If you are included in one of the above listed groups you will be eligible for OHIP coverage so long as you:
Make your primary place of residence in Ontario, and
Are you are physically present in Ontario for at least 153 days in any 12-month period.
OHIP regularly conducts eligibility assessments. They are conducted by the ministry on a routine basis, an attempt to ensure that only eligible Ontario health card holders have access to publicly funded health services
The ministry investigates each and every allegation it receives regarding potential health insurance abuse.
Ontario health insurance coverage is cancelled where health card holders are unable to prove entitlement to Ontario health insurance coverage.
Where fraud is suspected, cases are referred to the Ontario Provincial Police Anti-Rackets Health Fraud Investigation Unit for investigation and possible prosecution.
After the investigation the suspected person may be charged with fraud, a criminal offence .
If convicted of fraud exceeding $5,000, under the Criminal Code of Canada Section 380, a person could be imprisoned for up to 10 years. Restitution may also be ordered under the Criminal Code.
380(1) Every one who, by deceit, falsehood or other fraudulent means, whether or not it is a false pretence within the meaning of this Act, defrauds the public or any person, whether ascertained or not, of any property, money or valuable security or any service,
(a) is guilty of an indictable offence and liable to a term of imprisonment not exceeding fourteen years, where the subject-matter of the offence is a testamentary instrument or the value of the subject-matter of the offence exceeds five thousand dollars; or
(b) is guilty
(i) of an indictable offence and is liable to imprisonment for a term not exceeding two years, or
(ii) of an offence punishable on summary conviction,
where the value of the subject-matter of the offence does not exceed five thousand dollars.
Marginal note:Minimum punishment
(1.1) When a person is prosecuted on indictment and convicted of one or more offences referred to in subsection (1), the court that imposes the sentence shall impose a minimum punishment of imprisonment for a term of two years if the total value of the subject-matter of the offences exceeds one million dollars.