How to Get Around the Ontario healthcare system?

People who are new to Ontario need to learn a lot about how to use the province's publicly funded health care system to get care and how to get care. If you are waiting to become eligible for Ontario's health insurance or already have it, knowing how care is organised will help you get the right services when you need them.

This guide will explain who can get OHIP, how to find primary care, when to go to the emergency room, how referrals work, and what you can do if you aren't covered yet.

Who are all eligible to get the OHIP?

The Ontario Health Insurance Plan (OHIP) covers eligible residents' medical costs for free. To be eligible, you must live in Ontario full-time and be physically present in the province for at least 153 days in any 12-month period, including the first 183 days after moving.

Permanent residents and Canadian citizens automatically qualify as long as they meet the requirements for residency. 

Several types of temporary residents may also be eligible, such as

• People with a full-time work permit who have worked in Ontario for at least six months
• Applicants for permanent residence who have an Acknowledgement of Receipt (AOR)
• People who are in the programmes for live-in carers or seasonal farm workers
• People with a Temporary Resident Permit (case types 86–95)
• Ministers who work full-time
• Convention refugees or other people who are protected
• People whose spouses or dependents have an eligible permit may also be eligible.

How to get to the Primary Care?

A primary care provider, like a family doctor or nurse practitioner, is where most patients start their journey through the system. They take care of regular checkups, screenings, prescriptions, managing long-term illnesses, and other general medical issues. They can also send you to a specialist if you need it.

How to Find a Family Doctor?

Getting primary care in Ontario has traditionally meant signing up with one family doctor who takes care of you for life. But because there aren't enough doctors, many newcomers have to wait a long time.

Health Care Connect is a provincial service that connects people who live in the province with primary care providers who are accepting new patients. You can use it to look for a doctor. You can also call local clinics; some may have openings that aren't advertised if you call them.

What to Do If You Don't Have a Family Doctor?

You can get care in the following ways if you are still waiting for a doctor or don't have OHIP yet:

• Clinics You Can Walk Into: You don't need an appointment to go to a walk-in clinic for minor or non-urgent care. Most services are covered by OHIP. Without coverage, visits usually cost between $60 and $150.
• Web-based clinics: It's possible to talk to doctors online through sites like Health Connect Ontario (Health 811), Maple, Rocket Doctor, and Tia Health. If you have OHIP, many services are free. If you don't have it, fees vary.
• Health Centres for the Community: Community health centres (CHCs) provide medical care as well as social and housing services. Many don't need OHIP and can give free care, but there are different requirements to be eligible.
• Clinics for specialists: Most specialist services need a referral, but some clinics let you make your own or have walk-in hours. Specialist care is covered by OHIP. If you don't have coverage, consultations usually cost between $100 and $300.