-in clinics other Aussies rate, or how long their Health Care Connect match took? Ask in Cooee Canada, our Facebook group for Australians in Canada.

OHIP in Toronto: health cover for Australians, gaps and all