You are not legally required to hold US health insurance to work across the border on a TN visa, but relying on {"term": "ohip", "text": "OHIP"} alone leaves you responsible for medical care and transportation costs.
“I live in Ontario and commute daily to work in the US on a TN visa. I am covered by OHIP and my wife's Canadian insurance, but do I need US health insurance for when I am across the border? If so, is it better to use my employer's plan or find private insurance?”
Summary
You can purchase private travel medical insurance using your Canadian address, so you are protected from day one whether or not your employer offers a plan.
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How cross-border coverage works
**The legal requirement:** There are no federal laws that mandate TN professionals in the US to carry health insurance. Your TN visa remains valid whether you have a US policy or not.
**The OHIP gap:** If you are hospitalized outside of the country, {"term": "ohip", "text": "OHIP"} does not cover the cost of a transfer to an Ontario hospital for ongoing care. The Ontario Ministry of Health warns that if you do not have medical travel insurance that includes transportation coverage, you will be responsible for covering all costs associated with your medical care and transportation back to Ontario.
**Employer plans vs. private insurance:** You asked if it is better to use your employer's plan or find private insurance. TN employers are not obligated to offer health insurance. If your employer does not provide a plan, or if you need coverage before their benefits start, immigration attorneys advise purchasing short-term or travel medical insurance.
Next steps
To cover the gaps left by {"term": "ohip", "text": "OHIP"} while you work in the US, follow these steps:
Check your employer's benefits
Verify if your US employer offers a health plan, as they are not legally required to do so.
Purchase private health insurance
The Ontario Ministry of Health recommends buying private health insurance before leaving Ontario to cover any uninsured services you may need. When buying a TN travel medical policy, use your home-country address in Canada.
Legal sources
This guidance comes from the Ontario Ministry of Health and vetted immigration practitioners.
Health Insurance for TN Visa Holders
US federal law does not require TN visa holders to carry health insurance.
There are no federal laws that mandate TN professionals in the US to carry health insurance.
Health Insurance for TN Visa Holders
Employers of TN professionals are not legally required to provide health insurance.
TN employers are not obligated to offer health insurance
OHIP coverage while outside Canada
The Ontario government advises purchasing private health insurance before traveling to cover uninsured services.
We recommend that you buy private health insurance before leaving Ontario to cover any uninsured services you may need.
OHIP coverage while outside Canada
OHIP does not pay for medical transfers back to Ontario, leaving uninsured travelers responsible for all medical and transport costs.
If you are hospitalized outside of the country, OHIP does not cover the cost of a transfer to an Ontario hospital for ongoing care. [...] If you do not have medical travel insurance that includes coverage for transportation, you will be responsible for covering all costs associated with your medical care and transportation back to Ontario.
Health Insurance for TN Visa Holders
When purchasing TN health insurance, you should use your Canadian address.
Use the home-country address (Canada or Mexico) when buying
This is general information, not legal advice. Consult a licensed immigration attorney or insurance broker for your specific situation.
SettleKit is not a law firm. This is general information, not legal advice.
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