What is UHIP?

UHIP stands for University Health Insurance Plan. UHIP offers basic health care for eligible international non-residents studying or working at a participating Ontario universities.

The difference between UHIP and OHIP

OHIP provides basic medical health insurance for permanent residents of Ontario and is funded by provincial taxes, whereas UHIP provides similar coverage for international non-residents studying or working at an Ontario University. UHIP is a non-profit plan funded through member premiums. It is similar, though not equivalent, to OHIP.

For example, unlike OHIP+, UHIP does not provide coverage for prescription drugs to students under age 25.

UHIP Services

The plan provides medical services and supplies that OHIP covers for Ontario residents. These include:

• In-patient and out-patient hospital services.
• Physician services.
• Lab and diagnostic testing.
• Home care services.
• Some other specific programs available to an Ontario resident by the Ministry of Health (for example, Assistive Devices Program (ADP)).

Physician services that need pre-approval (except in an emergency)

1. Elective in-patient and out-patient surgery (for example, rotator cuff surgery) or treatment (for example, cancer, inpatient/outpatient psychiatric program).
   • Please email Cowan at case.mgmt@cowangroup.ca.
   • Find out which services and treatments need pre-approval from Cowan.
2. Medically necessary MRIs and CAT scans or referrals to a surgeon don’t need preauthorization.

UHIP reimbursement rate

• The services of a physician (covered up to 125% of what the physician charges for Ontario residents to the same overall maximum and terms as under OHIP).
• Services of a nurse practitioner are also eligible (covered up to 80% of what UHIP will pay for physicians).
• Ophthalmologist (covered up to 125% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP).
• Optometrist (covered at 100% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP).
• The services of a registered podiatrist (covered at 100% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP). Surgery is not covered.
• The services of a registered physiotherapist (covered at 100% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP).
• Lab services such as X-rays, ultrasounds and blood work (covered at 100% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP).
• Diagnostic services such as MRI and CAT scans (covered at 100% of what the provider charges for Ontario residents to the same overall maximum and terms as under OHIP).

Joining the Cowan Preferred Provider Network (PPN)

Please email Cowan at UHIP.admin@cowangroup.ca if you would like to join.

Keep in mind:

• PPN providers must direct bill Cowan for UHIP members.
• The clinic name will appear on the Cowan Preferred Provider Network website.

Checking UHIP eligibility

You can instantly confirm if your patient is eligible by using the Cowan Eligibility Tool.
UHIP members must show their UHIP card to their health care provider. Please directly bill members who don’t show you their card.
When billing members directly, you must include the following on the receipt or claim form:

• OHIP code(s).
• Diagnosis or diagnosis code.
• Cost of service.

What information is on a UHIP Member ID card?

• University ID: You’ll need this for billing.
• Policy number: You’ll need this for billing.
• Effective date: start date of UHIP coverage.
• Termination date: end date of UHIP coverage.
• Dependant information: lists the eligible dependants covered under UHIP.

Keep in mind:

• Some universities enroll member and dependants separately on 2 different records.
• Dependants will be enrolled with a member ID that starts with an alpha prefix of ‘DP’.
• In these cases, the members and dependants will each have their own UHIP coverage card.
• You need to see the dependant name on a coverage card to ensure eligibility.

Two ways to submit your bill to UHIP

Provider information	Service information	Claimant/member information
Clinic name and address. Payee name and address. Physician’s full name, designation and CSPO Number.	Diagnosis or diagnosis code. Date of service. OHIP fee code(s). Cost of service.	Policy #150150. UHIP member ID. First and last name. Date of birth.

When and how you are reimbursed

Cowan will mail you a cheque and explanation of benefits within 7 days of receiving the completed UHIP claim form/bill.
If you prefer direct deposit (electronic fund transfer):

• Complete the Direct Deposit Authorization form for International Student Policies.
• Email it to UHIP.admin@cowangroup.ca or fax it toll-free to 1-613-741-7771.

Questions about your submitted claim?

Please call 1-833-377-8447 and follow the prompts.