Canada’s publicly funded healthcare system is regarded as one of the best in the world, offering universal healthcare for all its residents. This, on top of the affordable cost of living in Canada, makes the country an attractive place for expats.
This comprehensive guide gives an overview of everything you need to know about the Canada health care system, Medicare. We will also look into the key aspects of healthcare in Canada under the Canada Health Act, including its strengths, challenges, and how to access its services as a citizen and expat.
You’ll discover:
How the Canada Health Care System Works
One significant benefit of living in Canada is the country’s universal health care system, Medicare, which is funded through taxes.
Canada ranks first for quality of life on the Global Residency and Citizenship by Investment Report, with its healthcare system being a significant contributing factor to its position.
The 2024 Commonwealth Fund Report also ranked Canada’s healthcare system seventh out of 10 high-income countries, and CEOWORLD ranked the system in fourth place out of 110 countries on their Health Care Index, showing the system’s success on a global scale.
If you qualify as a resident, you can get health coverage through your province or territory’s insurance plan, with each region setting its own eligibility rules.
Even though the eligibility may differ slightly between one province or territory and another, the basic standards of coverage for health services are generally the same.
These services include medically necessary hospital, physician, and some surgical-dental services, as determined by the provinces and territories.
Canada’s role in the healthcare system
While each province and territory has its own health insurance plan, the Canadian federal government sets national health care standards and helps fund the system.
The government also provides care for certain groups (veterans, refugees, inmates in federal penitentiaries, members of the Canadian Forces, and Inuit and First Nations people living on reserves), and offers other health-related supports such as health research and promotion.
The government will set national standards described in the Canada Health Act of 1984 for the 13 provincial and territorial health insurance plans. The provinces and territories must meet these standards to receive full payment under the Canada Health Transfer (direct health care funding).
These standards are:
- Public administration: Administer and operate the health services on a non-profit basis
- Universality: Provide health coverage to all residents
- Portability: Ensure residents are covered when they travel within Canada, when they move to another province or territory (until they can register for new coverage), and for travel outside Canada (limited coverage).
- Accessibility: Medically necessary services should be reasonably accessible for good health outcomes, based on medical need, not the ability to pay.
- Comprehensiveness: Ensure medically necessary services are provided and the full cost is covered.
Which services are provided by the healthcare system in Canada?
Public healthcare in Canada covers essential private healthcare services, including first-contact physician services and medically necessary services provided in hospitals.
Seniors, children, and people who receive social assistance also receive additional coverage to pay for certain health care services that are not fully covered by the system, such as home care, vision care, dental care, prescription medication, and ambulance services.
Those who do not qualify for additional coverage will pay for these additional services out of pocket or through a private health insurance plan.
Other services, such as cosmetic procedures, are not insured under a provincial or territorial plan.
Who is eligible for Canadian health care?
Eligibility for healthcare in Canada primarily extends to Canadian citizens and permanent residents. Provinces and territories administer their own healthcare plan, and eligibility criteria may vary slightly. Its excellent healthcare is one of the many benefits of Canadian citizenship and one of the reasons why so many Americans are moving to Canada.
Generally, Canadian citizens are eligible for health services from birth, while permanent residents (or those applying for Canadian citizenship), usually qualify after a waiting period, typically three months following their arrival in Canada. Temporary residents, such as foreign workers or international students, may have limited access to Medicare, often requiring additional insurance.
As an expat, understanding these eligibility guidelines is crucial for accessing Canada’s publicly funded healthcare system and securing the necessary coverage for your specific situation.
Registering for healthcare as an expat: Steps and requirements
The following list gives an overview of registering for Medicare as an expat. Note that registration processes and requirements may vary between provinces and territories in Canada, so it’s essential to research and follow the specific guidelines applicable to your location.
- Ensure you meet the eligibility criteria, typically Canadian citizenship or permanent residency, or comply with province-specific regulations.
- Contact the provincial or territorial health authority where you live to start the application process.
- Prepare essential documents like proof of identity, immigration status, and residency address.
- Wait for your application to be processed and approved. This may take some time, so ensure you have temporary health coverage or private insurance in the meantime.
- Once approved, you’ll receive a provincial health card, which is necessary to access healthcare services.
- Familiarize yourself with what is covered under your province’s healthcare plan and consider supplementary insurance for services not included.
- Notify the health authority of any changes in your personal information, such as a change in address or marital status.
Healthcare access in Canada
Access to medical care in Canada is typically straightforward. Patients do not need to pay directly for most covered health care services; instead, health care providers bill the provincial or territorial governments. However, Canadians often face wait times for non-emergency procedures and specialist consultations due to the high demand for services.
Supplementary insurance
Many Canadians opt for supplementary insurance to cover gaps in Medicare coverage. This additional insurance can help with prescription drug costs, dental care, and other services not covered by the public system.
Private Health Insurance in Canada
Private medical insurance in Canada for expats plays a crucial role in supplementing the country’s universal health system, which may not cover all medical expenses, and you may have to make out-of-pocket payments. Here are key points to consider:
- While Canadian Medicare provides essential services, it doesn’t cover everything. Expats often turn to additional insurance to bridge gaps in areas like prescription drugs, dental care, vision care, and certain specialist services, such as physiotherapy.
- Expats have a range of additional health insurance plans to choose from, catering to different needs and budgets. These plans offer varying levels of coverage, deductibles, and premiums, allowing individuals to tailor coverage to their requirements.
- Some expats may have access to private insurance through their employers, which can be a cost-effective option.
- Temporary residents and tourists can purchase travel insurance to cover emergency medical expenses while in Canada.
- The cost of private medical insurance varies based on factors such as age, health status, and the extent of coverage. For example, plans can start as low as C$61 per month for a 25-year-old and can range up to C$348 per month for a 75-year-old. Shopping around and comparing plans is essential to find the best fit.
- Private insurance offers peace of mind, ensuring expats can access a broader range of healthcare services and avoid unexpected out-of-pocket expenses.
Expats in Canada should carefully assess their healthcare needs, research available plans, and consider extra health insurance to complement the country’s healthcare system and ensure comprehensive coverage for their medical needs.
Provincial versus private health insurance: Making the right choice
Choosing between provincial and privately insured health services in Canada is a crucial decision that impacts an individual’s healthcare coverage and costs. Here’s a comparison to help you make an informed choice:
Provincial health insurance:
- Universal Coverage: Provincial healthcare plans provide universal coverage for essential medical services, ensuring equal access for all residents and reducing health disparities.
- No Premiums: Provincial health insurance is publicly funded through taxes in most provinces, and there are no monthly premiums.
- Limited Coverage: Provincial plans may have limitations, such as long wait times for certain procedures and limited coverage for certain drugs, procedures, and medical services.
Private health insurance:
- Supplementary Coverage: Private insurance offers supplementary coverage, filling the gaps left by provincial plans.
- Customization: Individuals can select plans tailored to their specific needs, with varying levels of coverage and premiums.
- Cost: Private insurance comes at a cost, with monthly premiums and potential deductibles.
The right choice often depends on individual circumstances. Expats, those with specific healthcare needs, or those seeking faster access to specialized care may opt for private insurance. However, most Canadians rely on provincial healthcare plans as the foundation of their coverage, while supplementing with private insurance to address specific needs.
Accessing Medical Services: Finding a Family Doctor
The country has an abundance of excellent family physicians and many community health centers to ensure Canada’s health system performance runs as smoothly as possible.
Many Canadians opt for one family doctor who provides basic care, treats illnesses, and offers advice to help prevent future health problems.
Family doctors may perform tests such as blood tests, blood pressure checks, and pap smears, and can refer patients to specialists when needed.
While not everyone has a family doctor, many prefer one for the continuity of seeing the same doctor who stays informed about the family’s medical history.
Making an appointment with a family doctor
With a family doctor, residents find it convenient to book appointments for any non-urgent care, with separate bookings for each family member. Appointments are usually made online or via telephone.
As with any family doctor, informing them about any medicines you take, including prescriptions from other doctors and over-the-counter drugs, is essential.
Specialist Care: Referrals, Wait Times, and Appointment Booking
Specialist medical care is an integral part of Medicare, but accessing it can involve specific processes and considerations:
- Referrals: In Canada, you usually need a referral from a primary care provider (family doctor) to see a specialist. This referral ensures that you receive appropriate care and that specialist services are used efficiently.
- Wait Times: Wait times for specialist appointments can vary significantly depending on factors like your location, the type of specialist needed, and the urgency of your condition. Making an appointment with your family doctor does not usually take more than a few days; however, the average wait for specialist health care services following a GP referral is 15 weeks.
- Priority Cases: Urgent or life-threatening cases receive immediate attention, ensuring timely care. However, non-urgent cases may experience longer wait times, highlighting the need for efficient triage systems.
- Appointment Booking: After receiving a referral, you’ll typically contact the specialist’s office to book an appointment. Be prepared to provide your referral letter and personal information.
- Second Opinions: You have the right to seek a second opinion from another specialist if you have concerns about your diagnosis or treatment plan.
Understanding the referral process and being patient with wait times is crucial when seeking specialist care in Canada. Health care professionals prioritize patients based on medical needs, aiming to provide quality care to all.
How to Get Medication in Canada
In a Canadian hospital, your medications are free. However, medicines from a pharmacy usually aren’t covered by public health insurance, so you may need to pay or use private insurance for coverage.
You can visit a pharmacist for minor illnesses or injuries like colds, headaches, or small cuts. They can suggest over-the-counter medicines, but can’t give prescription medication without a doctor’s prescription.
Generally speaking, you’ll get your prescription medication via the following process:
- Visit a healthcare provider and get a prescription for your medication. This can be a family doctor, specialist, or nurse practitioner.
- Take your prescription to a local pharmacy, where pharmacists can provide advice and dispense your medication.
- Check if you have prescription drug coverage through provincial plans, private insurance, or workplace benefits. Some groups of people, like seniors and low-income individuals, may receive comprehensive public coverage.
- If you’re not covered, be prepared to pay for the medication out of your own pocket. Consider discussing generic or lower-cost alternatives with your pharmacist to save money.
By understanding your coverage and speaking with healthcare professionals, you can access necessary prescription medications while managing expenses in Canada.
Find out more about Living in Canada
Dental and Vision Care in Canada
Dental and vision care are essential aspects of overall health, and understanding how these services are covered and the associated expenses in Canada is crucial for residents and expats alike. In the section below, we’ll explore the details of dental and vision care within the Canadian healthcare system.
Dental care
Dental care in Canada is a vital component of overall health and well-being, but it operates independently from the country’s publicly funded healthcare system.
Dental services are primarily provided through a combination of private practices, employer-sponsored insurance plans, and government programs for specific populations, such as children and low-income individuals.
Routine dental check-ups, cleanings, and minor procedures are typically covered by private insurance plans or paid for out-of-pocket. While some provinces offer dental care for children and low-income adults, coverage can vary significantly.
Vision care
Vision care is also an integral part of healthcare, but like dental care, it is largely separate from the publicly funded healthcare system.
Routine eye exams and prescription eyewear are typically covered through private insurance plans or paid for by individuals. Some provinces may provide limited coverage for eye exams, especially for children and seniors.
Expats in Canada are encouraged to explore vision care insurance options to offset the costs of eye examinations, glasses, or contact lenses. Annual eye check-ups are essential for maintaining eye health, and understanding coverage and expenses is vital to ensure optimal vision care while living in Canada.
Other Healthcare Services in Canada
Mental health support
Canada offers a wealth of resources and assistance to help expats navigate the challenges of mental health care and mental well-being. Canada’s Medicare provides access to psychiatrists, psychologists, and therapists, often covered by insurance or provincial health plans.
Additionally, numerous non-profit organizations and support groups specifically cater to expats, offering a sense of community and culturally sensitive mental health services. Online platforms, telehealth services, and crisis hotlines further ensure accessibility.
Maternity care and parental services
Canadian maternity care includes prenatal and postnatal care, hospital or home births, and access to skilled healthcare professionals like midwives and obstetricians. The country also offers generous parental leave benefits, allowing new parents to balance work and family life.
To access these services, expats need to register for their province’s healthcare program and fulfill any waiting period. It’s advisable to begin this process early in your pregnancy to ensure seamless care.
Pediatric care
Canada’s universal healthcare system covers a wide range of services for children, including routine check-ups, vaccinations, and treatment for illnesses and injuries.
Families can access pediatricians, family doctors, and healthcare facilities for their child’s healthcare needs. Pediatric specialists, such as pediatric surgeons, neurologists, and allergists, are also available if required.
Moreover, Canadian cities often have world-class children’s hospitals that are renowned for their expertise and research in pediatric medicine.
Rehabilitation services
Rehabilitation services in Canada play a crucial role in helping individuals recovering from injuries, surgeries, or other health conditions to regain their independence and quality of life. These services encompass physical therapy, occupational therapy, speech therapy, and more, with a focus on personalized treatment plans tailored to the individual’s needs.
Rehab services in Canada are not universally free; they are typically covered by provincial healthcare plans to varying extents.
Managing chronic conditions
Expats, and especially those who retire in Canada, can benefit from a network of specialists, support groups, and community resources to help manage their conditions effectively.
However, additional private insurance or paying expenses may be necessary for specific treatments, medications, or therapies related to chronic conditions.
Language and Cultural Considerations in Canadian Healthcare
Canada is a diverse nation and is well-known for its inclusivity of all nations, cultures, and religions, and this also extends to its healthcare system, where language and cultural considerations are integral aspects. Interpretation services are often available to assist patients with limited English or French proficiency.
Moreover, culturally sensitive care is encouraged, with healthcare professionals trained to understand and respect cultural differences, dietary preferences, and religious beliefs that may impact treatment decisions. This approach fosters trust and ensures patients receive care that aligns with their values and needs.
Accessing Healthcare in Rural or Remote Areas
Accessing healthcare in rural or remote areas of Canada poses unique challenges due to geographical isolation and limited medical infrastructure.
Residents often cope with extended travel distances to reach healthcare facilities, but this sometimes results in delayed care and potential health risks.
To address achieve health equity, telehealth services have gained in popularity, connecting patients with medical professionals via video consultations.
Mobile clinics bring essential health services directly to remote communities, overcoming accessibility issues. Furthermore, government programs incentivize healthcare professionals to practice in underserved areas.
Health Insurance for Temporary Residents
Temporary residents in Canada have several medical insurance options to consider. Many provinces offer healthcare in Canada for non-residents through special health plans, covering essential medical services. Additionally, private health care providers offer comprehensive coverage for various healthcare needs, including emergency medical care and prescription medications.
It’s crucial for temporary residents to research and select a suitable insurance plan that aligns with their specific visa requirements and personal health needs to ensure they have access to necessary medical care while in Canada.
Everything You Need to know Canada Permanent Resident Visa
Preventive Care and Wellness Programs
In Canada, preventive care and wellness programs are pivotal components of the healthcare system, promoting overall health and well-being. Health Canada, the federal ministry of health, encourages a proactive approach to health, emphasizing regular check-ups, vaccinations, and health screenings.
The government also supports various wellness initiatives, such as smoking cessation programs and healthy eating campaigns, to reduce the risk of chronic diseases.
By prioritizing preventive care and participating in wellness programs, all people living in Canada can proactively manage their health and contribute to the overall well-being of their communities, aligning with the goals set forth by Health Canada.
USA vs Canadian Healthcare
While Canada has a universal, tax-funded healthcare system that gives all citizens and permanent residents free access to healthcare services, the American healthcare system relies mostly on private insurance with support from a mix of public programs.
Americans pay about twice as much for healthcare as Canadians. In 2023, the annual medical expenses in America averaged $13,432 per person, compared to Canada’s average health expenditures of $7,013. Americans face higher out-of-pocket costs, and many skip care because of the price.
Key Take-Aways from Canadian Healthcare
Canada’s publicly funded healthcare system and public health insurance are a great way to ensure that healthcare services are accessible to everyone, regardless of their income or individual circumstances. Canadian citizens and permanent residents are entitled to free public healthcare, while tourists and visitors are not. However, anyone in Canada can seek private healthcare.
To get the most out of the Canadian healthcare system, make sure you understand your eligibility. If you’re a permanent resident, you should have full access. Be mindful that certain services, such as dental and vision care, as well as some rehabilitation services, are not included in the publicly funded system.
Frequently Asked Questions About Healthcare in Canada
Is healthcare free in Canada?
The Government of Canada ensures it is free for all citizens and permanent residents. This includes free emergency care for all undocumented immigrants and free non-emergency care for those who are pregnant women or children. In practice, however, barriers to healthcare remain for undocumented immigrants.
How long do you have to live in Canada to get free healthcare?
You must have lived in Canada and had a permanent resident status for at least three months to become eligible for Canada’s universal healthcare.
How good is the medical care in Canada?
Canada’s health care system is known for its quality and accessibility. It offers universal coverage for essential medical services, promoting overall well-being and providing care that is generally considered of high standard.
Is healthcare in Canada as expensive as in the US?
It is generally less expensive for residents due to its publicly funded system. In contrast, the United States has a largely private healthcare system, often resulting in higher costs for medical services and insurance.
Can Americans get healthcare in Canada?
Americans can access Canada’s medical care, but it is not covered by Canada’s public healthcare system. They usually need to pay out of their own pocket or have private insurance that covers healthcare services while visiting or residing in Canada.
How does free healthcare work in Canada?
Canada’s healthcare system provides residents with universal coverage for medically necessary services. Funded by the Canadian tax system, it offers reasonable access to doctors, hospitals, and essential treatments without direct costs at the point of care, ensuring equitable access for all citizens and permanent residents.
Who pays for medical care in Canada?
It is funded through a combination of federal, provincial, and territorial taxes. The federal government allocates these funds to cover the cost of essential medical services for all residents and permanent residents.
What is not covered by healthcare in Canada?
Generally, vision care, dental care, prescription medication, ambulance services, cosmetic procedures, and certain specialist services, like physiotherapy, are not covered under the universal healthcare plan in Canada.
Is private health insurance necessary in Canada?
Private health insurance is necessary in Canada for services not included in Medicare, such as prescription drugs, dental care, and vision care. It is a good idea to get private health insurance to avoid paying out of pocket for these services.
What are the wait times like for medical services in Canada?
In Canada, wait times for medical services can be lengthy, depending on the service.
Making an appointment with your family doctor does not usually take more than a few days; however, the average wait for specialist health care services following a GP referral is 15 weeks.
