Health Card Update: Accepting health cards, and reminder letters to the public

To: All Providers
Category: Dentist Services, Fertility Clinics, Independent Health Facilities, Midwife Services, Optometrist Services, Physician Services, Physiotherapy Facilities, Podiatrist Services, Primary Health Care Services, Registered Nurse with Extended Class
Written by: Health Insurance Branch; Health Programs and Delivery Division
Date issued: November 10, 2022

Accepting Expired Photo Health Cards and Red and White Health Cards

Until further notice, the MOH continues to request that health care providers accept expired green photo health cards and red and white health cards when:

  • the card passes Health Card Validation and
  • belongs to the person presenting it.

Please continue to urge red and white health card holders to update to the more secure green photo health card.

Health care providers should use existing protocols for providing services to individuals with invalid cards. Patients with invalid cards should be directed to ServiceOntario. Individuals can call ServiceOntario at 1-800-664-8988 or 416-327-7567 (TTY: 1-800-387-5559 ) for more information about their specific health card issue.

Letters to expired health card holders

From October 19 to 31, 2022, ServiceOntario sent reminder notices to those photo health card holders (with valid addresses) whose card expired between March 1, 2020, and October 16, 2022, reminding them to renew their expired health card.

Since some individuals may not have a valid address with the ministry, they may not receive a letter in the mail (i.e., they have moved and have not updated their address with the ministry). The ‘template’ letters linked below can be posted or provided to anyone presenting an expired health card in your office or at your practice.

Health card validation - an essential process

It is the patient’s responsibility to show their health card to the health care provider at each visit.

The ministry encourages providers to ask for a patient’s most recent health card and to validate it each time the patient visits. This helps providers reduce administration time associated with rejected claims due to incorrect version codes or patient ineligibility.

The ministry offers several automated health card validation services to assist providers in determining a patient’s eligibility and the validity of an Ontario health card at the time a service is rendered including:

  • Real Time Interactive Voice Response (IVR)
  • Real Time Health Card Readers (HCRs)
  • Overnight Batch Eligibility Checking (OBEC)

The Health Card Validation Reference Manual is available online. Additional resources can be found on the Ministry of Health website.

As always, claims submitted with a health number that does not pass Health Card Validation will not pay (regardless of whether the health card has expired or not) and these patients are responsible for payment of the service. However, health care providers should understand that if they collect payment from the patient, they will be requested to reimburse the patient in full if the patient subsequently establishes that he or she was an insured person at the time the insured service was provided. A patient with a health card that does not pass validation should be advised to call or visit a ServiceOntario centre.

Contact Information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524.