Are New Canadians Eligible for Provincial Health Insurance?

Universal health care is often touted as one of the benefits of living in Canada. But not everyone who lives here can access it. There are strict rules about eligibility that may affect many new residents.

Depending on your status, you may have only limited coverage. You may be covered by special programs run by the federal government. If you are welcoming a family member to Canada under the Super Visa program, they need private health insurance. In short, it's complicated, but you may have more options that you think.

Who's Eligible?

Canadian citizens and permanent residents are eligible for coverage through the public plan. Each province administers its own plan, deciding what services are covered and who is eligible. So, a prescription drug that's paid for in Ontario may not be paid for in Alberta.

Similarly, it is important to look at the rules for each specific province to know how your status may affect your coverage. Generally, if you are legally entitled to be in Canada and stay in a specific province for at least five or six months out of a year, you can get coverage.

Apart from Canadian citizenship or permanent residency, you may get coverage if you have a work permit or a study permit. You may also get coverage if you have applied for permanent resident status but haven't yet been approved. Some temporary resident permits also qualify. Convention refugees are also eligible for health insurance.

Who's Excluded?

Many classes of people fall outside the eligibility requirements. Refugees can receive coverage once their status is confirmed, but before that they cannot get provincial coverage. However, the federal government provides some limited coverage for refugee claimants under the Interim Federal Health Program.

Sound confusing? The list of exceptions -- and exceptions to the exceptions -- is long, and depends on the region. The good news is that those who are not eligible can usually still access emergency care.

What if You Move?

There is a waiting period for coverage to start in your home province. If you are moving to a new province, you are usually covered by your home province's coverage until you take up regular residence in the new region. The key factor is what province is your "primary" residence.

What About Visitors?

Visitor to Canada must have private health insurance. Otherwise, they will pay out of pocket for medical and hospital care in the country. That applies even to those coming to Canada on the Super Visa program, which allows stays for up to two years at a time for parents and grandparents of permanent residents. The government requires that Super Visa travellers purchase medical insurance before the visa is approved.

Learn More About Private Health Insurance

For those who make Canada their new home, universal health coverage can provide a sense of security and comfort. But it is a bit more complicated for those who fall through the gaps. If you have a loved one who is applying for a Super Visa, Insurance Hotline can give you more information about the kind of coverage they need. This gives you all peace of mind when you reunite in Canada.