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Health insurance for Canada

Canada’s publicly funded health care system, informally nicknamed Medicare, is excellent.

Ranked 30th in the world by the World Health Organization (WHO), it is considered better than the health care systems of the U.S. and Australia.  Health care is delivered regionally and most services are free at point of access, apart from Quebec, where patients are required to pay upfront for reimbursement later. It would be wise to note though that there are some things that do not fall into its remit and new residents are not covered straight away.

Funded nationally by taxes but administered locally, all permanent residents must first register for a Health Card with their territory or province.  Everyone (including babies) needs their own Health Card so if you have a spouse and/or children or other dependents, be sure to put in applications for them as well.  Emergency care can be administered without this card but for everything else, from a visit to the doctor or nurse to more specialist care, this card needs to be shown.

Hospitals and other facilities are usually run by trusts, municipalities, and voluntary organisations but policies such as disease prevention and health promotion programs are decided by the government at a national level. In turn, the whole system is covered by the Canada Health Act, which ensures:

  • Services delivered are not-for-profit, with each public authority being accountable to the local province or territory.
  • All necessary health services from doctors to surgical dentists are covered.
  • Everyone with the Health Card must receive the same level of care.
  • Coverage from their home province if someone decides to move.
  • Hospitals are properly funded with reasonable level of access for everyone.

Despite the comprehensive nature of Medicare, it is worth noting that there are a number of things that are not covered, including:

  • Prescription medication: The doctor will give you a prescription but you must get it filled yourself at a pharmacy. You may need to pay for the drugs out of your own pocket, your employer may cover them, or you may be eligible to join a provincial drug plan in certain circumstances.
  • Dental care: Dental care (other than dental surgery) is not covered except for certain cases such as children from low-income families. Most people either pay for general dental services directly or through insurance. Bear in mind that a root canal for a molar may cost around $900.
  • Physiotherapy: Only certain people qualify for publicly funded physiotherapy, but these include children and seniors (over 65s). In other instances, you will need to find a private clinic for treatment.
  • Ambulance services: In most instances, you will be asked to pay a small fee for ambulance services, called a co-pay.  In Ontario, this is $45 unless the trip is deemed not medically necessary in which case you will have to pay $240 for a land ambulance or the full cost of an air ambulance.
  • Prescription glasses: Routine eye examinations are not covered for people of working age, and neither are glasses.

In addition, it is normal for new residents to wait for at least three months before being covered by the Health Card, so it is important to arrange your own private health insurance in advance to see you through at least these initial three months.  The waiting period begins on the date that you establish your residence in Canada and ends after three calendar months.

Example: Moving to Toronto and joining OHIP

If you are moving to Toronto, Canada’s largest city, you would need to join the Ontario Health Insurance Plan (OHIP) to access public health care. Your main residence needs to be in Ontario, you need to be away from Ontario less than 30 days in your first six months of living there, and you need to be in Ontario for 153 days out of any 12-month period. You can apply as soon as you arrive but won’t be covered until three calendar months after arrival. You apply in person at a government office and will need to bring completed forms and identity documents. Once you receive your card you will need to show it every time you access health services. More information is available here.

If you travel to other provinces while living in Canada, it is usual for your provincial Health Card to be sufficient to gain access to health services.  If you travel outside Canada, the Canadian government will pay a set rate for emergency medical services only (not including ambulances), but residents are encouraged to take out private health insurance to cover any shortfall.

Our International Health Insurance Canada tops you up where the Canadian health system (Medicare) might fall short.

Alongside this is another level of provision delivered by private clinics. With reduced waiting times for procedures such as scans, they offer an attractive alternative. Costs are met by private insurance, with roughly 80 percent of it covered by the policy.

All in all, Canada offers an excellent level of medical care, expertly and fairly delivered. However, there is some ongoing debate about whether a more insurance-based system, similar to the U.S., would deliver a more efficient service but for now, it is clear that new residents need their own provision in order to cover their first three months and certain other aspects of care such as dental work.

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