Depending on certain details, your client might be eligible for healthcare coverage under either the Ontario Health Insurance Plan (OHIP) and/or Interim Federal Health Program (IFHP – the separate federal program that covers certain classes of refugees and claimants). They may also receive drug/extended benefits from Ontario Works (OW), Ontario Disability Support Program (ODSP), and/or Assistance for Children with Severe Disabilities (ACSD).

To determine the type of healthcare coverage to which your client is entitled, begin at the top left column, move downwards and respond to the queries indicated.

Client Characteristics: Coverage Type:
1. Permanent resident or convention refugee? Ontario Health Insurance Plan (OHIP)
1. Recipient of Ontario Works (OW)? or

2. Recipient of Ontario Disability Support Program (ODSP)?

3. Child receiving Assistance for Children with Severe Disabilities (ACSD)?

 Ontario Drug Benefit (ODB) Program & Extended Health Benefit

To determine the type of IFHP coverage to which your client is entitled, begin at the top left column and move downwards and respond to the queries indicated. The topmost relevant coverage type is applicable.

Client Characteristics: Coverage Type:
Resettled refugees, including –

  • Government-Assisted Refugees (GARs)
  • Blended Visa Office-Referred Refugees (BVORs)
  • Joint Assistance Sponsorship Program Refugees
  • Certain refugees sponsored by organizations with whom IRCC has entered into cost-sharing agreements
  • Certain people who are being resettled in Canada as a result of a public policy or humanitarian and compassionate considerations on the Minister’s own initiative
  • Privately Sponsored Refugees (PSRs)
 Basic Coverage – provided until client qualifies for OHIP.

Supplemental and Prescription Drug Coverage – provided as long as client receives income support from the Resettlement Assistance Program (RAP) or until the client is no longer under private sponsorship.
Protected persons in Canada, including –

  • Individuals who receive a positive decision on their asylum claim
  • Individuals who receive a positive decision on their pre-removal risk assessment (PRRA) and become a protected person
 Basic, Supplemental, and Prescription Drug Coverage – provided for 90 days from the date the asylum claim or PRRA is accepted, or until the client becomes eligible for OHIP.
Individuals entering between Ports of Entry (POEs) in Lacolle, Quebec on or after June 1, 2017, and before December 1, 2017 Basic, Supplemental and Prescription Drug Coverage – provided from the time they receive a date for their eligibility interview until they are eligible to have their claim referred to the Immigration and Refugee Board of Canada
Refugee claimants, including –

  • Refugee claimants awaiting decision* – individuals whose asylum claim is awaiting decision from the Immigration and Refugee Board of Canada (IRB), including any appeals of a negative decision on their claim
  • Rejected refugee claimants – individuals whose asylum claim is rejected by the IRB and the negative decision was not appealed, or whose right to judicial review or any appeal of that judicial review has been exhausted
  • Ineligible refugee claimants* – individuals whose claim for refugee protection is determined ineligible to be referred to the IRB and who are eligible to apply for a pre-removal risk assessment (PRRA)
  • ·Positive PRRA decision – individuals who receive a positive decision on their PRRA and receive a stay of removal.
 Basic, Supplemental, and Prescription Drug Coverage – provided until the client leaves Canada or becomes eligible for OHIP.

Note: IFHP coverage is cancelled immediately when the client’s asylum claim is withdrawn, determined to be abandoned by the IRB, or re-determined as ineligible and is not eligible to reapply for a PRRA.
Victims of Human Trafficking* who have a valid temporary resident permit (under section 24(3) of the Immigration and Refugee Protection Act) Basic, Supplemental, and Prescription Drug Coverage – provided over the duration of the temporary resident permit.
Detainees* – those detained under the Immigration and Refugee Protection Act (IRPA) Basic, Supplemental, and Prescription Drug Coverage – provided over the duration of the client being detained by the Canada Border Service Agency under the IRPA.
 *Also receive coverage for one Immigrant Medical Exam (IME)
Coverage Descriptions:

Basic Coverage – The level of coverage is similar to OHIP and other provincial or territorial health insurance plans.  Physician, nurse, and other healthcare professional services in the community and hospital are covered.  These services include diagnostic, pre- and post-natal care, laboratory, and ambulance services.

Prescription Drug Coverage – Comprehensive medication coverage similar to ODB

Supplemental Coverage– The level of coverage is similar to that provided for social assistance recipients.  Covered services include limited dental and vision care, services from allied healthcare practitioners.  Medical supplies, equipment and assistive devices are also covered.

Please note that clients who have questions about their IFHP coverage can contact the Immigration, Refugees and Citizenship Canada (IRCC) Call Centre at 1-888-242-2100.

To confirm your client’s IFHP coverage status, follow the steps described in the Submitting IFHP Billing Claims section.