10 important things expats need to know about healthcare in Canada
Canada is a popular destination for expats, with schemes like Canadian Experience Class aimed at attracting new residents to this sparsely populated country. With such spectacular and varied countryside and modern multi-cultural cities like Toronto and Montreal, it’s no wonder people from all over the world want to move there to start a new life.
If you are thinking of relocating to Canada to live and work, here are 10 things you may want to know about the healthcare system before you move.
Canada has a universal healthcare system in place (Medicare) that enables Canadian citizens and permanent residents (people who have permanently emigrated to Canada from another country and who hold permanent residents (PR) cards) to gain public health insurance. This entitles them to free basic healthcare services.
Medicare is a multifaceted, publicly funded healthcare system, but is not available to temporary foreign workers. It is underpinned by the Canada Health Act. Passed in 1984, this 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.
- Medicare health cards
When you arrive, whether you intend to stay for up to four years or to live there 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. To apply, you’ll need to fill out a health card form and provide proof of immigration status, residency, and identity. Make sure you have at least one of the following permissible IDs with you when applying:
- Birth certificate
- Confirmation of permanent residence (IMM 5292) or permanent resident card
It’s advisable to carry your health card with you at all times. It must be shown when visiting a doctor, getting a prescription or visiting a hospital, so that the patient is not charged for the service. The only exception is a medical emergency, although ambulance fees may apply.
It’s also important to have private health insurance in place from the moment you arrive in Canada to provide you (and your partner and any dependents) with cover while applying and waiting for your Medicare card. This may take three months or longer.
Some employers may offer this to employees as part of their benefits package, but it’s wise to check it is in place from the date of arrival and the exact nature of the cover e.g. does it cover partners and dependents?
- Provincial and territorial healthcare plans
In Canada, the universal healthcare program is broken down into provincial and territorial systems. While the federal government is responsible for administering national standards, and providing funding support for healthcare services, the provincial and territorial governments are in charge of managing, organizing and delivering healthcare services. Each province and territory has its own health insurance plan and ministry of health.
According to the Canadian Institute for Health Information, total healthcare expenditure was expected to be $228 billion in 2016 (around $6,299 per person) – making up 11 percent of total GDP. While access to public healthcare is free at the point of receipt, meaning patients do not have to pay an out-of-pocket charge to visit a general practitioner (GP) – also known as a general or family doctor – or go to hospital, for example, the system is paid for through taxes. According to the Fraser Institute, the average Canadian paid $4,222 for public health insurance in 2015, and the average couple paid $11,767.
- Medical exams and work permits
Temporary foreign workers must apply for a work permit and should be covered by their employers for medical and health insurance, as well as workers’ compensation, when they arrive in the country. To apply for a work permit, applicants need to be in good health. Temporary workers planning to stay in Canada for more than six months may need to have a medical exam. If they are applying for permanent residency, they are required to have an immigration medical exam.
- Private healthcare
Expats that are eligible for Medicare may also want to also take out international health insurance, so that they are covered for any eventuality. Medicare only covers basic healthcare, while extended health plans can ensure access to prescription medications, dental care, physiotherapy, ambulance services and prescription glasses. New residents may also choose to take out private insurance to cover them until their public health insurance is set up, which could take up to three months.
- Hospitals and general practitioners
In urban areas of Canada, hospitals and general practitioners (doctors) are widely available. Hospitals are usually private non-profit organizations, and most doctors are also in private practices. Expats are entitled to see the doctor, and simply have to register and book an appointment to do so. If they want to visit a specialist, they will need to get a referral from the doctor. Patients are entitled to change as often as they like.
- Waiting times
Canada’s medical facilities are often busy and, as such, patients might experience long waiting times – both for hospital visits and treatments. According to the Fraser Institute, in 2016, patients had a median wait of 20 weeks for “medically necessary” procedures.
- Pharmacies and medicines
Patients can purchase prescription and non-prescription medication from a range of drug stores, grocery stores and hospitals across major cities in Canada. For particularly expensive medicines, they might want to hold onto their receipt so that they can claim the expense from Medicare or their insurance provider. Depending on the province and area of Canada, pharmacies are usually open from 9am to 5.30pm from Monday to Friday, as well as limited hours on Saturday.
Like all healthcare services in Canada, each ambulance service is regulated by the province or territory. The number to call an ambulance is 911.
While expats with permanent residency can access public health services through Medicare, they may wish to take out private health insurance. This will give them access to a greater range of medical services, and it may help to avoid long waiting times in busy hospitals.
Temporary workers cannot access Medicare so will need to rely on private health insurance. Whether they use private or public healthcare (or a mixture of the two), permanent residents and temporary workers will both be able to access a wide range of high-quality medical services.
Disclaimer: The information included in this article is provided for information purposes only and is not intended to constitute professional advice or replace consultation with a qualified medical practitioner. All information contained herein is subject to change.