OHIP out of country coverage is much narrower than most Ontarians expect. Outside Canada, OHIP pays only set daily amounts for sudden emergencies, and you can lose coverage altogether if you spend too long away from Ontario. Below are the 212-day rule, the two-year extended absence, what OHIP pays abroad, how to claim, and a worked US hospital bill.
OHIP out of country coverage: does OHIP cover you outside Canada?
Only in part. Outside Canada, OHIP pays a set rate for emergency hospital and doctors' services for an acute, unexpected illness or injury that needs immediate treatment. Hospital stays are paid at up to $400 a day and outpatient care at up to $50 a day. To keep OHIP at all, you generally can't be away more than 212 days in any 12 months.
Ontario's OHIP coverage while outside Canada page warns that emergency care abroad generally costs much more than OHIP may pay. The Government of Canada's Well on Your Way guide adds that provincial plans won't pay up front.
This guide covers Ontario only. To compare all 13 plans, see provincial health coverage time-away rules; for gaps at home, see what OHIP does not cover.
How long can you be out of Ontario and keep OHIP?
Ontario must be your primary home, and you must be physically present in the province at least 153 days in any 12-month period. That's the test in the Ministry of Health's registration guidance. Put the other way, you can be away for up to seven months, or 212 days, in any 12-month period.
The OHIP 212-day rule in practice
The OHIP 212 day rule has three details that catch people out:
- It's a rolling window. Ontario looks at any 12-month period, so a winter that crosses January doesn't reset on New Year's Day.
- It counts days outside Ontario, not only outside Canada. A summer month at a cottage in another province uses up part of your allowance.
- Going over has consequences. More than 212 days outside Ontario in any 12-month period may mean reapplying for OHIP at a ServiceOntario centre.
A November-to-April winter in Florida is about 180 days. Add a summer month in another province and you pass 212. The pages we checked don't say how travel days are counted, so count conservatively. And if you were away more than seven months in the last 12, Ontario's health card renewal page says you may need extra documents to renew.
The two-year extended absence
If you'll be outside Canada for more than seven months in a 12-month period, you can keep OHIP for up to two years if:
- you have a valid Ontario health card
- Ontario remains your primary home
- you were in Ontario at least 153 days in each of the two 12-month periods immediately before you leave
Before you go, take your health card and proof of residency, such as a mortgage, lease, property tax bill or driver's licence, to a ServiceOntario centre. Ontario extends this to family members when you leave for full-time work or study, so on a long vacation, each traveller should check their own eligibility. The pages we checked don't say how often you can use it, so ask ServiceOntario. It keeps your card valid but doesn't raise what OHIP pays abroad.
What OHIP pays, and doesn't, for care abroad
An OHIP out of country emergency claim is paid at fixed amounts, not at the foreign hospital's prices:
| Care outside Canada | What OHIP pays (as of October 2026) |
|---|---|
| Emergency inpatient care in an operating room, coronary care, intensive care, or neonatal or pediatric special care unit | Up to $400 a day |
| Emergency inpatient care at lower levels | Up to $200 a day |
| Emergency outpatient care | $50 a day or the hospital's bill, whichever is less |
| Emergency doctors' services | A set rate. The page we checked gives no dollar amount. |
| Planned treatment you choose to get abroad | Nothing, unless the ministry approved it in writing first |
Canadian dollars, from Ontario's OHIP coverage while outside Canada page, checked October 2026. Emergency means an acute, unexpected condition, illness, disease or injury that needs immediate treatment.
Getting home is a separate cost. The Government of Canada warns that a medical evacuation could cost more than $50,000.
Planned treatment abroad needs prior approval
OHIP may pay the full cost of approved treatment outside Canada, but only with the Ministry of Health's written approval before you receive it. Under the out-of-country criteria, the treatment must:
- take place in a hospital or licensed health facility
- not be experimental or research
- be accepted in Ontario as appropriate for your medical circumstances
- be unavailable in Ontario, or face a delay here that would lead to death or medically significant irreversible tissue damage
Your Ontario doctor applies, with a specialist's written confirmation. The form has been electronic since April 15, 2024, according to ministry bulletin 240404. Without approval, you generally pay all costs, except in an emergency. If you're refused, you can ask for an internal review or a hearing before the Health Services Appeal and Review Board.
Does OHIP cover travel to the USA? A worked example
Yes, under the same emergency rules as anywhere outside Canada. Canada's travel advice for the United States warns that treatment there is expensive and visitors without travel health insurance pay out of pocket. Hospitals must treat emergencies, but they charge for every service.
To see the gap, take a published bill. Quebec's health insurance board, RAMQ, gives an example of a heart attack treated in Florida: $25,000 in hospital charges for a three-day stay, plus $1,000 in doctors' fees. Here's that bill run through OHIP's daily maximums:
| Line on the bill | Amount billed | OHIP would pay | Left for you or a private insurer |
|---|---|---|---|
| Hospital, 3 days, all in coronary or intensive care | $25,000 | Up to $1,200 ($400 × 3) | At least $23,800 |
| Hospital, 3 days, all at a lower level of care | $25,000 | Up to $600 ($200 × 3) | At least $24,400 |
| Doctors' fees | $1,000 | Part, at OHIP's set rate | The difference |
Illustrative example. Bill amounts are from RAMQ's published Florida example, in Canadian dollars; under Quebec's rates, RAMQ paid $300 of the hospital charges and $435 of the doctors' fees. The OHIP column applies Ontario's daily maximums as of October 2026. A real claim depends on the level of care and OHIP's assessment.
Without private coverage, you would owe at least $23,800 of the hospital charges. With an emergency medical travel policy, the insurer pays eligible costs above OHIP's share, up to the policy limit and minus any deductible, if the claim fits the policy's terms.
Travel within Canada: OHIP in other provinces
Your Ontario health card works across Canada, with limits. According to OHIP coverage outside Ontario:
- Covered: medically necessary insured doctor and hospital services, such as emergency care, diagnostic tests and lab work in a public hospital.
- Not covered: ambulance services, including transport and paramedic care, plus home care and long-term care.
- Paying and claiming: a doctor may charge you even if you show your card. Quebec doesn't take part in reciprocal billing for doctors' services, so a Quebec doctor may bill you directly. Keep the receipt and claim it from OHIP.
These days also count toward your 212. Out of province travel insurance can fill gaps such as an ambulance bill, depending on the policy. Compare options on our travel insurance page.
How to claim from OHIP after care abroad
If you paid a bill yourself, here's how to claim:
- Get a detailed statement from the hospital or doctor, in English or French, showing admission and discharge dates, the services, the discharge diagnosis and itemized fees. OHIP wants the original.
- Attach proof of payment.
- Fill in the Out-of-Province/Out-of-Country Claim Submission form and keep copies of everything.
- Submit within 12 months of the date you received the service.
If a travel insurer handled the bill, ask whether it will claim OHIP's share for you. Billing agencies can submit these claims electronically, according to ministry bulletin 240303.
What travel insurance costs for an Ontario traveller
Travel insurance prices rise with age and trip length, as Instasure's model shows:
| Example traveller | 14-day trip | 90-day trip | 182-day trip |
|---|---|---|---|
| Age 65 | $105 ($84 to $130) | $675 ($540 to $837) | $1,365 ($1,092 to $1,693) |
| Age 75 | $238 ($190 to $295) | $1,530 ($1,224 to $1,897) | $3,094 ($2,475 to $3,837) |
Instasure estimates for an example profile (one Ontario traveller, emergency medical only, USA or worldwide), per trip, as of October 2026: typical figure, then range. Modelled estimates, not quotes or averages. Our model doesn't rate medical questionnaire answers, which can change a real quote a lot.
For travel insurance for seniors, the medical questionnaire can decide whether a claim is paid; see travel insurance with pre-existing conditions and snowbird travel insurance.
Hosting family from abroad? Visitors and tourists aren't eligible for OHIP, so see visitors insurance in Canada. For students from abroad, see international student health insurance in Canada.
Checklist for Ontario snowbirds
Use this checklist for the OHIP snowbird rules before you book:
- Count every day outside Ontario in any rolling 12 months, including trips within Canada, and stay well under 212.
- Check the 153-day test for the two prior 12-month periods if you might be outside Canada more than seven months, then visit ServiceOntario before you leave.
- Keep proof Ontario is home, such as your lease or mortgage, property tax bill and driver's licence, and check your health card's expiry date.
- Buy emergency medical cover for every day of the trip, and answer the medical questionnaire carefully.
- Pack your health card, policy number and your insurer's emergency assistance number.
- Keep itemized bills and proof of payment, and claim within 12 months.
Michael's take
As a planner, I'd treat OHIP's payments abroad as a small rebate, not as insurance. The worked example shows why: OHIP's daily maximums barely dent a foreign hospital bill, and for a retiree the rest would come out of savings meant to last decades. So I budget travel coverage as a fixed cost of the winter, like flights, and buy it for the full stay before booking anything non-refundable.
My rule of thumb is to keep a simple travel log with every departure and return date, including trips within Canada. Ontario's limits run on a rolling 12 months, and memory is a poor calculator. If you're considering the two-year absence, check your 153-day history and see ServiceOntario before you leave, not after.
Next steps
Get an instant estimate for your trip with our travel insurance quote tool, then compare travel insurance in Ontario.
For a long winter or a medical condition, request a call from our Snowbird travel desk. A licensed advisor in Ontario can walk through the medical questionnaire with you and compare insurers. Estimates are model-based ranges, not quotes.
