Travelling out of Canada, into Canada, and between provinces
Several different situations get called the same thing, and they cover different risks. This page sets out what each one is for, what provincial health coverage does and doesn't pay when you leave your province, and the insurance rule that applies to parents and grandparents on a super visa.
What OHIP pays outside Canada
This is the number that surprises people. For an unexpected emergency abroad, Ontario pays doctors at Ontario rates and hospitals at fixed daily amounts: up to $50 a day for emergency outpatient services, $200 a day for standard inpatient care and $400 a day for a day involving intensive or operating room care.
A single night in a US hospital can cost many multiples of those daily amounts, and the gap is yours. Ontario also pays nothing towards getting you home: the province's own guidance says it is essential to buy travel medical insurance that includes the cost of transportation if illness or hospitalisation changes when you can travel.
Which situation is it?
Canadian residents travelling abroad
Emergency medical cover for a sudden illness or injury while away. The first choice is single trip versus an annual plan covering every trip in a year, which tends to be the cheaper route for anyone travelling more than once or twice. Trips within Canada are usually priced well below international ones. Trip cancellation and interruption cover answers a different question: money lost when a trip doesn't happen or is cut short, rather than medical bills when it does. All-inclusive packages combine the two, which is usually cheaper than buying them separately and worth comparing either way.
Travelling to another province
The one people assume is covered. Your provincial plan follows you for doctors and public hospital care, but not for an ambulance, not for prescriptions filled outside a hospital, and not for private clinics. An air ambulance home from a remote area is the case that turns this from a nuisance into a serious bill.
Visitors to Canada
A visitor is not covered by any provincial health plan, so a hospital stay is billed privately and at full cost. Visitor plans cover unexpected emergency medical treatment during the stay, including hospital care and prescriptions, and are commonly arranged by the family here rather than by the person travelling. Plans meeting the super visa conditions are the same type of cover, bought to the amount and term those rules require.
Parents and grandparents on a super visa
Here insurance isn't optional, it's part of the application. The rules are set by Immigration, Refugees and Citizenship Canada, not by any insurer, and they are specific about the amount and the term.
Students, in both directions
Canadians studying abroad, Canadians studying in another province, and international students studying here. These plans differ from ordinary travel cover in a way that matters: they usually include routine care as well as emergencies, often with dental, vision and physiotherapy, because a student needs a doctor for ordinary reasons over an academic year. A school's own plan is the first thing to read before adding anything to it.
Cover you may already have
Some credit cards and employer benefit plans include travel medical cover, often with age limits, trip length limits and conditions of their own. Worth reading before buying anything, because the question is what the existing cover leaves out rather than whether it exists.
And when you stay inside Canada
Within Canada, an Ontario health card still covers medically necessary physician services and care in a public hospital in another province. What it does not cover is the list that tends to generate the bill: ambulance services, including transport and paramedics, prescription drugs given outside a hospital, home care, private clinics and facilities, and diagnostic or laboratory work done outside a public hospital.
Ontario's own guidance recommends private health insurance before travelling within Canada for exactly this reason. It is the gap people are most surprised by, because nothing about crossing a provincial border feels like leaving the health system.
The super visa insurance rule, as written
Applicants must show private medical insurance that provides a minimum emergency coverage of $100,000, is valid for at least one year from the date of entry, and covers health care, hospitalisation and repatriation. It must be valid for each entry to Canada.
Policies from insurers outside Canada are accepted where the company is authorised by the Office of the Superintendent of Financial Institutions to do insurance business in Canada. The current requirements are on the IRCC page linked below, and immigration rules change: that page governs, not this one.
Where the plans differ: pre-existing conditions
This is what separates one plan from another far more than the headline limit, and it is where claims are refused. Plans generally fall into three shapes:
No health questions
Quick to buy and cheapest to hold, and existing conditions are excluded. Fine for someone with no medical history worth declaring, and the wrong choice for anyone managing a condition.
Cover subject to a stability period
An existing condition is covered if it has been stable for a set period before the trip, commonly a number of months. What counts as stable is defined in the policy, and usually includes changes in medication or dosage, which is the detail people miss.
Medically underwritten
You answer a health questionnaire and the insurer decides what it will cover before you travel. More work up front, and the only route that gives a clear answer about a known condition rather than one you find out at claim time.
Age and limits
Older applicants often face a questionnaire where younger ones do not, and the amount of cover is usually chosen up to a maximum rather than fixed. Both change the price considerably.
What these plans usually bundle
The categories below turn up in most plans in some form. What matters is not whether a plan mentions them but the limit on each one, so this is a list of things to look up rather than things to assume.
Emergency medical
Hospital and physician care for a sudden illness or injury, prescriptions while away, emergency dental after an accident, and ambulance. This is the part that exists to stand between you and a foreign hospital bill.
Getting you home
Transport home for treatment, a flight after a delayed recovery, and in the worst case repatriation. Usually a separate limit from the medical cover, and often the largest single cost in a serious claim.
Trip cancellation and interruption
Prepaid costs you cannot get back when a trip is cancelled for a covered reason, and the cost of cutting one short. Sold separately, or bundled into an all-inclusive plan with the medical cover.
Baggage and delay
Lost, stolen or delayed luggage, and the essentials bought while waiting for it. Small amounts next to a medical claim, and the ones people claim for most often.
What people usually check before buying
How pre-existing conditions are treated
Most emergency medical policies ask whether existing conditions have been stable for a set period before departure. The definition of stable, and the length of that period, differ between policies and are the most common reason a claim is refused.
How long a single trip can be
Annual multi-trip plans usually cap the length of each trip. Going over that cap can leave the later part of a longer stay uncovered rather than simply costing more.
The deductible and the limit
A higher deductible lowers the premium and raises what you pay first. The overall limit is what matters in a serious event, since that is the number a hospital bill is measured against.
What counts as an emergency
Policies cover sudden and unexpected conditions. Follow-up care, planned treatment and anything you travelled in order to receive are treated differently.
Repatriation
Getting home for treatment, or being flown home at all, is a separate line of cover from the treatment itself, and it is often the largest single cost in a serious case.
The free-look period
Many policies can be reviewed for a short window after purchase and returned for a refund if they are not right, provided the trip hasn't started and nothing has been claimed. It is the cheapest opportunity to read the wording properly.
Pausing or extending
Plans for longer stays sometimes allow cover to be paused or extended without starting again. Worth asking about before buying if the dates are uncertain, since extending later is not always possible.
When cover starts
Buying before departure matters. Many policies will not cover anything that began before the policy did, and some have a waiting period after purchase.
