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There are still more than 3-and-a-half million residents with the old red-and-white cards, including a CTV reporter who was told her OHIP card had been cancelled and she'd have to pay $60 to see a doctor.
The old cards don't have expiry dates, but government officials say people were sent three notices to get the newer one.
If the card holder doesn't respond, and the health card hasn't been used in seven years, the government will suspend it.