The Health System in Canada

The Health System in Canada

Canadian Public Health Insurance

In Canada, the health system is public. It aims to serve everyone equally and it is governed by the Canada Health Act. While the federal government provides financial support for the health system, the delivery of the health care services is managed by provincial governments.

For example, the province of Ontario has the Ontario Health Insurance Plan (OHIP), which provides health care services to residents of Ontario and individuals from other provinces and countries that suffer health problems in Ontario. Health care in Canada is free of charge to permanent residents for ‘medically necessary’ treatments. However, most medications required for treatment have to be paid for. If treatment is deemed not to be medically necessary (such as elective cosmetic surgery), this is not covered by the public system. A large proportion of Canadians has employment or other health plans that cover part or all of the costs of the medicines required for treatment.

Canada’s public health system means that health care services are provided to everyone equally. However, in the recent years, crowded hospitals and emergency rooms, and long waiting times for the treatment have induced a public outcry for better service delivery and private health care centers. Most recently, a court in Quebec ruled that individuals have the right to choose between the public and private health care. It is illegal in Canada to perform medically necessary services outside of the public health system; therefore, there are no private medical establishments. For non-medically necessary services (such as elective cosmetic surgery), there are a number of private establishments.

Eligibility and Conditions

In order to be eligible for health care treatment and services in Canada, you must have a permanent resident status. Some refugees are allowed permanent resident status while in Canada and they are eligible for health care.

Keep in mind that there is a 3-month period after the arrival in Canada (if arriving as a permanent resident) before you are eligible for health care. You should purchase private health insurance for that three-month period.

In order to apply for health card in Canada, you will need three of the following:

For Permanent Residents / Landed Immigrants:

  • Canadian Immigration Identification Card
  • Confirmation of permanent residence (IMM 5292 Form)
  • Permanent Resident Card
  • Record of Landing (IMM 1000 Form)
  • For Other Immigration

For Stateless Persons

  • Letter from Immigration and Refugee Board confirming Convention Refugee or Protected Person status
  • Protected Person status document
  • Temporary Resident Permit (restrictions apply)
  • Work Permit (restrictions apply)
  • Written confirmation from Citizenship and Immigration Canada that you have applied for permanent residence in Canada and have passed the immigration medical exam
  • Your passport and landed immigrant papers / permanent resident card.

For province-specific regulations, visit the Health Canada website. For example, in Ontario, to be eligible for health coverage by the Provincial health plan you have to belong to one of the following categories:

  • You are a Canadian citizen, permanent resident or landed immigrant, convention refugee, or are registered as an Indian under the Indian Act
  • You have submitted an Application for Permanent Residence or an Application for Landing and have been confirmed by Citizenship and Immigration Canada as having satisfied the medical requirements for landing
  • You are a foreign worker who holds a valid work permit or employment authorization which names a Canadian employer situated in Ontario and your prospective occupation and is valid for at least six months
  • You are a foreign clergy member who will be providing services to a religious congregation in Ontario for at least six months
  • You hold a Temporary Resident Permit or Minister’s Permit with a case type 80 (for adoption only), 86, 87, 88 or 89
  • You are the spouse, same-sex partner, or dependent child (under 19 years of age) of a foreign clergy member or eligible foreign worker who is to be employed in Ontario for a period of at least three consecutive years
  • You hold a work permit or employment authorization under the Live-In Caregivers in Canada Program or the Foreign Domestic Movement
  • You have been issued a work permit or employment authorization under the CaribbeanCommonwealth and Mexican Season Agricultural Workers Program administered by the federal department of Citizenship and Immigration
  • And you make your permanent and principal home in Ontario
  • And you are in Ontario for at least 153 days of the first 183 days immediately following the date you establish residency in Ontario (you cannot be absent for more than 30 days during the first 6 months of residency)
  • And you are in Ontario for at least 153 days in any 12-month period

Private Health Insurance

While the health care system in Canada covers basic services, including primary care physicians and hospitals, there are many services that are not covered. These include special requests like dental services, optometrists, and excluded prescription medications.

Private health insurance plans are usually offered as part of employee benefit packages in many companies. Incentives usually include vision and dental care. Alternatively, Canadians can purchase insurance packages from private insurance providers.

The main reason many choose to purchase private insurance is to supplement primary health coverage. For those requiring services that may not be covered under provincial health insurance such as corrective lenses, medications, or home care, a private insurance plan offsets such medical expenses.

While private insurance can benefit those with certain specific needs, many Canadians choose to rely exclusively on the public health system.

Accessing Health Care

Accessing Canada’s health care system involves first applying for a provincial health card. Excluding inmates, the Canadian Armed Forces and certain members of the RCMP, the Canada Health Act requires all residents of a province or territory to be accepted for health coverage. There is a waiting period in place for new immigrants that cannot exceed three months.

Once a health card is assigned, it is used whenever visiting a physician or health care provider. The health card contains an identification number, which is used to access a person’s medical information.

After obtaining health coverage, one can register with a primary care physician. For routine visits to a physician, one needs only present their health card. There are typically no forms to be filled out or individual service fees.

The availability of physicians depends largely on the number of doctors and the current demand for medical services. Currently there is about 1 primary care doctor for every 1000 Canadians.

Health Care Funding

Health care in Canada is funded at both the provincial and federal levels. The financing of health care is provided via taxation both from personal and corporate income taxes. Additional funds from other financial sources like sales tax and lottery proceeds are also used by some provinces.

Alberta, British Columbia, and Ontario also charge health premiums to supplement health funding, but such premiums are not required for health coverage as per the Canada Health Act.

Sources : justlanded – theimmigrationoffice

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