UHIP & COVID Vaccines

Currently, UHIP members are eligible to receive the COVID-19 vaccine, based on provincial eligibility guidelines that include: supply of vaccine, age, occupation, and ‘hot spots’ that have a high infection rate.  Eligibility changes quickly depending on supply and demand.  Members are encouraged to bookmark their local public health web page and check daily for updates.

The locations below provide COVID-19 vaccinations.  The Ministry of Health (MOH) reimburses mass vaccination sites, mobile clinics, pop-up clinics, public health units and pharmacies for administering the COVID-19 vaccination, but does not reimburse private doctor offices or nurse practitioners for individuals without OHIP.  Depending on where the UHIP member is vaccinated, there may be charge, and it’s eligible for reimbursement under UHIP – see below.

Within Ontario, Hull or Gatineau:

Where is the UHIP member getting their vaccination?

Who pays?

Designated mass vaccination site

Mobile or pop-up clinics 

Public health unit

Designated pharmacy

Government of Ontario

  • Member should not receive any charges
  • if there is a charge, member should contact case.mgmt@sunlife.com for handling

 

Primary care setting (eg. Family doctor, campus clinic)

Community walk in clinic

We encourage members to use designated mass vaccination clinics, pharmacies, or PPN physicians and clinics to avoid out of pocket expenses.

UHIP

Preferred Provider Network (PPN)

  • We encourage members to use designated mass vaccination clinics, or pharmacies to avoid out of pocket expenses.
  • To avoid out of pocket expenses, if possible, members should attempt to book/receive their vaccination within the PPN.  These clinics will bill Sun Life directly at UHIP rates.
  • The maximum UHIP reimbursement when the sole reason for the visit is to receive the vaccine:
 
If administered by a doctor If administered by a nurse practitioner

G700: $7.00

G593: $16.25

G700:  $5.60

G593: $13.00

Total UHIP reimbursement: $23.25 Total UHIP reimbursement: $18.60

Outside of PPN

  • That go to doctor’s offices outside of the PPN may be charged over and above UHIP’s reimbursement rates.
  • Member will need to complete & submit a claim to Sun Life for reimbursement.

G700 & G593 = The payable OHIP fee codes when the sole reason for the visit is to receive the COVID-19 vaccine

Important: 

  • Members can access the Ontario provincial website to find out when/where they can book their vaccine https://covid-19.ontario.ca/book-vaccine/
  • Each Public Health Unit, mass vaccination site and pharmacy has their own booking requirements.  Some online booking portals require a Provincial health card number.
  • If the online booking process requires a member to enter a health card number, the member should call the booking centre to schedule their appointment, and advise they don’t have OHIP coverage.

 

Outside Ontario, but within Canada:

Where is the UHIP member getting their vaccination?

Who pays?

Mass Vaccination site

Mobile or pop-up clinics

Public Health unit

Designated pharmacy

Government of the province:

  • Member should not receive any charges
  • if there is a charge, member should contact case.mgmt@sunlife.com for handling

Primary care setting (eg. Family doctor, campus clinic)

Community walk in clinic

UHIP

  • Members may be out of pocket and charged more than what UHIP reimburses. 
  • Member will need to complete & submit a claim to Sun Life for reimbursement.
  • The maximum UHIP reimbursement when the sole reason for the visit is to receive the vaccine:
If administered by a doctor If administered by a nurse practitioner
G700: $7.00 G700:  $5.60
G593: $16.25 G593: $13.00
Total UHIP reimbursement: $23.25 Total UHIP reimbursement: $18.60

G700 & G593 = The payable OHIP fee codes when the sole reason for the visit is to receive the COVID-19 vaccine

Important: 

  • Similar to Ontario, each Province has a public health website with information about their vaccination roll-out plan and eligibility.  Members should bookmark their provincial public health site and check daily for updates to book their vaccination when available.
  • Many pharmacies are offering the option of pre-registration.  This allows members to have their contact information ready at the pharmacy for when they become eligible for the vaccine.