Last Updated on May 10, 2022 by Allard John Keeley
You’ve made it to Canada as a permanent resident and that’s reason to celebrate. One of the many reasons you have for being glad to be starting a new life in the country is that you are eligible for free, public healthcare. While some health services lie outside the Canada Health Act and are fee-based, most healthcare in Canada is public and free.
But there is a catch for new arrivals to the country. The actual healthcare programs in Canada are run by the provinces while the federal government sets the overall guidelines and then contributes towards the provincial costs incurred in running their healthcare programs. That means that there is a different healthcare program for each province, and common to all of them is that the provincial healthcare programs require a waiting period before you can apply for a health card and receive healthcare for free.
That’s why you have to purchase private health insurance to cover the waiting period from your arrival in Canada to the date you become eligible for your provincial healthcare program. Most programs require a 3-month wait but that period can be extended if your application to the program is delayed for one reason or another. Let’s take a look at the main provincial healthcare programs and see what sort of waiting periods you’ll need to cover as a new arrival to Canada.
Ontario Health Insurance Plan (OHIP)
Ontario Health Insurance Plan (OHIP) is the provincial healthcare plan you must apply to in order to access health services in Ontario. The eligibility requirements are:
- Be physically present in Ontario for at least 153 days (5 months) in any year, and
- Be physically present in Ontario for 153 days of the first 183-day (6 months) period when you arrive in Ontario.
As well, you must be one of the following:
- A Canadian citizen, OR
- An Indigenous person, OR
- A Permanent Resident, OR
- Have applied for permanent residency and have not been denied (but also not yet been approved – in other words your application for PR status is being processed), OR
- Be in Ontario on a valid work permit of at least 6 months validity, OR
- Be in Ontario on a valid work permit as a Live-in Caregiver, OR
- Be a Convention Refugee or other Protected Person, OR
- Have a Temporary Resident Permit (types 86 through 95), OR
- Be a Clergy member ministering in Ontario for at least 6 months.
Unless you qualify for immediate coverage, it will generally take up to 3 months from the date of your approval for your OHIP coverage to start. You will have to take out private health insurance to cover that period. The only new Canadians who may qualify for immediate coverage are internationally adopted children under 16 years of age, so all other new arrivals to Canada who are residents of Ontario should take out private health insurance for at least 3 months.
Ontario Blue Cross is a major provider of private insurance, but there are other options available as well. Google “Ontario Private Health Insurance” to see other options.
Remember that you apply for OHIP at a ServiceOntario centre. You must bring with you:
- A completed Registration for Ontario Health Insurance Coverage form
- 3 original (not copies) ID documents:
- Permanent Resident Card (or Canadian Birth Certificate for citizens)
- Proof of residence in Ontario (Ontario Driver’s License or other similar ID)
- Identity supporting document (Credit Card or Passport, etc.)
British Columbia Medical Services Plan
In British Columbia (BC) the provincial healthcare plan is called the Medical Services Plan (MSP) and is mandatory for all eligible residents of the province as well as their dependents. For residents to be eligible they must:
- Be either Canadian citizens or permanent residents;
- Live in the province;
- Be physically present in the province for at least 6 months of the year.
For new arrivals to Canada who are settling BC, you will normally face a waiting period of up to 3 months after arriving in the province before you become eligible for MSP. However, you should apply for MSP as soon as you arrive in BC. This means you will have to take out private health insurance to cover those 3 months. As in the case of Alberta, you may wish to take out private health care insurance for 6 months should your application be delayed, but of course this is not necessary.
Pacific Blue Cross is a major health insurance provider in BC. Go here for more information. Or Google “BC Health Insurance” for other options.
Alberta Health Care Insurance Plan
Alberta’s healthcare system and health insurance system are different parts of the same provincial healthcare program:
- Alberta Health Services runs the provinces healthcare system, it’s hospitals and clinics and medical professionals.
- Alberta Health Care Insurance Plan (AHCIP) is the insurance plan that pays for the services that eligible patients use.
Unfortunately, there is some confusion as to how long it takes to be eligible for AHCIP. At the AHCIP website they state that:
When you move to Alberta from another province or country, there may be a waiting period before you become eligible for coverage under the AHCIP.
At Alberta Health Services however, they state:
You are covered by Alberta Healthcare from the time you arrive in Alberta, but you must file your application within 90 days of arriving in Alberta.
So, while there seems to be a contradiction as to when you are eligible for free healthcare in Alberta, the best option is to take out private health insurance that kicks in as soon as you arrive and then apply for a re-imbursement of any costs when you receive your AHCIP card. While waiting periods tend to be around 3 months in other provinces, the lack of clarity on waiting periods means you might consider taking out private insurance for a longer period – say 6 months, if you can afford to. One option is Alberta Blue Cross. Go here for more information.
And apply to the AHCIP before you’ve even unpacked your bags.
While there is some limited information in English, most of Quebec’s healthcare system’s webpages are in French. Go here for more information.
RAMQ is the provincial department/agency where you apply for a health card. Go here for more information in English on how to apply and on eligibility. RAMQ states the following:
Private insurance during the waiting period pending eligibility
Apart from certain exceptions, RAMQ does not reimburse the cost of the healthcare received during the waiting period. During this period, to save you from having to pay for any healthcare services that you or your family members may need, we strongly recommend that you take out private insurance within 5 days following your arrival in Québec. Thereafter, coverage is more difficult to obtain. For information about private insurance, contact the OmbudService for Life – Health Insurance (OLHI).
In other words, as in most other provinces, you should immediately apply for private insurance when you arrive in Quebec. Quebec Blue Cross is a major provider but there are a number of other alternatives. You should research the options for private health insurance in Quebec online before arriving so you can apply for private health insurance as soon as you arrive in the province. This goes for any province in Canada.
Manitoba Health Services Insurance Plan
The Manitoba Health Services Insurance Plan (MHSIP) requires in order to be eligible to:
- A Canadian citizen, or
- A Permanent Resident, or
- A Work Permit Holder (including their Spouse and Dependents).
It also requires you to:
- Have your permanent residence in Manitoba
- Live at least 6 months of every year in Manitoba.
Once you arrive in Manitoba, go here for information on how to register.
Coverage begins on the first day of the 3rd month of your arrival in Manitoba. For example:
If you arrive in Manitoba on the 29 of April, the month of April counts as your first month even though there is only 1 day left in April. That means your 3 months waiting period is calculated as follows:
- April 29 – 30 = Month 1
- May 1 – 31 = Month 2
- June 1 – 30 = Month 3
Coverage begins July 1
In other words, assuming you register with the MHSIP as soon as you arrive in Manitoba, you will have from slightly over 2 months up to a 3-month wait before you are eligible for coverage. So, you will have to purchase private insurance to cover that period. Manitoba Blue Cross is a major insurance provider in the province, although as always, there are other private insurance companies available. Google “Manitoba Private Health Insurance” for more options.
Nova Scotia Medical Services Insurance
Medical Services Insurance (MSI) programs deliver healthcare in Nova Scotia on behalf of the provincial government but are run by Medavie Blue Cross. It is a public healthcare program but before receiving health services you need an MSI Health Card. You have to apply for an MSI card, and you should include documentation of your Permanent Resident or other immigration status in order to be deemed eligible.
- Be a Canadian citizen or Permanent Resident,
- Have your permanent residence in Nova Scotia,
- Be physically present in Nova Scotia at least 183 calendar days (6 months) of every year, and
- Be registered with MSI.
As a new arrival to Nova Scotia you also must:
- You must have a work permit valid for a minimum of 12 months and sign a declaration that you will not be absent from the province for more than 31 days per year (except for work reasons); coverage begins on the date of your arrival in Nova Scotia or the date your work permit begins – whichever is the later date; OR
- You must have a study permit valid for a minimum of 12 months and sign a declaration. However, you can only apply for coverage on the 1st day of the 13th month after your arrival in Nova Scotia as a student. In other words, coverage begins after 1 year.
Finally, as mentioned above, there is an ombudsman for private health insurance complaints and queries throughout Canada. OHLI is the OmbudService for Life and Health Insurance in Canada. Go here for more information and to use OHLI to resolve any difficulties you might have with private insurance in Canada.
Riley Haas has been a leading expert since 2011 on immigration matters, with hundreds of publications online. Published author of three books about political philosophy, the Beatles and the Toronto Maple Leafs, respectively. BA from Bishop’s University, MA from McMaster University. You follow Riley on Substack https://rileyhaas.substack.com.