Understanding Gaps in Canada’s Public Health System

Understanding these gaps and how privately-funded health care works is really important for newcomers to Canada. Here’s what you need to know:

What’s Not Covered By Canada’s Public Health System?

Newcomers may not have access to provincial health care for their first few months in Canada (rules vary from province to province). 

Here’s an incomplete list of common exclusions:

• Prescription Medications: Many prescription medications are not covered under most provincial health plans. The availability of government-funded prescriptions varies from province to province. 
• Dental Care: Routine dental check-ups, cleanings, fillings, and orthodontics are not typically covered by Canada’s public healthcare system.
• Vision Care: Eye exams, prescription glasses, and contact lenses are typically excluded.
• Mental Health Services: ‘Acute’ mental health services for individuals in distress can be available, but there is limited public coverage for counseling and therapy.
• Allied Health Service Providers: Limited or no public coverage outside of certain traumatic injury recovery services. Your treatment for ‘run of the mill’ injuries or soreness would often require private insurance.

Does Canada Have Prescription Coverage?

Canada’s prescription drug coverage can be difficult to understand. 

Generally speaking, if you’re at a hospital and the doctors give you medication, it is free. But if you go to a doctor at a clinic who prescribes you medication that you’ll then pick up from a pharmacy, there may be extra costs. (The doctor visit is free for Canadian permanent residents and citizens, and some temporary residents with provincial coverage.)

But for the most part, whether there are extra costs for the prescribed drugs depends on the province or territory you live in. (With a few exceptions coming at the federal level, since the Canadian federal government is taking steps to make contraception and insulin available to everyone for free.) 

Each province and territory has a drug plan that includes varying amounts of coverage for certain drugs and they have different exclusions. For drugs that aren’t covered by provincial or territorial drug plans, there are usually out-of-pocket costs and these can be expensive if you don’t have health insurance. 

Newcomers to Canada are particularly hard hit when it comes to prescription insurance coverage. Statistics Canada reported that in 2021, 29% of immigrants did not have prescription coverage compared to just 17% of non-immigrants in Canada. Newcomers to Canada are also less likely than Canadian-born workers to have access to employer-sponsored drug insurance. 

If you’re new to Canada and you want to close the gap, consider a free quote from a health insurance provider in Canada, such as Moving2Canada partner Cigna Global.

Is Dental Care Free In Canada?

We won’t sugar coat it, dental care in Canada can be expensive without private insurance. As a result, there are significant gaps between people who have private insurance and those who don’t in terms of who accesses dental care in Canada each year. Don’t let a gap in coverage become an avoidable gap between your teeth.  

Unfortunately, dental care is not covered by Canada’s public healthcare system whether it’s an emergency or preventative. There are limited exceptions, such as emergency dental surgeries performed in hospitals in some provinces. But, on the whole, you should assume that you will need to pay privately for your dental care in Canada. 

For newcomers, this is important to know because dental coverage won’t become available under your provincial or territorial public healthcare plan. It’s something that you need to plan to cover personally or through an employer-sponsored plan, which may also have a wait period since many employers do not provide healthcare for the first three to six months an employee works with the company. 

There are a range of dental-only plans and dental enhancements you can add to your health insurance plans in Canada.

Preventative and Allied Health Care Coverage in Canada

Beyond dental and prescription coverage, there is a host of preventative and allied health care that are not usually covered or easy to access through Canada’s public healthcare system. Here’s a brief overview of some of the important health care services that are not likely to be covered by Canada’s public healthcare system:

Vision Care in Canada

Regular eye exams are important for detecting vision problems and eye diseases early. However, Canada’s public healthcare system does not cover routine eye examinations, nor does it usually cover the cost of getting glasses or contact lenses. These expenses are generally out-of-pocket unless you have private health insurance. 

Mental Health is Health!

Mental health is health, too! And newcomers to Canada are more likely to experience anxiety and depression among newcomers, with 25% of newcomers who have lived in Canada for 5 years or less reporting at least moderate symptoms of anxiety. 

These newcomers also face barriers accessing mental health services, largely due to cost. For the most part, if newcomers do not have coverage for mental health support through their employer, they are unable to afford this care. 

Allied Health Services

Allied health services, like acupuncture, remedial massage, physiotherapy, chiropractic, dieticians and nutritionists, and similar services, can be beneficial for your overall wellness and preventative care. These services are also rarely covered by Canada’s public health system, so private health insurance or employer-sponsored insurance helps make these services more accessible. 

Private Health Insurance For Newcomers To Canada

If you’re a newcomer to Canada, you will likely face unique challenges in accessing Canada’s public healthcare system, including: 

• Limited to no access to provincial health care in your first few months in Canada. 
• Limited or intermittent access to employer-sponsored health care, since many employers have a waiting period before employer-sponsored healthcare coverage begins. This is often 3-6 months. This means newcomers to Canada face 3-6 month waiting periods for any coverage to kick in. 
• Newcomers to Canada often face periods of un- or under-employment as they seek to gain Canadian work experience, which means there may be multiple job shifts in the early years in Canada, and intermittent access to employer-sponsored coverage. 
• Insufficient coverage provided by employer-sponsored insurance. Many employer-sponsored packages offer limited coverage with lower limits, such as $500 limits for mental health services, which equates to just 2-3 sessions. 
• If you are eligible for publicly-funded support, access is often very slow. Access to private clinics and providers can mean that you are able to access health and wellness supports you or your children need much faster than if you wait . 

Given the significant gaps in Canada’s public health care and the unique challenges newcomers face, private health insurance can offer an affordable solution to closing these gaps in health care coverage. Increased access to healthcare in your early years in Canada can set you up for better health and wellness in your future, while easing the anxiety that too often comes while settling into your new home country. It can also ease the financial burden of accessing much needed medical resources, including dental and prescription medications. 

Moving2Canada’s partner, Cigna Global, offers flexible health insurance coverage for newcomers to Canada. Cigna’s International health insurance offers:

• 24/7 access to multilingual service centers.
• Global network of 1.5 million hospitals and healthcare professionals, and plans that offer coverage in Canada and your original home country so you’re covered during return visits. 
• Access to medical support in over 200 markets and territories.
• Quote in 2 minutes, buy online in under 10 minutes.

Get your free quote