Government of Canada

Canada Health Act (Medicare)

A complete guide to Canada's publicly funded healthcare system. Explore coverage details, provincial health cards, and eligibility for citizens and newcomers.

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:

  1. Proof of Status: Canadian Citizenship card, Permanent Resident (PR) card, or Work Permit.
  2. Proof of Residency: A utility bill, bank statement, or rental agreement showing your name and address in that province.
  3. Proof of Identity: A credit card, passport, or employee ID card.

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Frequently Asked Questions

Can I use my Ontario Health Card in British Columbia?
Yes, for emergencies. Thanks to the "Portability" principle of the Canada Health Act, you can use your home province's card in another province for medically necessary services. However, if you move permanently, you must switch to the new province's plan after 3 months.
Is abortion covered in Canada?
Yes. Abortion services are legal and considered medically necessary in Canada. They are publicly funded and available at no cost to the patient in hospitals and clinics.
Can I pay a doctor to get faster treatment?
Generally, no. Doctors who work within the public system are prohibited from charging patients extra fees for insured services (Extra-Billing). Access is based on medical need, not ability to pay.
What is the Canadian Dental Care Plan (CDCP)?
The CDCP is a new federal initiative designed to help cover the cost of dental care for Canadian residents with a family net income of less than $90,000 who do not have access to dental insurance.
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About the Founder & Mission

Digital Information Expert & Health Tech Blogger

Hi, I am Sandeep Jagdev, a Senior Digital Marketing Expert and the founder of HealthCardHospitalList.com. While I am not a doctor, my extensive experience in digital research allows me to bridge the gap between complex government data and the general public.

*Disclaimer: We are an information aggregator and guide. While we consult with medical experts for clarity, we are not a government body. Always verify final details with official hospital desks.*