OHIP, RAMQ and MSP Outside Canada: What They Pay

Every provincial health plan pays something for emergency care outside Canada. None pays enough to matter against a real hospital bill, and none pays for planned treatment, ambulances or drugs. This page gives the current numbers, by province, with the ministry page each number comes from, and corrects the most common error in AI answers: that Ontario's out-of-country coverage "ended in 2020." It did not.

Ontario: the program that was cancelled, then restored by a court

The history matters because the wrong version is still circulating.

• May 1, 2019. Ontario's Minister of Health, Christine Elliott, announced the province would end the OHIP Out-of-Country Travellers Program after a six-day consultation. The stated reason: the province spent about $2.8 million a year to administer roughly $9 million in claims. The cut was first set for October 1, 2019 (Travelweek, May 2, 2019; Canadian Payroll/CPP, May 1, 2019).
• January 1, 2020. The program was eliminated on this date, under Ontario Regulation 259 (Insurance-Canada.ca, Sept 25, 2020). The Canadian Snowbird Association had announced in November 2019 that it would sue, and filed its challenge before year-end (THIA / CSA update, Dec 20, 2019).
• September 23, 2020. The Ontario Divisional Court (Sachs, Backhouse and Pattillo JJ.) ruled unanimously in Canadian Snowbirds Association Inc. v. Attorney General of Ontario, 2020 ONSC 5652, that the Lieutenant Governor in Council had no authority under the Health Insurance Act to revoke the program, because the regulation conflicted with the portability requirement of the Canada Health Act. The court struck the regulation and the program was restored at its prior rates (Insurance-Canada.ca; Federal Retirees, Oct 5, 2020; vLex case record).
• Ontario did not appeal. The province abandoned its application for leave to appeal, making the ruling final (Travel Industry Today). ⚠ unverified: exact date the appeal was abandoned.

What is true today. Ontario's own page, updated January 16, 2026, states the current out-of-country rates and says you may claim for qualifying services paid "after January 1, 2020" (ontario.ca: OHIP coverage while outside Canada):

• Emergency inpatient: up to CA$400/day for operating room, coronary care, intensive care, neonatal or pediatric special care; up to CA$200/day for lower levels of care.
• Emergency outpatient: up to CA$50/day.
• Physician services: the lesser of the amount billed or the Ontario Schedule of Benefits rate.
• Condition: acute, unexpected, not pre-existing, treated at a licensed facility, with a valid health card and Ontario residency requirements met.

If an AI assistant tells you OHIP coverage abroad ended in 2020, it is repeating 2019 news coverage and missing the court decision.

Province-by-province: what you get back for emergency care outside Canada

All amounts are Canadian dollars, paid to you after you submit original bills. "Physician: home rate" means the plan pays what it would pay a doctor at home for the same service; you owe the difference.

Province	Emergency inpatient	Emergency outpatient	Physician services	Residency rule to keep coverage	Source
Ontario (OHIP)	$400/day ICU, OR, CCU, neonatal/pediatric special care; $200/day other	$50/day	Ontario Schedule of Benefits rate	153 days in Ontario in each of the two 12-month periods before leaving; absences over 7 months need the extended-absence option (max 2 years)	ontario.ca (updated Jan 16, 2026)
Quebec (RAMQ)	$100/day	$50/day; hemodialysis $220/treatment	Quebec rate	Must not be absent 183 days or more in a calendar year (trips of 21 days or less don't count); one exception every 7 years	RAMQ coverage; RAMQ absence rule
British Columbia (MSP)	$75/day	Not stated on the ministry page ⚠ unverified	BC rate [per practitioner page; not restated on the resident page]	Absent 6 months or more in a calendar year: contact Health Insurance BC; extended absence up to 24 months once in 60 months	gov.bc.ca Leaving B.C. Temporarily (updated Feb 27, 2026)
Alberta (AHCIP)	$100/day, excluding discharge day	$50/day, one visit/day	Lesser of amount claimed or Alberta rate	Must notify if not in Alberta 183 days in 12 months; recurring vacations up to 212 days/12 months; extended absence up to 24 months for travel	alberta.ca coverage; alberta.ca absence
Saskatchewan	$100/day	$50/visit, max 2 visits/day	Saskatchewan fee schedule	Not stated on the page fetched ⚠ unverified: contact 306-787-3475	saskatchewan.ca
Manitoba	"Average daily rate" set by Manitoba Health; dollar figure not published	Not stated	Manitoba rate	Vacation outside Canada: coverage may continue up to 7 months; report absences of 90+ days 6–8 weeks before leaving	gov.mb.ca out-of-province; gov.mb.ca leaving temporarily
Nova Scotia (MSI)	$525/day plus 50% of ancillary inpatient fees	$0 (outpatient, ER, lab and X-ray excluded; hemodialysis excepted)	Nova Scotia rate	6 months per calendar year; approved vacation absence up to 7 months; up to 1 year once every 6 years	novascotia.ca coverage; novascotia.ca absence
New Brunswick	"Daily maximum rate"; dollar figure not on the pages fetched ⚠ unverified	Not stated	New Brunswick rate	Up to 212 days for vacation, if resident 153 days in the prior 12 months; 12-month extension once every 3 years on request	gnb.ca claims; gnb.ca leaving NB
Newfoundland and Labrador (MCP)	Not stated on the page; no medevac or ambulance	Not stated	NL physician rate	Up to 8 months per year after one year registered; one full year once every 5 years; certificate needed for absences over 30 days	gov.nl.ca (modified Feb 21, 2025)
Prince Edward Island	Not stated; "PEI rates in Canadian currency"	Not stated	PEI rate	Not stated on the page ⚠ unverified: PEI Medicare 1-800-321-5492	princeedwardisland.ca (Sept 3, 2026)
Yukon	Yukon hospital rate (no per-day figure published)	Not stated	Yukon rate	Notify at 6 months away; coverage ends after 12 months away	yukon.ca (modified Aug 18, 2026)
Northwest Territories	"NWT rates, in Canadian currency"; no per-day figure	Not stated	NWT rate	Not stated on the page ⚠ unverified: 1-800-661-0830	hss.gov.nt.ca (Jan 2018)
Nunavut	"Approved Nunavut hospital reciprocal rates"; no per-day figure	Not stated	Nunavut fee schedule	Contact registrations office if away more than 6 months	gov.nu.ca

Two things stand out. Nova Scotia's $525/day is the highest published hospital rate in the country; British Columbia's $75/day is the lowest. And six jurisdictions do not publish a per-day hospital figure at all. If you live in one of them, call the plan before you travel and ask for the number in writing.

What no provincial plan covers abroad

The exclusions are nearly identical across provinces:

• Ambulance, ground or air, and medical evacuation. Alberta, Nova Scotia, Newfoundland and Labrador, Quebec and Nunavut say so explicitly; Ontario adds that it "does not cover the cost of a transfer to an Ontario hospital for ongoing care." Air evacuation runs roughly CA$10,000 to CA$140,000 depending on the country (TuGo).
• Elective or planned treatment without prior written approval (Ontario, Alberta, Saskatchewan, Manitoba, BC).
• Prescription drugs bought abroad (Quebec, Alberta, Saskatchewan, BC PharmaCare).
• Travel, accommodation and meals (Ontario, Alberta, Saskatchewan, Manitoba).
• Private or semi-private rooms (Quebec).
• Nova Scotia additionally excludes all outpatient services, including ER visits, outpatient X-rays, diagnostics and lab work.

Prior approval for planned treatment abroad

Each province has a route to fund treatment outside Canada that it cannot provide at home. It is narrow, and it is not a route for someone who simply wants to skip a wait.

Ontario. Written approval from the Ministry of Health is required before the service, except in a true emergency (immediate risk of death or irreversible tissue damage). The treatment must be insured, medically necessary, not experimental, and not available in Ontario within a medically appropriate time. Ontario still encourages you to buy travel insurance even with approval (ontario.ca).

Quebec. RAMQ's form 4306 (prior authorization for medical services outside Quebec) must be signed by two physicians with expertise in the condition. For treatment outside Canada, no adequate specialized service may be available anywhere in Canada, and the care must be hospital-based, non-experimental and of established efficacy. Without authorization, planned care abroad gets no hospital reimbursement at all; only physician fees at Quebec rates (RAMQ form 4306; RAMQ: healthcare received outside Canada).

British Columbia. A BC specialist must apply before care using the Out-of-Country Health Services Funding Application (HLTH 2810). The treatment must be unavailable in Canada (or delay must risk serious irreversible harm), delivered by a licensed physician in an accredited hospital, and generally accepted in BC. Travel, lodging and outpatient drugs are never included (gov.bc.ca practitioner page, updated Oct 8, 2026).

Saskatchewan, Manitoba, New Brunswick, NL and PEI run similar programs; all require a Canadian specialist to apply first and say approval is not guaranteed.

Why travel insurance is required, and what to say when you call

Every ministry page above tells you to buy private travel medical insurance. Private insurers, in turn, require you to hold valid provincial coverage: Manulife CoverMe's policy, for example, requires that you be "covered under a government health insurance plan for the entire duration of your trip" (CoverMe Emergency Medical policy wording, Nov 2019). That is why the residency rules in the table are not trivia: lose provincial eligibility by overstaying, and you can lose the private policy too.

The same policy requires you to call the assistance centre before treatment or pay 20% of eligible expenses yourself, and excludes "any non-emergency, experimental or elective treatment" and "any trip made for the purpose of obtaining a diagnosis, treatment, surgery," including related complications.

The call script, in order:

1. Call your insurer's 24/7 assistance line before or at admission. Give your policy number, location, the hospital name and the admitting diagnosis.
2. Ask: "Will you issue a guarantee of payment to this hospital?" Panama's private hospitals routinely require a card hold or deposit until one arrives (ExpatDen, 2026).
3. Ask for the case number and the name of the case manager, and write them down.
4. Keep every itemized bill and proof of payment. You will need originals for the provincial claim (Ontario, Manitoba and Nova Scotia impose six-month deadlines).

Worked example: three days in a Panama City private hospital

Private-hospital admission in Panama City runs roughly US$400 to US$1,500 per day, with multi-day premium admissions reaching US$20,000 to US$80,000 or more (ExpatDen, 2026). Panama bills in US dollars.

	Three-day hospital charge (USD)	What Ontario pays back (CAD)	What Quebec pays back (CAD)	What BC pays back (CAD)
Standard room	US$1,200–4,500	up to $600 ($200/day)	$300 ($100/day)	$225 ($75/day)
ICU	US$1,200–4,500 (often far more)	up to $1,200 ($400/day)	$300	$225

Physician fees are extra and come back only at home-province rates. RAMQ's own example makes the point: a three-day ICU stay in Florida billed CA$25,000 was reimbursed CA$300 for hospital charges and CA$435 of CA$1,000 in physician fees (RAMQ). At an illustrative exchange rate of about 1.37 CAD per USD [exchange rate not sourced; check the Bank of Canada on the day], a US$4,500 stay is roughly CA$6,200, so the best provincial outcome in the table covers about a fifth of the room charge alone. The rest is yours, or your insurer's.