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OHIP: proposed cuts to emergency out-of-country and osteopath coverage
Aon Insights

OHIP: proposed cuts to emergency out-of-country and osteopath coverage

 

The Ministry of Health and Long-Term Care (ministry) is proposing to end Ontario Health Insurance Program (OHIP) coverage for emergency services (arising while outside the country) for Ontarians travelling outside of Canada. If approved this change would take effect October 1, 2019.

Currently the Out-of-Country Travellers Program provides reimbursement at the following rates for services required to treat conditions that are acute, unexpected, arose outside Canada, and require immediate treatment.

For out-of-country inpatient services:

  • a maximum of $400/day for higher level of care (e.g. Intensive Care Unit, operating room);
  • a maximum of $200/day for any other level of care;

Otherwise:

  • $50/day for outpatient services; and
  • $210 for renal dialysis.

This proposal does not affect current publicly funded health care coverage for Ontarians travelling in other parts of Canada.

Osteopath services

In addition, the ministry is proposing to end OHIP coverage for osteopath services provided out-of-province. Regulation 280 under the Drugless Practitioners Act, which regulated the profession of osteopathy in Ontario, was revoked on October 25, 2004, and as a result osteopathy is no longer recognized as a regulated health profession in Ontario nor are there any active OHIP billing numbers. There have been no claims submitted for osteopathy services rendered in Ontario for over seven years. OHIP has however, paid annually on average, a total of $100 or less for osteopathy services rendered in other provinces to Ontario patients. This regulatory amendment will eliminate this residual inconsistency in coverage for osteopathy services provided out of province versus in province.

In isolation, these proposals are not expected to have a significant impact on plan sponsors. However, they reflect a renewed trend towards public to private cost shifting.