OHIP and health care

[Meliss 0]

Alright a few quick questions- being a Canadian and moving to the States, I understand the insurance thing and I know I will have it for myself and children BUT..... what is the general rule of thumb when it comes to maintaining OHIP coverage.. or other provinces aswell. When I move does that mean I am no longer covered in CANADA? What if I am home on vacation (in Canada) does my health card still work? And the kids, since they are still coming back here to spend time with their father - does the health card thing keep up for them? There are rumors about if you come back to Canada every 6 months and touch Canadian soil you do not lose health care coverage. Just wondering.... Thanks.

[billsgirl 0]

i dont know about coming back every 6 months, but i was told once i leave the province of quebec ...thats it...no longer covered.

[Kathryn41 3,205]

OHIP is for Ontario residents only. Coming home for a visit every 6 months will not qualify you for OHIP. Your coverage stops when you give up your residency in the Province. If you tried to keep your provincial residency while coming to the US, then you put your status in the US at risk.

If you have joint custody with the kids, their father may be able to make a case for health coverage for the children while they 'live' with him in Ontario, but I doubt he would be successful. Returning and new residents to Ontario are not eligible for health care until after 90 days of residence so I suspect their coverage would end when they move as well. The best plan would be to purchase travel insurance to cover them when they return to Canada for visits.

Snowbirds (Canadians wintering in Florida) are able to maintain coverage while they are out of the country since they do not give up their principal residence in Canada. If they are outside of the Province more than 6 months, then their OHIP coverage expires.

Medical insurance is very different in the US and medical care is expensive. I don't mean to frighten you, but many of the things you used to take for granted will no longer exist.

Edited June 14, 2006 by Kathryn41

[zyggy 9]

Alright a few quick questions- being a Canadian and moving to the States, I understand the insurance thing and I know I will have it for myself and children BUT..... what is the general rule of thumb when it comes to maintaining OHIP coverage.. or other provinces aswell. When I move does that mean I am no longer covered in CANADA? What if I am home on vacation (in Canada) does my health card still work? And the kids, since they are still coming back here to spend time with their father - does the health card thing keep up for them? There are rumors about if you come back to Canada every 6 months and touch Canadian soil you do not lose health care coverage. Just wondering.... Thanks.

In order to be eligible for OHIP, you must maintain a residence in Canada, live there for more than 6 months out of the year and pay Canadian Income Taxes... It would be pretty hard to convince US Authorities that you haven't abandoned your US Permanent Residency Status if you have to follow those rules...

Sorry, but if you move to the US, you lose your Canadian health care. Almost all US Health Insurance policies cover for emergency health care in Canada.

Edited June 15, 2006 by zyggy

[Jersey Girl 2]

Couldn't have said it better than Kathryn41 and zyggy. The other wrinkle is getting coverage in the U.S. When I moved from Ontario to Jersey six months ago, I thought it would be easy to find a full-time job with medical benefits. Wrong. So many jobs are part-time or on a project-basis-only that health insurance becomes your responsibility alone. I still haven't gotten insurance and know I'm playing with fire.

Even if I got family coverage through an employer (and there could be a 3 month waiting period), my Canadian husband wouldn't be eligible when he arrives, since he wouldn't have a social security number yet. At least that's my understanding. He'd be in Limbo, and travel insurance (purchased in Canada) is only valid if you have OHIP. And you won't have OHIP once you move.

In Canada, we pay high taxes and get medical coverage. In the U.S., we pay lower taxes and coverage becomes our responsibility. If someone crunched the numbers, I'd bet it's still cheaper in the U.S. and you get immediate, expert attention. So let's just suck it up and start paying.

As an aside, my husband's co-sponsor was concerned about being financially responsible if he landed in a U.S. hospital without insurance. Seems Medicaid kicks in for immigrants if they need it.

Edited June 15, 2006 by Jersey Girl

[zyggy 9]

Couldn't have said it better than Kathryn41 and zyggy. The other wrinkle is getting coverage in the U.S. When I moved from Ontario to Jersey six months ago, I thought it would be easy to find a full-time job with medical benefits. Wrong. So many jobs are part-time or on a project-basis-only that health insurance becomes your responsibility alone. I still haven't gotten insurance and know I'm playing with fire.

Even if I got family coverage through an employer (and there could be a 3 month waiting period), my Canadian husband wouldn't be eligible when he arrives, since he wouldn't have a social security number yet. At least that's my understanding. He'd be in Limbo, and travel insurance (purchased in Canada) is only valid if you have OHIP. And you won't have OHIP once you move.

In Canada, we pay high taxes and get medical coverage. In the U.S., we pay lower taxes and coverage becomes our responsibility. If someone crunched the numbers, I'd bet it's still cheaper in the U.S. and you get immediate, expert attention. So let's just suck it up and start paying.

As an aside, my husband's co-sponsor was concerned about being financially responsible if he landed in a U.S. hospital without insurance. Seems Medicaid kicks in for immigrants if they need it.

Jersey Girl..

1)A SSN is not required to add a spouse to a health insurance policy. I added mine before she got hers. Anyone who tells you that is blowing a bunch of smoke...

2) Medicaid is a need-based federal benefit... immigrants are not eligible for this. However, some states have agreed to pick up the tab for immigrants on their own.

[Jersey Girl 2]

Thanks, zyggy. I'll remember this when it comes time to get insurance and include my Canadian husband.

As for means-tested benefits ... I read this on USCIS "How do I file an Affivdavit..." It's for the I-130 and form I-864. Evidently, emergency Medicaid is not a mean-tested benefit. But what would it include?

"Currently, Federal means-tested public benefits include Food Stamps, Medicaid, Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), and the State Child Health Insurance Program (CHIP). States and local jurisdictions may also designate certain of their programs as means-tested public benefits.

"The following types of programs are not counted as means-tested public benefits: emergency Medicaid ... "

[Reba 2]

as a Canadian when you move from the country you are no longer eligible for provincial health care insurance, and you are required by law to notify them that you have left the country. Check out the OHIP website for info http://www.health.gov.on.ca/english/public...ip/ohip_mn.html

many Canadians will try to tell you otherwise, but the point is, that it is illgal to retain your provincial healthcare once you have taken up residency in another country. Not to mention of course what zyggy said and that it could be detrimental to your status in the US, should they decide that by you keeping your OHIP means that you have not cut ties with Canada.

Also, if you used your OHIP after you've taken up residence in another country, and they charge you with fraud, you are liable to pay the medical costs, and possibly jail time.

Under the Criminal Code of Canada Section 380, a person convicted of fraud exceeding $5,000 could be imprisoned up to 10 years. Restitution may also be ordered under the Criminal Code.

A person, who has been convicted of a provincial offence under the Health Insurance Act, is subject to a penalty of up to $25,000 and/or jail up to 12 months for a first offence. For a subsequent offence the penalty is a fine of up to $50,000 and/or jail up to 12 months. Under the Health Insurance Act, a court can also order a person convicted, to pay compensation or make restitution to a person who suffers a loss as a result of the offence.

[leolexi 0]

not to beat a dead horse, but what if my wife will still be working in canada? she will be there 3-4 days a week, and i assume be paying canadian taxes for the job there.

not sure how the tax situation will work either (anyone know? does she pay both countries?); but, even with this amount of time spent in the country, she wouldnt be eligible for ohip?

thank you.

[Reba 2]

how do you plan to manage that? Which country will be her primary residence, and how do you suppose she will be allowed to continue to go back and forth?

As for taxes, check with these folks http://www.serbinski.com/

If she tries to have 2 residences and has a visa or green card for the US, she may well could lose her status if they feel she is not using it accordingly.

[zyggy 9]

not to beat a dead horse, but what if my wife will still be working in canada? she will be there 3-4 days a week, and i assume be paying canadian taxes for the job there.

not sure how the tax situation will work either (anyone know? does she pay both countries?); but, even with this amount of time spent in the country, she wouldnt be eligible for ohip?

thank you.

Canadian Health Care is only applicable for those resident in Canada. If she is not resident in Canada, then she cannot have Canadian Medicare...period...

In her case, yes, Canadian taxes will be withheld from her paycheck. However, the US tax treaty does not allow for double taxation. In her case, she would file a US return with you and declare her foreign earnings and a foreign tax credit. In addition, she would file a non-resident tax return in Canada. There has been plenty of coverage in this forum in the past on the cross border taxation issue. I suggest that you use the advanced search to do some research...

In any case, you should consult with a cross-border tax specialist to determine the best plan for your situation. When doing the numbers, you may very well find that paying the higher taxes and getting little benefit for it could cause you to reconsider your continued employment in Canada. I know that it certainly did for us. Take what Canada gives you... your spouse would be eligible for EI if she moved to the US to be with you. That may not happen if she stays with her employer after she relocates to the US.

Edited June 19, 2006 by zyggy

[leolexi 0]

how do you plan to manage that? Which country will be her primary residence, and how do you suppose she will be allowed to continue to go back and forth?

As for taxes, check with these folks http://www.serbinski.com/

If she tries to have 2 residences and has a visa or green card for the US, she may well could lose her status if they feel she is not using it accordingly.

people travel back and forth all the time between the 2 countries for work. there is even a checkbox on the i94 to indicate what the primary trip purpose is, biz or personal. so, im not quite sure what you are asking here.

thanks to both you and zyggy on the clarification of the healthcare..

[zyggy 9]

how do you plan to manage that? Which country will be her primary residence, and how do you suppose she will be allowed to continue to go back and forth?

As for taxes, check with these folks http://www.serbinski.com/

If she tries to have 2 residences and has a visa or green card for the US, she may well could lose her status if they feel she is not using it accordingly.

people travel back and forth all the time between the 2 countries for work. there is even a checkbox on the i94 to indicate what the primary trip purpose is, biz or personal. so, im not quite sure what you are asking here.

thanks to both you and zyggy on the clarification of the healthcare..

lexi .. I think what people are getting at is... How can one consider themselves a resident of the US of they are in Canada for 3 to 4 days a week. In your case, there is a very real threat of having the CBP one day stating that she is not a true resident of the US due to her constant travelling and residing in Canada.

This may be a case where you have to choose what is the most important to you... Having your wife with you in the US with a new job in the US, or you in Canada with her with you having a new job in Canada. Keeping one toe in Canada (or in your spouses case half her body) could result in more problems than you care to stand... You have to choose between one or the other .. straddling is not one of the choices...

The purpose of permanent residency is just that... leaving and breaking all your ties in your home country and establishing new roots in the US....

There may be ways that your spouse can pull what she wants off.. but keeping herself on the payroll of a Canadian company and doing work in Canada is not one of them...

Just a suggestion, she may want to consider forming her own consulting company and contract herself to her old company, but you should get expert help from an accountant and an attorney before you do that... but keeping the same arrangement that she has always kept is not a good idea...

Edited June 20, 2006 by zyggy

[Reba 2]

zackly!

[leolexi 0]

lexi .. I think what people are getting at is... How can one consider themselves a resident of the US of they are in Canada for 3 to 4 days a week. In your case, there is a very real threat of having the CBP one day stating that she is not a true resident of the US due to her constant travelling and residing in Canada.

how do international business travellers have the security of being able to come home to their country then?

This may be a case where you have to choose what is the most important to you... Having your wife with you in the US with a new job in the US, or you in Canada with her with you having a new job in Canada. Keeping one toe in Canada (or in your spouses case half her body) could result in more problems than you care to stand... You have to choose between one or the other .. straddling is not one of the choices...

The purpose of permanent residency is just that... leaving and breaking all your ties in your home country and establishing new roots in the US....

There may be ways that your spouse can pull what she wants off.. but keeping herself on the payroll of a Canadian company and doing work in Canada is not one of them...

Just a suggestion, she may want to consider forming her own consulting company and contract herself to her old company, but you should get expert help from an accountant and an attorney before you do that... but keeping the same arrangement that she has always kept is not a good idea...

shes doing this now, working both in the US from our home and in the office while in canada. now, her company is also in the process of expanding into the US, so travel and communication at both levels is necessary at this point. in addition, she is providing training to people both here and there, so, how does this continue to happen? the canadian company should invest more money in someone to travel to the US on a weekly basis instead of utilizing the resources that already reside here?

Thanks for the information, but i find it hard to believe that with all the business travel throughout the world, and with the rise of foundations like nafta, that an opportunity for the US to have a new immigrant not only avoid the burden of needing UE, but to benefit from her taxable earnings from another country would be frowned upon. I will, however, discuss this with her and some legal assistance.

maybe im just looking at it wrong, so sorry if i seem ignorant on the subject. but, then again, how did importing/exporting become so lucrative, if not for the immigrant with a vision?

We arent trying to scam any one system or another, we are trying to be able to afford a home and the cost of living by both working..