Guide to OHIP Seniors Coverage in Ontario

ohip seniors coverage

*Please note that Seasons Retirement does not have any afflation with this program. Please call 416-314-5518 or visit the government of Ontario website for enquiries or more details.

As our parents and grandparents grow older, their medical needs may change for various reasons. For overall good health and well-being, staying on top of these changes

and getting the health care you need becomes very important.

Current healthcare expenditure can be costly, especially for individuals without a steady source of income. But the good news is that older adults in Ontario can enjoy access to essential healthcare services on the province’s health insurance plan.

The Ontario Health Insurance Plan (OHIP) is a government program that pays for a wide range of medical services for all residents of Ontario, including older adults. So, your parents or grandparents don’t have to worry much about funding their healthcare needs.

Your older loved ones can find a comfortable place to call home in any of Seasons’ communities in Ontario. We offer various living options to older adults in Canada, including independent living, supportive living, assisted living, and memory care.

The Ontario Health Insurance Plan covers several essential medical services. In this article, we’ll discuss what the OHIP seniors coverage offers your older loved one.

Eligibility Requirement for OHIP Seniors Coverage

Ordinarily, everyone in Ontario should be eligible for the Ontario Health Insurance Plan. However, a residency test requires the presence of your older one in Ontario for a minimum of 153 days each year or for at least 153 days of the first 183 days after moving to the province.

The following are other criteria your older adult needs to meet to qualify for OHIP:

  • They must be a citizen of Canada or an indigenous person.
  • If neither of those mentioned above, they must be a permanent resident of Canada or at least a permanent residence applicant.
  • Convention refugees or protected persons are also eligible.

For older adults born in Ontario or who have lived in the province for several years, their access to OHIP seniors coverage can begin immediately. Likewise, older persons moving from another region to a retirement home in Ontario can enjoy the benefits of the provincial health insurance plan right away.

What Services Does the OHIP Cover for Seniors?

The Ontario Health Insurance Plan offers various health services to older adults in the province. So, if you’re wondering what OHIP covers for seniors over 65 years, you should continue reading to find answers.

Below are some services that Ontario Health Insurance Plan provides to older adults.

1.    Physiotherapy

Maintaining good physical condition is very important for all adults to stay active in retirement, and physiotherapy is a field of clinical science that can help them achieve this.

For adults over 65 years in Ontario, the health insurance plan will cover their physiotherapy expenditures after a physician has referred them. Government-funded physiotherapy clinics will also provide an examination, treatment, and rehabilitation to older persons recovering from an injury.

Under OHIP coverage, your loved ones will get the opportunity to work closely with a physiotherapist who will analyze their situation and help determine the best treatment procedure to move forward with.

2.    Vision Care

Vision care is one of the essential aspects of senior health. Your older loved ones need to take good care of their eyesight, as it plays a significant role in their independence. Routine visits to an eye physician are an excellent way to start.

Does OHIP cover eye exams for seniors? Yes. However, it is worth noting that Ontario Health Insurance Plan pays for only one yearly visit to an optometrist, including any follow-ups. All your parents or grandparents will be required to do to enjoy this health service is to show their health card at the eye clinic.

3.    Prescription Drugs

Under the OHIP drug coverage for seniors, older adults can access prescription drugs. They receive this service via the Ontario Drug Benefit – one of the senior benefits in Ontario, which now covers the total cost of about 5,000 prescription drugs.

Older adults are entitled to free drugs and medical supplies like allergy shots, needles, alcohol swabs, glucose test strips, etc. We must say that OHIP doesn’t take care of all prescription tablets for older persons. There are certain medications older adults may need to pay for themselves.

4.    Home Care Service

Does OHIP cover home care for seniors? Yes. This is particularly helpful for older persons who need the assistance of care workers to get by in their daily lives. Home care services will assist your loved ones with bathing, house maintenance, meal preparation, and so on.

Of course, many retirement communities in Ontario can provide older adults personalized care and adequate medical attention. But some older adults believe they can maintain their independence for longer if they stay home. Luckily, the Ontario Health Insurance Plan can support them with the home care services they may need.

5.    Ambulance Services

During a medical emergency involving an older adult, Ontario Health Insurance Plan covers full or partial costs of the ambulance service. However, a medical practitioner must deem the emergency trip medically necessary to be covered by OHIP.

If found medically necessary, your loved one will only be required to pay $45. On the flip side, they will have to pay $240 if deemed a non-emergency situation. That said, your parents or grandparents may not have to pay any money if they are recipients of provincial social assistance, specific home care service, or long-term care at a licensed retirement home.

All older adults enrolled on the Ontario Health Insurance Plan also have access to the health services below:

  • Medically necessary visits to a general practitioner
  • Hospital services include doctors, diagnostic testing, accommodation, meals, and so on.
  • In-hospital dental surgery.
  • Podiatry services: OHIP covers $7-16 per visit with an annual cap of $135.
  • Nurse practitioner visits.

Final Words

OHIP seniors coverage provides primary and essential care to older adults in the province. And, even though it doesn’t cover every medical cost your older loved ones may incur during their retirement, the government-funded benefit is quite valuable to older adults in Ontario.

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