What Medical Services Does OHIP Cover For Seniors?

Posted by Insurance Hero on February 6th, 2020

Retirement is considered as a time for relaxation but while it has its advantages, seniors would eventually lose their employee benefits due to retirement. Sadly, this comes at a time when the individual will probably need health care coverage more than an average person. Seniors are exposed to a lot of medical conditions such as cancer, stroke, Alzheimer’s disease, etc.

You need some forms of insurance to live longer. Thankfully, OHIP coverage for seniors can address some of these conditions. Although the provincial health insurance plan is not comprehensive, it covers a lot. Read on to learn more.

What Does OHIP Cover?

Like any other province, Ontario covers only medically necessary conditions in its provincial or government-funded healthcare plan. Although medically necessary conditions may differ from province to province, they include several conditions in Ontario.

Some of these conditions include general practitioner services, ambulance services, hospital services, prescription drug services, optometry services, podiatry services, physiotherapy services, nurse practitioner services, etc.

Furthermore, some of these services are only partially covered and some may not be covered for people of certain age groups, unless in an exceptional situation. Visit Insurdinary to find out more.

What Does OHIP Cover More For Seniors?

OHIP coverage for seniors and younger people may be a bit more than the coverage available for other people. For instance, seniors can assess more coverage in prescription drugs, ambulance services, optometry services, etc.

To get prescription drug coverage in Ontario, you need to sign up for the Ontario Drug Benefits program. This program covers only 4,400 drugs and if your drug is not covered, you can apply for the Exceptional Access Program.

OHIP also provides coverage for ambulance services, however, you are required to make a co-payment for the service. The co-payment amount depends on whether the condition is medically necessary or not. A co-pay of is required for medically necessary conditions and 0 is required for medically unnecessary conditions.

Although the provincial government subsidizes long-term-care coverage in Ontario, you are required to make a monthly contribution to it, depending on the type of room you want. Private rooms are the most expensive, followed by semi-private rooms and then basic rooms.

Rather than going for expensive long-term care insurance, most Ontario seniors prefer to purchase life insurance with long-term care rider. You also need to get additional health insurance to cover medical services not provided by your provincial plan. Click here to learn more about OHIP coverage for seniors.