At a Glance: Canadian Healthcare
| Legislation Name | Canada Health Act (CHA) |
|---|---|
| Common Name | Medicare |
| Funding Model | Publicly Funded (Tax-based), Single-Payer |
| Administration | Provincial & Territorial Governments |
| Cost to Patient | $0 for medically necessary hospital/doctor services |
| Official Website | Health Canada |
Canada's healthcare system, known to Canadians simply as "Medicare," is a source of national pride. It is designed to ensure that all residents have reasonable access to medically necessary hospital and physician services without paying out-of-pocket.
Unlike the systems in many other countries, Canada does not have a single national plan. Instead, it has a national program that is composed of 13 interlocking provincial and territorial health insurance plans. All of these plans share certain common features and standards as a condition of receiving federal funding.
The role of the federal government is to set national standards and provide funding (via the Canada Health Transfer), while the provinces and territories are responsible for the actual management, organization, and delivery of health services.
The 5 Pillars of the Canada Health Act
To receive full funding from the federal government, provincial health insurance plans must meet five criteria established under the Canada Health Act (1984). Understanding these pillars explains why the system works the way it does.
1. Public Administration
The health insurance plans must be administered and operated on a non-profit basis by a public authority appointed by the provincial government.
2. Comprehensiveness
The plan must cover all "medically necessary" services provided by hospitals, medical practitioners, and dentists working within a hospital setting.
3. Universality
All insured residents of the province or territory must be entitled to the insured health services provided by the provincial plan on uniform terms and conditions.
4. Portability
Residents moving from one province to another must continue to be covered for insured health services by their "home" province during any waiting period (up to 3 months).
5. Accessibility
The plan must provide all insured persons with reasonable access to medically necessary services without financial or other barriers (e.g., no extra-billing or user charges).
Provincial Health Cards & Plans
Since healthcare is managed provincially, you must apply for the health card specific to the province where you live. This card is your ID for all medical appointments.
| Province / Territory | Plan Name | Card Name |
|---|---|---|
| Ontario | Ontario Health Insurance Plan (OHIP) | Ontario Health Card |
| British Columbia | Medical Services Plan (MSP) | BC Services Card |
| Quebec | Régie de l'assurance maladie du Québec (RAMQ) | Health Insurance Card (Sun Card) |
| Alberta | Alberta Health Care Insurance Plan (AHCIP) | Alberta Personal Health Card |
| Manitoba | Manitoba Health | Manitoba Health Card |
| Saskatchewan | Saskatchewan Health | Saskatchewan Health Card |
| Nova Scotia | Medical Services Insurance (MSI) | Nova Scotia Health Card |
What is Covered vs. What is NOT Covered
While the core of the system is free, many newcomers are surprised to learn that "Universal Healthcare" does not mean "Everything is Free."
✅ Covered (Free of Charge)
- Doctor Visits: Visits to General Practitioners (GPs) and walk-in clinics.
- Specialists: Consultations with specialists (e.g., Cardiologist, Dermatologist) *if referred by a GP*.
- Hospital Stays: Standard ward rooms, nursing care, meals, operating room fees, and medications administered while in the hospital.
- Diagnostics: X-rays, blood tests, and lab work ordered by a doctor.
- Maternity: Prenatal care and childbirth services.
❌ Not Generally Covered (You Pay)
Unless you have private "Supplemental Insurance" (often provided by employers), you usually pay for:
- Prescription Drugs: Medicines you buy at a pharmacy (outside of a hospital setting) are not covered for most adults, though seniors and low-income groups often have provincial drug plans.
- Dental Care: Routine cleanings, fillings, and extractions are private.
- Vision Care: Eye exams and glasses (coverage varies by province; often free for children/seniors).
- Ambulance Services: Most provinces charge a fee (e.g., $45 to $240) for ambulance transport unless it is a transfer between hospitals.
- Physiotherapy & Massage: Unless performed in a hospital.
For Newcomers & Work Permit Holders
If you are moving to Canada, obtaining health coverage should be your priority. However, coverage is not always immediate.
The Waiting Period
Some provinces (like British Columbia, Ontario, and Quebec) previously had a waiting period of up to 3 months before your health coverage began.
Note: Ontario waived its 3-month waiting period during the pandemic and has kept it waived for now, but rules can change. Always check the official provincial website upon arrival.
Interim Federal Health Program (IFHP)
Refugees, protected persons, and victims of human trafficking may be eligible for the IFHP, which provides temporary health coverage until they become eligible for provincial plans.
Private Health Insurance
It is highly recommended that all newcomers purchase private travel/health insurance to cover the first 3 months of their stay in Canada to protect against emergency costs while waiting for provincial coverage to kick in.
How to Apply for a Health Card
The process involves visiting a provincial service center (e.g., ServiceOntario, ICBC Driver Licensing Office). You generally need three types of documents:
- Proof of Status: Canadian Citizenship card, Permanent Resident (PR) card, or Work Permit.
- Proof of Residency: A utility bill, bank statement, or rental agreement showing your name and address in that province.
- Proof of Identity: A credit card, passport, or employee ID card.
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