OHIP : Requesting a Review of your OHIP Eligibility

If it is determined that you are not eligible for OHIP coverage or that you are no longer eligible, you may request a review of the ministry's decision by the General Manager of OHIP.

When a determination has been made that a registrant/applicant is not eligible for OHIP, the ministry issues a letter explaining why and provides information on the process for requesting a review of the decision by the General Manager.

Anyone may request that the General Manager review the determination of their OHIP eligibility simply by making the request in writing. The written request may be either mailed or faxed to the General Manager at:

General Manager, OHIP
Ministry of Health and Long-Term Care
49 Place d'Armes, 3rd Floor
Kingston ON K7L 5J3
Fax : (613) 548-6524

The General Manager reviews each case thoroughly and will often need to follow up with you to obtain documents or more information about the circumstances of your case. Response times will vary depending on the complexity of your case and the number of cases waiting to be reviewed.

Typically, you will receive a decision from the General Manager on your case no later than four to six weeks following your request. A letter will be sent to you to inform you of the General Manager's decision and to outline the legislative, regulatory and/or policy basis for the decision.

In those cases, where the General Manager overturns a previous decision, the letter from the General Manager will also contain information on the next steps for you to obtain your health card and/or health coverage.

If you are not satisfied with the determination of your OHIP eligibility by the General Manager, you may then request a review of your case by the Health Services Appeal and Review Board (HSARB).

The Health Services Appeal and Review Board (HSARB) is an independent tribunal that hears appeals under several health related statutes. Generally, the board will hold a hearing to review your case where both you and the General Manager of OHIP will attend. The board then decides whether or not the General Manager's decision regarding your eligibility for OHIP was in accordance with the Health Insurance Act and its regulations.

When you appeal to the HSARB, the board will let you know when your hearing is scheduled and what you need to do before the hearing takes place. After the hearing, the appeal board will release its decision.

For more information on requesting a review by the General Manager, OHIP :

Call the ministry INFOline at :
1 866 291-0609
For TTY service, call :
1 800 387-5559

For more information on requesting a review by the HSARB visit the HSARB Web site.

September 2006