Health Care and Insurance

Health CareHealth care system is one of the things Canadians are especially proud of. The country’s residents benefit from high-quality medical services that are basically free for anybody with public insurance.

As stated in the US News’ 2019 Best Countries report, Canada ranks 5th in the list of countries with the best public health systems. And according to the Indigo Wellness Index, Canada scores highest in the ranking of the world’s healthiest countries based on 10 key metrics including obesity, depression, alcohol and tobacco use, and government spending on health care.

Good-quality health care system is one of the reasons there are many long-living persons in the country. Canada ranks 11th among 140 countries in term of healthy life expectancy (71.2 years on average), according to the 2018 Global Competitiveness Report by the World Economic Forum. The average life expectancy in Canada is 81 years for men and 85 years for women, as stated by the World Health Organization.

Public and Private Clinics

Health care services in Canada can be primary and secondary. Primary health care services include basic emergency services, prevention and treatment of injuries and common diseases, referrals to hospital and specialist care, primary maternity care, and rehabilitation services. In case of a disease or injury, Canadians go to see a family physician (a general practitioner or GP) first. If they wish to see a specialist or are counselled to see him, their GP makes a referral to specialized care at a hospital, which would be secondary health care services.

The majority of clinics in Canada are public and they provide insured services for free. The Canada Health Act establishes the national standards — the criteria and conditions that provinces and territories must meet in order to receive financing from the government.

The best public hospitals in Canada are located in large cities, such as Calgary, Montreal, Toronto, and Vancouver.

Canada’s top 10 hospitals (based on the hospital’s recommendation from peers, the patient’s experience, and data on quality of treatment and hygiene)

Sources: Newsweek and Statista

  • Toronto General Hospital (Toronto)
  • North York General Hospital (Toronto)
  • Rockyview General Hospital (Calgary)
  • Jewish General Hospital (Montreal)
  • Sunnybrook Health Sciences Centre (Toronto)
  • Montreal General Hospital (Montreal)
  • Royal Jubilee Hospital (Victoria)
  • The Royal Victoria Hospital (Montreal)
  • Vancouver General Hospital (Vancouver)
  • Foothills Medical Centre (Calgary)

The complete rankings (top 85) can be found on the Newsweek’s website.

There are also around 900 private clinics across Canada that are typically run independently by physicians or surgeons. The majority of the private clinics charge patients with fees. Procedures that are performed in these clinics include regular check-ups, MRI scans, surgeries, dentistry, dietetics, counseling, therapy, etc. Unlike public hospitals, many private sector facilities have no overnight beds. For instance, laws in British Columbia prohibit patients from staying at private clinics for over 24 hours.

Health Care and InsuranceCosts of Medical Services in Canada

Canadian citizens and permanent residents, as well as some international students and foreign workers on work permits, may apply for public health insurance from their province or territory and get treatment in a publicly funded hospital without charges.

For these categories of patients, health care is free, or, strictly speaking, semi-free as its costs are paid through taxation-based federal and provincial funding (or through fixed monthly premiums, like in British Columbia).

However, foreign residents and recently-arrived immigrants without working health insurance should pay for medical services. The costs can be as high as C$2,000 for one-day hospital accommodation and more than C$1,000 for MRI.

Example of approximate hospital inpatient fees in Ontario for patients without Canadian provincial or federal health insurance, CAD

Uninsured resident of Canada Non-resident of Canada
Room charges per day:
Ward (regular) 1,900 2,800
Ward (Intensive Care) 5,200 5,200
Private room 2,100 3,100
Other charges:
X-ray 30 and more 50 and more
MRI 1,350 2,030
Laboratory test 125 125
Ambulance charges per trip 240 240

Some of the private clinics require health cards and bill the public health care plans and also charge patients with extra fees. Other clinics do not require a health card and charge patients directly for all services.

There are different kinds of private clinics in Canada: ‘boutique’ physician clinics, MRI clinics, surgery clinics, diagnostic clinics, etc.

‘Boutique’ physician clinics are clinics in large cities that charge membership fees that run up to thousands of dollars per year. According to the Ontario Health Coalition, in Alberta, mixed medical services cost C$1,775, plus C$600 for MRI. In British Columbia, a comprehensive health assessment would cost C$1,850, and annual fees range from C$895 to C$3,495. In Ontario, prices range from C$1,500 to more than C$4,000 per year. In Quebec, fees to see a doctor are measured by the minute and range from C$95 to C$320. Urgent visits are more expensive, and an annual exam costs C$400.

Fees for MRIs in private MRI clinics are generally C$800–900. The least expensive MRI services are offered in Quebec (C$600–750 for a basic scan) and sometimes can surpass C$950 in Alberta and British Columbia. Scans for additional body parts can add C$500 or more to the price.

Diagnostic clinics charge patients a thousand dollars for a scan with extra amounts for additional body parts. Cataract surgery clinics charge seniors from С$100 per eye, and eye surgery costs often amount to C$1,500–2,000 or more. Orthopedic surgeries also charge patients with thousands of dollars.

Health Care and InsuranceHealth Insurance in Canada

If you do not wish to pay thousands of dollars for medical services, you should obtain health insurance. You can get it for free, if:

  • You are a temporary or permanent resident and live in the province legally (free health insurance does not apply to tourists)
  • You have lived in the province for 12 months or longer
  • You did not apply for a residence permit in another country, province or territory

To apply for free health insurance, you need to complete a form that can be found on the provincial Ministry of Health’s website. You should also provide your ID, visa or Permanent Resident card, and documents showing your place of residence.

With public health insurance, you will not be involved in billing since the insurance claim against the provincial insurer is handled by your doctor. There are no lifetime limits, and you can still access health coverage when you change or lose your job.

In half of Canadian provinces and territories, newcomers can have access to provincial health insurance coverage on the date of their arrival in the province or territory. However, in other regions, there is a waiting period of up to 3 months after you establish residency. These provinces and territories include:

  • British Columbia
  • New Brunswick
  • Northwest Territories
  • Ontario
  • Prince Edward Island
  • Quebec
  • Saskatchewan

For instance, if you moved to New Brunswick on August 20, the month of August will count as the first month, with September and October as the following two. In this case, coverage would begin on November 1.

Therefore, if you are moving to one of those regions, it is recommended to buy temporary private insurance, preferably before you arrive in Canada. Otherwise, you will be charged with fees as foreign nationals.

The recommended coverage is C$50,000 and recommended insurance period is 3 months (or the rest of the current month plus 2 months). You can use an insurance calculator to plan your insurance expenses, compare different companies, and buy insurance. Private health insurance can cost between C$125 and C$500 depending on your age, coverage, pre-existing conditions, and an insurance company.

Popular insurance companies in Canada include 21st Century Enhanced, Destination Canada, Travelance, and Manulife. The latter is more expensive and is recommended to those having heart issues.

To use the public health system, you need to get a health card and become a member of the Health Insurance Plan in a particular province or territory.

Health Insurance Plans

The Canada Health Act covers medically necessary inpatient and outpatient services (it means that they are free for those having health insurance):

  • Standard ward accommodation
  • Diagnostic procedures such as X-ray and blood tests
  • Drugs administered in a hospital
  • Use of operating and case rooms, as well as anesthetic facilities
  • Nursing services
  • Maternity care

The Canada Health Act does not cover:

  • Prescription drugs
  • Home care or long-term care (however, provinces and territories may pay for certain home and continuing care services, but not the cost of accommodation)
  • Dental care
  • Mental health care
  • Cosmetic surgery and some forms of elective surgery

It means that most Canadians rely on private insurance from their employers or the government to pay for the services that are not covered by the Canada Health Act. Provinces provide partial coverage for children, low-income residents, and seniors. These supplementary health benefits often include prescription drugs, dental and vision care, medical equipment (wheelchairs, prostheses, etc.), and the services of physiotherapists and other health professionals.

Each province and territory has its own health insurance plan that covers different services:

  • Alberta: medically required physician services, diagnostic procedures, laboratory tests, certain dental surgeries, nursing services, psychiatrist visits, and some other services
  • British Columbia: services by physicians and midwives, dental and oral surgery performed in a hospital, necessary eye exams, X-ray, and some orthodontic services. Residents of British Columbia pay monthly premiums (up to C$37.50 for an adult depending on the income). These premiums will be eliminated on January 1st, 2020
  • Manitoba: physicians’ services, surgeries, anesthesia, x-ray, and laboratory services
  • New Brunswick: standard hospital accommodation and meals, nursing service, drugs administered in the hospital, operating room, delivery room and anesthetic facilities, laboratory tests, X-ray, therapies, surgical supplies
  • Newfoundland and Labrador: visits to a physician’s office, surgical, diagnostic and therapeutic procedures, anesthesia, pre- and post-operative care, complete maternity care, radiology interpretive services, medically necessary surgical-dental procedures
  • Northwest Territories: basic hospital and medical treatment (does not provide coverage for medicine from the drugstore, dental services, and medical supplies)
  • Nova Scotia: medically required hospital, medical, dental and optometric services with some restrictions
  • Nunavut: diagnosis and treatment of illness and injury, surgery, obstetrical care, eye examinations, treatment and operations, the ICU (Intensive Care Unit) ward, nursing services, laboratory, diagnostic procedures and interpretation, drugs administered in the hospital, operating room, case room, anesthetic facilities, therapies
  • Ontario: doctor visits, hospital stays, abortions, podiatry, ambulance services, eligible dental surgery, and other services
  • Prince Edward Island: primary care services, physician and in-hospital services, home care, palliative care, long-term care, addiction services, drug programs, mental health services
  • Quebec: surgeries, anesthetics, medical examinations, diagnostics, tests, and other services
  • Saskatchewan: inpatient and outpatient services, dental services, and prescription drugs
  • Yukon: medically required hospital and medical services, as well as certain dental-surgical procedures

Medical coverage in any Canadian province or territory will give you access to basic health services in any other Canadian region. With your provincial health card, the claims will be paid by the host province and reimbursed by the home province. For instance, you can obtain medical services, if you are covered by the province of British Columbia and need to access emergency medical services in Alberta. However, you may need to bear some expenses, such as ambulance transportation, emergency dental services, etc.