Overview of the Canadian Healthcare System
As a new expat moving to Canada, it's important to understand how public healthcare works and supplemental private coverage options:
Public vs. Private Healthcare
Canada has a public healthcare system that provides universal coverage for most medical services through provincial plans. Additional private insurance fills gaps not covered under public plans.
Provincial Health Insurance Plans
Each province and territory provides health insurance to eligible residents through provincial plans that cover hospital and physician services. Supplemental private plans can expand coverage.
Prescription Drug Coverage
Prescription drug costs are not covered under the Canada Health Act. Some provincial plans offer limited prescription drug coverage, often for seniors and low-income residents only. Private plans help fill this gap.
Health Insurance Options for New Expats
As a new resident, you must figure out the best coverage:
Provincial Health Plans
Once eligible as a resident, enroll in your province’s health plan for basic medical coverage. Waiting periods for newly arrived residents may apply.
Private Health Insurance
Supplement with private expatriate insurance plans that expand coverage like prescription drugs, dental, vision and more. These help fill gaps.
Travel Insurance
Get temporary visitor insurance to bridge healthcare coverage during your initial transition and waiting period before provincial plan eligibility.
Comparing Provincial Health Insurance Plans
Coverage details vary slightly depending on which province you live in:
British Columbia
- Waiting Period: 3 months
- Prescription Drugs: Limited “Fair PharmaCare” coverage based on income and costs
Alberta
- Waiting Period: 3 months
- Prescription Drugs: No coverage except for seniors
Saskatchewan
- Waiting Period: 3 months
- Prescription Drugs: Coverage for low-income residents; others must pay out of pocket or have private insurance
Manitoba
- Waiting Period: 3 months
- Prescription Drugs: Coverage for low-income residents; others must pay out of pocket or have private insurance
Ontario
- Waiting Period: 3 months
- Prescription Drugs: Seniors and social assistance recipients get coverage. Others pay out of pocket.
Quebec
- Waiting Period: 3 months
- Prescription Drugs: Mandatory prescription drug insurance plan for all residents
New Brunswick
- Waiting Period: Up to 12 months
- Prescription Drugs: No coverage except for certain groups like low-income residents
Nova Scotia
- Waiting Period: 3 months
- Prescription Drugs: Coverage for seniors and low-income residents. Others pay out of pocket.
Prince Edward Island
- Waiting Period: 3 months
- Prescription Drugs: Cost coverage programs available for eligible low-income residents
Newfoundland and Labrador
- Waiting Period: Up to 12 months
- Prescription Drugs: Income-based prescription drug program offers limited coverage.
Private Health Insurance for Expats
Private expatriate health insurance helps fill gaps in provincial coverage:
Supplemental Coverage
Private plans expand coverage for prescription drugs, dental, vision, paramedical providers, medical devices, travel insurance and more.
Plan Options and Features
Plans range from basic emergency hospital/doctor coverage to comprehensive plans with enhanced benefits. Shop multiple providers.
Estimated Costs
Expect monthly premiums of $100 to $300+ depending on your age, health status and coverage level selected. Deductibles also apply.
What's Covered by Public Health Insurance?
Here are typical services included under provincial health plans:
Doctor and Hospital Visits
Visits to physicians, walk-in clinics, and emergency rooms are covered as are stays in hospitals, whether planned or unplanned.
Diagnostic Tests
Medically necessary testing like x-rays, MRIs, CT scans, ultrasounds and lab work are included when ordered by a doctor.
Surgery and Transplants
Both inpatient and outpatient surgeries are covered when deemed medically necessary, as are organ transplant procedures.
Emergency Care
Immediate medical care required in an urgent situation like a heart attack, stroke, injury accident, etc. is covered.
Prescription Drugs
Coverage varies by province. Some cover seniors and low-income residents only. Otherwise prescription costs are out of pocket.
Exclusions and Limitations
Some key things typically not covered by provincial healthcare include:
Dental and Vision Care
Routine dental checkups/cleanings and vision exams plus glasses/contacts are not covered. Must pay these costs out of pocket.
Ambulance Transportation
Emergency ambulance trips can be expensive. Fee coverage varies by province. Check if private insurance can help.
Prescription Limitations
Provincial drug coverage often has deductibles, copays, expensive premiums, and/or annual caps that leave gaps.
No Out of Province Coverage
Provincial health plans only cover residents within that province. Private travel insurance is recommended when traveling.
Tips for New Expats Navigating Canadian Healthcare
Follow these key tips as a newcomer to healthcare in Canada:
Apply for a Provincial Health Card
Apply for your provincial health card as soon as eligible. Carry it always and present it to access free public healthcare services.
Understand Your Private Policy
Read your private expatriate policy terms closely. Know deductibles, exclusions, reimbursement procedures, and how to submit claims.
Maintain Records and Receipts
Keep all medical receipts and records to support potential claims or drug expenses. Stay organized.
Ask About Unclear Fees
If charged for a service you thought would be free, ask for clarification. Don't assume you must pay.
Consider Tax Implications
Premiums for private health insurance may be tax deductible. Consult an accountant on what healthcare costs can reduce your taxes.
Navigating healthcare as a newcomer to Canada can be confusing at first. But following provincial enrollment requirements, getting supplemental private coverage, keeping organized records, and asking questions will ensure you get access to the excellent medical care Canada offers its residents. With some diligence about understanding public and private insurance options, expats can rest assured knowing they are well covered.
How long is the waiting period for provincial health coverage?
Waiting periods range from 3 to 12 months depending on your province of residence before becoming eligible for free public health services under provincial plans.
What medical services are not covered?
Exclusions typically include routine dental, vision, prescription drugs, ambulance transportation, medical devices, mental health, and cosmetic services. Private insurance can help cover these.
Do I need provincial AND private health insurance?
Yes, it is recommended to have both types of coverage. Provincial plans cover hospital and doctor services while private insurance fills gaps not covered under public health plans.
Am I covered when traveling out of my home province?
No, provincial health plans only cover within your province of residence so supplemental travel insurance is needed when traveling inter-provincially or internationally.
Can I deduct my private insurance premiums on my taxes?
Yes, premiums paid for private health insurance may be eligible medical expenses that can be claimed as tax deductions in Canada.
