Health care in Canada

Health care in Canada: Getting the best for you and your family

If you’re considering relocating to Canada to live and work, among your concerns will be ensuring you understand the health care system and knowing you’ll have access to all its services.

Canada has many enticements for the expat, from the influences of its varied cultures — the indigenous First Nation peoples, Inuit and the Métis, European Francophone and Anglophone Canadians — to its awe-inspiring landscapes. Canada’s geography includes some of the remotest places on earth including forests, frozen wastelands, lakes, waterways and high mountain ranges in contrast to bustling cities like Toronto and Vancouver. A broadly secular society, people from a wide array of cultures and faiths continue to make Canada their home.

Resident status and health care eligibility

Opportunities for work are highest in the largest cities such as Toronto, Calgary, Montreal and Ottawa and you can find seasonal and permanent work in a wide range of sectors. A system of health care is available to every registered resident. So it’s important that the newly arrived expat takes the necessary steps to become eligible. Resident status is obtained through a process of selection, and involves contacting and being assessed by the Canadian authorities through a consulate, Canadian embassies or the high commission.

Broadly there are six categories under which a person is eligible:

• skilled worker class
• business class
• provincial nomination
• family class immigration
• Quebec selected immigration
• international adoption

Applying for temporary health insurance

The application process takes time, involves meeting criteria through a point system and paying certain fees. For those who are self-funded coming from the U.S., UK or elsewhere, it’s important to obtain temporary health insurance as you arrive in Canada.

For those coming on assignment, it’s likely that larger organisations and companies will offer health insurance as part of an employee benefit package, and this can represent a considerable benefit for the employee and his/her dependants.

When you arrive, whether you intend to stay for up to four years or to live in Canada permanently and claim residency, you’re expected to register for eligibility to access Medicare. You’re advised to apply swiftly — within 5 days of arrival — for three months’ temporary health insurance if you are not already covered by an employer or other arrangement you’ve made, until you receive your Medicare card. To register for your card, you’ll need identification when you apply.

Make sure you have least one of the following permissible IDs:

• passport
  
• birth certificate
  
• confirmation of permanent residence (IMM 5292) or permanent resident card

Insured persons are defined as residents of a province and as ‘a person lawfully entitled to be or to remain in Canada who makes his home and is ordinarily present in the province’.

Once you receive your Medicare card, it’s important to carry it with you at all times and to show it whenever you seek Medicare treatment.

Health care in Canada

Health care in Canada is highly regarded in the world for its comprehensive care, affordability, and portability criterion, which means that Canadians are legally covered by public health care insurance when they travel within Canada. For interprovincial travel, your provincial Health Care card will normally be sufficient for medical services away from your home.

If going outside of Canada, it may be worth taking private health insurance to cover any expenses over and above the set rate emergency allowance provided by the Canadian government.

Life expectancy at birth is high and cancer survival rates are good, even if there are sometimes long waits for surgery and for appointments with specialists. Decisions about care provided are made at a provincial level, and regional politics decides the level of provision given to students, the poor, elderly and unemployed citizens.

Health care is delivered regionally and most services are free at point of access.

Quebec has its own system and patients usually pay before accessing treatment and are reimbursed later. Not all aspects of care are delivered by Medicare and new residents may not be covered immediately or for all services.

A brief history of the Canada Health Act

Interestingly, national health care provision has not always existed. In 1947, the beginning of a social health care system began when the Saskatchewan government introduced a hospital insurance program. In 1966, Parliament created the national Medicare program, with Ottawa contributing 50% of the provincial health care costs. By the end of the 1970s, the Canadian Health Coalition was formed and, in 1984, the Canada Health Act was passed. The national health care system, known as Medicare, makes provision for all Canadian citizens including First Nations people, the Inuit and Métis. Delivered regionally, most services are delivered free at point of access. Although new residents may find themselves not covered straight away and some services are not part of Medicare’s remit. Once obtained, the Health Care card covers a comprehensive set of services.

Essentially, the act ensures there is a ‘basic standard’ of health care coverage and ‘reasonable access’ for ‘all residents of Canada’ to services from physicians and hospitals where ‘medically necessary’, across the territories and provinces of Canada. These services are pre-paid and have uniform terms and conditions, although delivered by separate regions.

Rural versus urban

When relocating, you may be concerned about getting the best care wherever you live. As an employee on assignment you may well be heading to an urban area. If you’re an expat seeking a new life in Canada you may be choosing to settle in a rural area. It’s estimated as much as 95% of Canada is rural and around 30% of the population lives in remote communities. These include diverse populations and ethnic groups with differing needs.

Accessing health care can be a challenge in rural Canada, with limited distribution of even basic provision, and a difficulty in recruiting and retaining practitioners such as physicians. The challenge of distributing health care to remote communities is the subject of on-going reviews and planning to increase and maintain access and to encourage involvement of the communities themselves in creating new strategies.

‘Top-up’ your insurance

It’s might be worth maintaining a level of supplemental ‘top-up’ insurance throughout your residency. Although Canada has universal health care, it doesn’t provide complete coverage for all services. ‘Top-up’ private medical insurance can be arranged to cover costs for exclusions such as physiotherapy, dental treatment and ambulance services. For many, an attractive alternative is adding another level of provision, offering access to private health clinics with benefits such as reduced waiting times for procedures and diagnostics, including scans.

Pre-trip planning

For those planning a move to Canada, Aetna International offers members pre-trip planning advice to ensure your health needs are catered for and to help you navigate the health care system in Canada. From an occupational health perspective, we can help to set employees up for success before they embark on their assignments by discussing their health care needs.

Whatever your reason for choosing to stay in Canada, whether for a season, a couple of years with a temporary work visa, or permanently – consider your health care needs and whether you need to invest in additional cover, even if you’re eligible for state health care through Medicare.

For more information on pre-trip planning, a range of additional health and wellness support programmes or for details on our medical insurance policies, please get in touch with one of our expert sales consultants.

From seeking work and deciding where to settle to calculating the cost of living, you’ll find out much more about living and working in Canada from our Canada Destination Guide.

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