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OMA Priority Insurance Program (OPIP)

A plan created just for OMA members.

OPIP is designed to ensure that Ontario physicians have access to the type of benefits that many Ontarians receive as part of an employee benefits program, providing you and your family with unique protection solutions. 

What’s included in the OMA Priority Insurance Program (OPIP)?


  • Prescription drugs, hospitalization, paramedical services and more
  • $2-million emergency out-of-country travel coverage1
  • A Health Care Spending Account is available to those members who opt out of health insurance if they have health coverage elsewhere
  • If you wish to upgrade your coverage at additional cost, Health Plus and Dental coverage is also available
Learn more

Critical Illness

  • Tax-free lump sum payment2 of $50,000 after 30 days of surviving a diagnosis of one of 25 covered serious illnesses
  • Members under age 65 can also purchase an additional $50,000 each for coverage for themselves and their spouse
Learn more

Legal Expense Insurance3

  • Protects you, your spouse and children living at home from unexpected legal issues and costs
  • Unlimited access to a Legal Helpline
Learn more

Optional upgrades

  • OMA Insurance recognizes doctors sometimes want their coverage to go beyond basic protection and offer more comprehensive coverage that includes enhanced benefits for themselves and their family
  • For this reason, we offer exclusive optional upgrades that, when added to OPIP, go beyond basic coverage to offer more protection
Learn more


To access OPIP without having to answer medical questions, you must enrol within 90 days (about three months) of your initial OPIP offer. If you do not choose to participate in OPIP within 90 days of receiving your initial offer, you can apply at any time with medical evidence.

If you are an eligible physician, the government-subsidized Physician Health Benefit Program (PHBP) helps pay the cost of your Critical Illness Insurance and Health coverage (or HCSA if you opt out of the Health coverage) provided through OPIP.

You are an eligible physician if you are:

  • A member in good standing of the Ontario Medical Association or, if not a member, have paid all dues and assessments owed under the Ontario Medical Association Dues Act, 1991
  • Registered with the College of Physicians and Surgeons of Ontario and have acquired an independent practice license
  • Actively engaged in providing medical services4 in the province of Ontario for at least 15 hours per week on average and is remunerated by the Ministry through OHIP, or by an employer for providing insured clinical services
  • A Canadian resident who has submitted the application in a province or territory other than Quebec, and not a resident of Quebec at the time the application is submitted after the Group Policy has come into force

If you are not currently enrolled in OPIP and are a newly practicing physician, an enrolment form will be sent to you. A newly practicing physician includes:

  • An OMA member beginning to practice in Ontario
  • A newly graduating resident who has become a practicing physician in Ontario

You will be eligible to enrol without medical evidence within 90 days (about three months) from the date you receive notification of your eligibility. After this date, medical evidence will be required to apply.

If you were ineligible at the time of the initial offer, you may be eligible to enrol for OPIP without medical evidence if you are returning to work from:

  • Parental leave of absence
  • Total disability
  • Residual disability
  • Opting out because you moved to another province to practice and have now returned to Ontario

If you did not enrol in OPIP when initially eligible, you may be eligible to apply for OPIP, but you will be required to provide medical evidence

It is an ongoing obligation to maintain your qualification for this subsidy and you must inform OMA Insurance if your qualifying status changes. OMA Insurance may ask for you to verify your qualifying status in the future. If any of the following criteria occur, you will no longer qualify for the subsidized portion of OPIP:

  • No longer residing in Canada
  • No longer registered with the College of Physicians and Surgeons of Ontario
  • No longer providing medical services in the province of Ontario for at least 15 hours per week due to reasons other than total disability
  • Absent from practice for more than 18 months (about one and a half years) due to a parental leave of absence

To continue your coverage once you have ceased active practice, you must:

    a. Have been covered by the program for at least 12 months

    b. Provide written notification of your change in eligibility and your intent to continue the coverage within 60 days (about two months)

    c. Pay the full cost of the plan

    d. Be under age 70 for the Critical Illness coverage to continue

If you do not meet criteria a) and b), then your coverage will terminate. If you do not meet d), your Health insurance can continue but your Critical Illness Insurance will stop at age 70. With this continuance option, you are still eligible for Legal Expense Insurance.

Contact Manulife at 1-888-596-8881 to ask about the continuance program for OPIP. 


The cost of OPIP is funded through a combination of government subsidy, OPIP reserves and member premiums.

The actual cost of your OPIP coverage is much higher than your annual contribution and is calculated based on sex, family status, age, and smoking status. The difference between the actual cost of OPIP and your annual contribution is paid for in two ways: government subsidy and OPIP reserve.

The Physician Health Benefit Program (PHBP) is a program subsidized by the Ontario government through Ontario Physicians Services Inc. (OPSI), a wholly owned subsidiary of the OMA established solely to administer this government subsidy, to help provide eligible physicians with Health Insurance (or a Health Care Spending Account) and Critical Illness Insurance.

The percentage of your premium that is subsidized may vary from year to year depending on the amount of government funding, the number of participants in the plan and the total amount of claims, up to a maximum set in the OPSI agreement.

The subsidized amount may need to be reported as income for tax purposes on your income tax return. For a more detailed explanation of the tax implications, visit the OPIP tax considerations page.5

Under the supervision of the OMA Insurance Committee, the OPIP reserve is used to build reserves for future stability as well as providing the cost-effective and value-added protection of Legal Expense Insurance. 

Frequently asked questions

If you are currently enrolled in OPIP, and you do not work the minimum 15 hours per week on average required because you are on parental leave, your OPIP subsidy may be extended up to 18 months from the date your parental leave commences. 

If you are currently enrolled in OPIP, and you do not work the minimum 15 hours per week on average required because you are disabled and receiving disability benefits from an insurer or through Canada Pension Plan disability program, your OPIP subsidy may be extended until such time as you are no longer disabled. 

Emergency out of province/country travel medical coverage is only available with Health/Health Plus insurance. 

Take action


Contact us

To learn more about OMA Insurance programs call

(Monday – Friday 8:45am – 5pm ET)

Or speak to an advisor

ARAG Legal Helpline
Have a legal question or want to make an LEI claim?

(Monday – Sunday 8:00am – 12:00am ET)

Ready to apply?

If you're ready to lock in the coverage that works best for you, take the next step and get a quote for the coverage you need, then proceed to the application. It helps to have birth dates and medical history information handy on everyone you would like to cover, like your spouse, children or a co-applicant.

Get a quote and apply

Our 30-day satisfaction guarantee

If you are not satisfied with your coverage, simply return your insurance certificate to Manulife within 30 days of receiving it, and any premiums paid for the coverage will be promptly refunded6