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Toronto Health Insurance; The Perks and Downfalls

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This page provides information to Canadians about Toronto health insurance.

Coverage for health insurance in Canada differs depending on what province you live in. The provincial health insurance authorities establish their own criteria for coverage under their plans. Therefore when hired in cities in Canada there are some discrepancies that effect what is covered and to what extent.

Qualification and Coverage
To qualify for health insurance coverage in Ontario you have to be a Canadian citizen, make your principal home in Ontario and be physically present for 153 days. Once those stipulations are met and the proper forms are filled you become covered.

Toronto Health Insurance Once you qualify to be covered by Toronto health insurance you have access to the Trillium Drug Program. The deductible for the program is paid in quarterly installments. A family can receive prescriptions for only $2.00 an order. This seems like a vastly superior drug plan compared to most Canadian provinces. Most provinces, like New Brunswick do not seem to pay for prescriptions or medicines or even direct someone to find out how to receive coverage.

A portion of medical supplies are covered for people who qualify. Insulin pumps are funded under the Assistive Devices Program for adults who have type 1 diabetes. Clinical criteria to the program must be established before the funds are granted. This puts Toronto health insurance coverage above most provinces in Canada who will not cover any of these expenses.

You will not find reimbursement for services from chiropractors, massage therapists or naturopaths. Psychologists are not covered under Toronto health care as compared with coverage in Quebec which does include coverage for psychology sessions. Hospital stays are covered but for basic rooms only.

Some treatments not covered include elective surgeries not necessary for medical causes. These include cosmetic surgeries, acupuncture, and treatment of varicose veins, psycho-analysis and consultations by phone, fax or emails. Laboratory services unless provided in a hospital and specialized examinations like ultrasound, CAT scans and MRI’s. You will also have to pay for examinations for certification of health while applying for a life insurance policy, starting or holding a job or for qualifying for passports.

Dental and out of Canada Procedures
Some dental operations are covered however routine check ups are not. Children under 10 receive a free dental examination once per year, also emergency checkups and x- rays.

Out of country procedures are covered for emergencies only. Toronto health insurance will pay up to $400 per day for special services like operating room, coronary and intensive care units and neonatal or pediatric care units.

The Toronto health insurance provincial plan seems to be more specific as to what you will receive that that of other provinces. For example, British Columbia’s system is based strictly on family income and how much reimbursement you receive depends on how much you make.

Read more about Ontario Health Insurance.