Ontarians urged to get travel insurance as out-of-country OHIP coverage officially ends

It's a new year —  and that means provincial changes to OHIP have kicked in, leaving Ontarians travelling outside Canada without built in, out-of-country health insurance.

Critics say the switch could lead to increased costs and erect barriers to health care, while the province maintains the program just wasn't working.

But both sides are unified on one message: anyone from Ontario travelling abroad should make sure to buy insurance before heading off on any trip. 

"Consumers and travellers should not be travelling without insurance," said Louise Blazik, director of Travel College Canada.

"The government has always strongly encouraged individuals to purchase additional travel health insurance so they are adequately covered every time they leave Ontario to travel abroad," said David Jensen, Ministry of Health and Long-Term Care spokesperson, in an email.

The province announced its decision to scrap the program last May following a six-day public consultation, saying it was very costly and did not provide value to taxpayers.

OHIP previously covered out-of-country inpatient services up to $400 per day for higher levels of care like intensive care, as well up to $50 per day for emergency outpatient and doctor services.

Jensen told CBC Toronto that the program spent a third of its funding on administrative costs and didn't help with meaningful travel coverage.

"The program's coverage is very limited with five cents of every dollar claimed," he said.

"Fully 95 per cent of claims are paid directly to insurance companies. With this limited coverage and low reimbursement rate, OHIP-eligible Ontarians who do not purchase private travel health insurance can be left with catastrophically large bills to pay."

Premiums surge

A consequence of the cancellation is insurance companies have now hiked their premiums, said Marissa Lennox, chief policy officer with the Canadian Association of Retired Persons (CARP).

"We've heard from our members that they have been affected by this. Their premiums have gone up as a result as companies prepare for the new year," she said.

"It's become a barrier for them, that they can no longer afford the cost of private insurance because those companies are now bearing the full brunt of the costs."

The market for travel among retired people in Canada is huge, Lennox said, adding that almost 40 per cent of the province's population aged 65 or older took a trip outside the country last year.

"This is just an example where the government has made a decision without fully considering the full impact it would have on older adults in Ontario. They haven't done anything to address the fact that premiums have gone up," she said.

The Canadian Snowbird Association has said the program's cancellation would not only impact seniors who travel south during the winter months, but also cross-border shoppers and anyone planning a family vacation.

Province cites high administrative costs

Minister of Health Christine Elliott previously said the province was spending $2.8 million to administer approximately $9 million in claim payments through the program every year. 

In a 2018 report, Auditor General Bonnie Lysyk said the Ministry of Health processed an average of 88,000 out-of-country claims per year over a five-year period through the program, and paid an average of $127 per claim.

Lysyk also noted the high administrative costs of the program, but said they arise because staff must check varying physician services fee rates and process claims manually. She recommended that the government seek ways to reduce administrative costs by adopting a single reimbursement rate for all health services obtained outside Canada.

Blazik, who has worked in the travel industry for decades, said the province's old program wouldn't make a dent in a bill for a significant hospital stay in another country — especially the U.S.

On average, it can cost several thousand dollars a day to stay in an American hospital, she said.

"People absolutely have to have travel insurance," Blazik said.

"Without that, hospital expenses just off the bat are horrendous."