Insurance and drug coverage
Sorting through the confusion
Refugees are often uncertain about what health-insurance coverage they have. Once they arrive in Canada, they receive so much paperwork – and in a language that they don’t understand – that they often don’t know which document is for health care.
They tend to carry all their paperwork with them. It can be helpful to simply ask: “Can you show me all your papers?”
At that point, you can find the relevant health-insurance documents.
For more information about coverage or help accessing services for refugees and immigrants, contact the Ottawa Newcomer Health Centre: 613-691-0192 extension 6002.
Ontario Health Insurance Plan (OHIP)
All privately sponsored refugees and government-assisted refugees have permanent residency once they arrive. That means they are eligible to apply for provincial health insurance right away.
However, enrolment in OHIP is not automatic. Every refugee must apply for it. A settlement worker or sponsor usually helps with this application.
To apply for OHIP coverage, refugees must go in person to a ServiceOntario centre with the following documents:
- A completed OHIP application form
- Confirmation of Permanent Residence (IMM5292, IMM5688)
- A mortgage, rent or lease agreement in the refugee’s name
See a list of other accepted documents.
As a refugee, they may not be covered under OHIP right away. If they do receive OHIP coverage immediately, they will be given a temporary certificate that can be used until they receive their photo health card in the mail.
Interim Federal Health Program
Refugees may not be covered under OHIP right away. If there is a waiting period, all refugees will be covered under the Interim Federal Health Program (IFHP) for up to a year once they arrive in Canada.
IFHP certificates are given to all refugees at the airport as soon as they arrive in Canada.
Changes to IFHP eligibility
Beginning April 1, 2016, coverage is now the same for all individuals eligible under the IFHP, replacing the six types of coverage that have been in place since November 2014.
Eligible groups include:
- Resettled refugees
- Other protected persons
- Asylum claimants
- Rejected claimants
- Immigration detainees
- Victims of human trafficking
- Other groups identified by the federal immigration, refugees and citizenship minister.
Coverage under IFHP
IFHP pays for the services that are normally covered by a provincial health card. All refugees get:
- Basic coverage: The following benefits are only covered up to a maximum dollar amount and only until refugees qualify for OHIP:
- Inpatient and outpatient hospital services.
- The services of medical doctors, registered nurses and other health-care professionals licensed to practice in Canada.
- Care for pregnant women before, during and after birth.
- Laboratory, diagnostic and ambulance services.
To ensure that the services being prescribed are covered, consult the IFHP Basic Coverage Benefit Grid.
- Supplemental coverage: The following benefits are only covered up to a maximum dollar amount:
- Limited dental care
- Limited eye care
- In-home health and personal-care services for the elderly and people recovering from disability, illness or injury
- Long-term care
- Services provided by clinical psychologists
- Services provided by occupational therapists, speech-language therapists and physiotherapists.
To ensure that the services and products being prescribed are covered, consult the IFHP Supplemental Benefit Grid.
- Prescription-drug coverage: Coverage includes medications on the Ontario drug formulary as well as vitamins and parasitic medications. Up-to-date benefit grids and formularies can be found under IFHP Prescription Drug Coverage.
Submitting IFHP claims
Health-service providers who are willing to serve refugees and claim through the IFHP must be registered with Medavie Blue Cross. The company works on behalf of the federal government to reimburse health-care workers and hospitals for the services they provide to refugees.
For more information about how to verify patients’ eligibility and submit claims, read the Government of Canada’s overview of IFHP for health-care professionals.