All About Healthcare And Health Insurance In Canada For Expats

How to access Canada's healthcare as an expat: your options, health insurance in Canada, eligibility and costs.

One of the most critical factors in your decision to move to a new country is access to good healthcare and affordable health cover. This guide serves as a brief overview of the healthcare system and health insurance in Canada for expats.

Is healthcare free in Canada?

The publicly-funded Canadian Healthcare system provides primarily free services to Canadian citizens with few exceptions. All citizens qualify regardless of history or standard of living.

However, the system does not cover prescription drugs, home care or long-term care, prescription glasses or dental care. For these services, it is recommended to supplement with private health insurance.

Numerous other non-essential services may also not be covered, depending on the province in which you reside. It is best to check with your provincial healthcare provider for coverage.

How much do Canadians pay for healthcare?

Healthcare in Canada is publicly funded. This means that both Federal and Provincial taxes support healthcare.

Federal support amounts to approximately 23% through the Canada Health Transfer Act, while Provincial taxes amount to the majority. The Federal funding is calculated on a per capita basis.

While this all sounds great, some provinces have to supplement the revenue with healthcare premiums. 

If you live in Ontario or British Columbia, you have to pay a premium of about CA$75.00/month per couple or family. Children less than 19 years old do not have to pay a premium.

Both provinces have a lower income threshold below which premiums are not paid.

Without insurance coverage, expect to pay CA$900-$1100 for an emergency room visit or CA$100-$600 for a clinic visit. This excludes treatment or prescription drugs.

Pregnancies, for example, are quite expensive but certainly cheaper than the U.S.A. An ultrasound will cost about CA$400/visit. A normal birth and delivery in the hospital will be, on average, CA$7,000. 

How does Canada’s healthcare work?

All provinces provide free emergency services even without a government health card. Emergency services are provided by the emergency departments at the local hospitals.

health insurance in Canada
Toronto General Hospital in Discovery District in Toronto

If the services needed are beyond the scope of local resources, patients will be transferred to bigger city hospitals via ambulance services.

Family doctors are accessed at local clinics, while specialists in most fields can be found in the larger cities. You will need a referral by your family doctor for most specialist services.

Some local clinics may arrange for visiting specialist services monthly.

The great thing about the healthcare system is that it is portable between provinces. All costs when travelling to another province are reimbursed at the home province’s fee rate.

Services that are covered are determined on a provincial level, so they may differ from province to province.

Some groups of people fall under Federal jurisdiction, including indigenous people living on reserves, RCMP, armed forces personnel and Federal inmates. 

Canada has a robust vetting system for healthcare personnel so that you can be sure knowledgeable staff are hired.

Canadian healthcare problems

However good healthcare in Canada is, it does have its problems that can affect you as a resident.

First, it is costly to sustain this concept due to an ageing population leading to more chronic illnesses and more expensive services. 

There are long wait times for non-essential services and some surgeries, such as magnetic resonance imaging, computer tomography. Even wait times in emergency rooms are on the rise. As an example, seniors may have to wait two to three years for hip replacement surgery.

Chronic disease is increasing among the senior population, increasing the need for community-based solutions.

Canada’s provincial health insurance covers a narrow scope of services.

There is less adequate care in isolated places and among the poor mostly due to available personnel and equipment.

The patchwork system of public and private coverage for prescription drugs has led to a lack of access to new drugs.

The less than efficient funding programme has led to a shortage of medical personnel and medical technology.

Healthcare in Canada for non-residents

With few exceptions, you may not qualify for the free healthcare programme if you reside in Canada for less than six months. 

The Interim Federal Health Programme provides temporary health insurance to refugees, protected persons and refugee claimants.

Non-residents who may be covered by healthcare include international students with study permits, clergy members, foreign workers with work permits, or foreign nationals in the process of obtaining their permanent residency.

It is recommended that you obtain private health insurance until you obtain residency.

Basic private health insurance rates can range anywhere from about CA$75-$200/month. However, premium health care can be as much as CA$800/month.

Healthcare in Canada for temporary residents

If you are from outside Canada, you may still be eligible for healthcare coverage as a temporary resident.

Eligibility requirements include a minimum 6-month work permit or study visa, designation as a refugee, intent on maintaining a resident in the province for 12 months, and a physical presence in the province for a minimum amount of time.

For example, in Ontario, the time is 153 days out of 12 months, whereas, in Alberta, that time is 183 days.

It is highly recommended to purchase private insurance in case your application for provincial health insurance is denied.

How do new immigrants get health insurance in Canada?

As a new immigrant to Canada, you will want to know how to apply for provincial health insurance.

In some provinces, it is recommended that you apply as soon as you arrive as the waiting period is up to 90 days, for example, in British Columbia. 

You can pick up the application form at local hospitals, doctor’s offices, immigration law offices or other locations, or you may download it from the corresponding provincial website.

Documents required:

  • Your proof of identification (driver’s license, passport, resident card, birth certificate)
  • Confirmation of permanent resident status: you may submit a paystub, utility bill or rental agreement for this
  •  You must also prove legal entitlement to be in Canada using your permanent resident card (both sides) or Canada entry document (both sides)

Once you have gathered all the supporting documentation and have filled in the application form, you may either take it with all the original documents to an authorised registry office or mail the form with photocopies to the provincial headquarters of the insurance.

NOTE: Presenting the application in person at the registry office is much quicker, and there is usually no charge for this service (5 days vs 6 weeks by mail).

In British Columbia, you may apply as soon as you move, but coverage will not start until after three months. You can submit your application online here.

There is also a second step to complete enrolment in the plan; you will need to obtain a Photo BC services card to be used when you access healthcare.

You will need to make an appointment at your nearest ICBC driver licensing office to have your photo taken. Bring two pieces of identification and declare that you are a resident. Your unique healthcare number will be printed on the card.

Private health insurance in Canada

Although publicly funded health insurance in Canada covers basic medical needs, some or all prescription drugs are not covered. Dental and eye care are not covered. Alternative treatments such as acupuncture, massage therapy, naturopaths are also not included in the coverage.

health insurance in Canada
Wellesley St James Town Health Centre in Toronto, a St. Michael’s family practice centre.

You may want to supplement coverage with private health insurance that can be customised according to your needs.

Your employer will often opt into supplemental health insurance so that deduction will automatically be made on your pay stub.

According to health law in Canada, if your employer offers health benefits, you are legally obligated to get on the programme. You may choose to purchase other supplemental health insurance for additional coverage. Still, the only way to opt out of an employer health programme is by taking a leave of absence. 

You may also decide to go entirely with full coverage with private health insurance.

The advantage of this is that you can customise according to your medical needs and pay the premiums accordingly.

Be aware, though, as with most private health insurance, any medical services you receive, you will be directly billed for, and you will have to get reimbursement from the insurance company.

Private health insurance is expensive, costing CA$800-$1200/year for family supplemental private insurance. Individual additional private insurance may be as much as CA$500 per year. Complete coverage will be more expensive. 

Health insurance in Canada – summary

Although Canada’s healthcare system has been held up as a shining example of socialised healthcare, it is a patchwork system at best, with each province responsible for the health standards.

It is free coverage for basics but does not cover the increasing needs of an ageing population.

You will definitely need supplemental health insurance to cover eye care, prescription drugs and dental services.

For the best deal on private health insurance Request a free quote from our partner, International Citizens Insurance.

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Debbie Strub
Debbie knows expat life very well. Her father was in the air force, so as a child she moved around a lot. Her most colourful memories come from the four years spent in Germany. After moving back to Canada, her family lived in Edmonton, Alberta, where Debbie graduated from N.A.I.T. with a Medical Laboratory Technologist diploma. As an adult, Debbie worked in the United Arab Emirates and volunteered in Ghana in her career in healthcare. Debbie is married and currently resides in a small town in southern Alberta with her husband, two dogs, and two cats, actively planning their retirement in Ecuador.
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