Global Major Cities Guide

An overview of access to public and private healthcare services and the Ontario Health Insurance Plan (OHIP).

Sections

1. Overview of Healthcare in Toronto

Toronto’s healthcare system is part of Ontario’s publicly funded healthcare system, which operates under the Canada Health Act. The system is primarily funded through taxes and provides medically necessary services to residents at no direct cost. However, there are some services that are not covered, and private insurance may be required to supplement these.

The healthcare system in Toronto is a mix of public and private services:

Public Healthcare: Covers essential medical services such as doctor visits, hospital stays, and diagnostic tests.
Private Healthcare: Covers services not included in public healthcare, such as dental care, prescription drugs (for most people under 65), vision care, and physiotherapy.

2. Ontario Health Insurance Plan (OHIP)

The Ontario Health Insurance Plan (OHIP) is the public health insurance program that provides access to healthcare services in Toronto.

What OHIP Covers:

Visits to family doctors and specialists.
Hospital stays and emergency services.
Diagnostic tests such as X-rays and blood work.
Some surgical procedures.
Maternity and prenatal care.
Mental health services provided by physicians or psychiatrists.

What OHIP Does Not Cover:

Prescription medications (except for certain groups, such as seniors or those on social assistance).
Dental care (except for specific surgeries performed in hospitals).
Vision care (eye exams are only covered for those under 20 or over 65).
Cosmetic surgery.
Physiotherapy, chiropractic care, and other allied health services (unless under specific circumstances).

Eligibility for OHIP:

To qualify for OHIP, you must:

Be a Canadian citizen, permanent resident, or hold an eligible immigration status (e.g., work permit, study permit with specific conditions).
Make Ontario your primary residence.
Be physically present in Ontario for at least 153 days in any 12-month period.

How to Apply for OHIP:

Gather Required Documents: You’ll need proof of identity (e.g., passport), proof of residency in Ontario (e.g., lease agreement, utility bill), and proof of immigration status (e.g., permanent resident card, work permit).
Visit a ServiceOntario Centre: Submit your application in person at a ServiceOntario location.
Wait for Your OHIP Card: There is typically a three-month waiting period for new residents, during which you’ll need private health insurance.

3. Private Health Insurance

Since OHIP does not cover all healthcare services, many residents in Toronto purchase private health insurance to cover additional costs. Private insurance is often provided through employers, but you can also purchase it independently.

What Private Insurance Covers:

Prescription medications.
Dental care (cleanings, fillings, orthodontics).
Vision care (glasses, contact lenses, eye exams for adults).
Paramedical services (e.g., physiotherapy, massage therapy, chiropractic care).
Travel insurance for medical emergencies outside Canada.

Cost of Private Insurance:

The cost varies depending on the coverage and provider. On average:

Individual plans: CAD $50–$200 per month.
Family plans: CAD $150–$400 per month.

Some popular private insurance providers in Toronto include:

Manulife
Sun Life Financial
Green Shield Canada
Blue Cross

4. Accessing Healthcare Services in Toronto

Toronto has a wide network of healthcare facilities, including hospitals, walk-in clinics, family doctors, and specialists. Here’s how to access them:

Family Doctors (Primary Care)

Family doctors are your first point of contact for non-emergency medical issues.
You can find a family doctor through the Health Care Connect program if you don’t already have one.
Appointments are free with OHIP.

Walk-In Clinics

Walk-in clinics are ideal for non-emergency issues when you don’t have a family doctor or need immediate care.
No appointment is necessary, but wait times can vary.
Services are free with OHIP, but you’ll need to show your health card.

Hospitals

Toronto has world-class hospitals, including Toronto General Hospital, Mount Sinai Hospital, and Sunnybrook Health Sciences Centre.
Emergency services are available 24/7, but you may face long wait times for non-urgent issues.
Bring your OHIP card for free treatment.

Specialists

You’ll need a referral from a family doctor to see a specialist (e.g., dermatologist, cardiologist).
Wait times for specialists can range from weeks to months, depending on the urgency and specialty.

Pharmacies

Pharmacies are widely available and provide prescription medications, over-the-counter drugs, and health advice.
Major chains include Shoppers Drug Mart, Rexall, and Walmart Pharmacy.

5. Costs of Healthcare in Toronto

For those covered by OHIP, most essential services are free. However, you may incur costs for services not covered by OHIP:

Prescription Medications: Costs vary but can range from CAD $10–$200+ per prescription. Many pharmacies offer generic options at lower prices.
Dental Care: A routine cleaning can cost CAD $100–$300 without insurance.
Vision Care: Eye exams cost around CAD $80–$150 for adults aged 20–64.
Paramedical Services: Physiotherapy sessions typically cost CAD $75–$150 per session.

6. Healthcare Tips for Newcomers

Get Private Insurance During the OHIP Waiting Period: If you’re a new resident, ensure you have private insurance to cover the three-month waiting period for OHIP.
Carry Your Health Card: Always carry your OHIP card, as it’s required to access free healthcare services.
Understand Wait Times: Non-urgent care can have long wait times, so plan accordingly. For faster service, consider walk-in clinics or virtual healthcare options.
Use Telehealth Ontario: Call 811 to speak with a registered nurse for free health advice 24/7.
Explore Community Health Centres (CHCs): CHCs provide healthcare services to underserved populations, including newcomers, and may offer services not covered by OHIP.
Learn About Prescription Assistance Programs: Programs like the Ontario Drug Benefit (ODB) and Trillium Drug Program can help reduce medication costs for eligible residents.

7. Cultural Considerations

Language Support: Toronto is highly multicultural, and many healthcare providers offer services in multiple languages. Interpretation services are also available in hospitals and clinics.
Patient Rights: You have the right to informed consent, privacy, and access to your medical records.
Preventive Care: Preventive healthcare, such as vaccinations and regular check-ups, is highly emphasized in Canada.

8. Emergency Services

In case of a medical emergency, dial 911 for an ambulance. Emergency services are covered by OHIP, but there may be a fee for ambulance transport (approximately CAD $45 for OHIP holders and CAD $240 for non-OHIP holders).

9. Key Resources

ServiceOntario: For OHIP applications and information. Website
Telehealth Ontario: Free health advice. Dial 811.
Health Care Connect: To find a family doctor. Website
Toronto Public Health: Offers various health programs and services. Website

By understanding the healthcare system in Toronto and taking proactive steps to secure coverage and access services, you can ensure a smooth transition and maintain your health and well-being in this vibrant city. Let me know if you need further assistance!