What Are the Benefits of OHIP Coverage for Seniors?


Quick Answer

Benefits for Seniors enrolled in the Ontario Health Insurance Program include coverage for all medically necessary services provided by physicians. Coverage for services from other health care providers is generally partially covered. If eligible, OHIP pays for home care for seniors, but does not cover the cost of retirement homes.

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Full Answer

Ontario's Ministry of Health and Long-Term care administers the OHIP. The Ministry pays for some dental surgeries if they are performed in a hospital. Regular dental services are not covered and are paid by the individual. Yearly eye exams are covered for individuals 65 years or older. Visits to specialists, such as podiatrists or physiotherapists, may be partially covered.

Eligible seniors may receive coverage from OHIP for long-term care facilities. Long-term care facilities differ from retirement homes in that residents of retirement homes are largely independent and do not require constant monitoring or care. To qualify for assistance with long-term care, the individual must require frequent assistance with daily living, 24-hour nursing and personal care and on-site supervision or monitoring for safety and well-being. Benefits for qualified individuals include all personal and nursing care funded by the government, and individuals must pay for their own accommodations such as room and board. Rates for accommodations are set by the government and are the same across Ontario.

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