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Do Canadian provincial health insurance plans cover you?

If you are Canadian residents traveling outside of your home province or outside of Canada, DO not take it for granted that your provincial government health insurance plan is going to cover all your emergency medical expense. A hospital day rate in the USA may be as high as US$3000 per day and emergency evacuation can cost you up to US$50,000. All the provincial health authorities strongly recommend Canadian residents to buy travel insurance from private insurance company when traveling outside Canada.

The Canadian health care system, is one of the best in the world, unfortunately it is expensive too. Visitors and tourists to Canada are not eligible to any of the provincial insurance program. Yes, you have to pay your own bills and hospitals can charge thousands of dollars a day. If you are planning to study or work in Canada, some provincial plan provide coverage only if your visa is valid for at least 12 months. For short term study and work plan, you are advised to look for private medical insurance.

TravelInsuranceQuotes has the best solution for all kinds of insurance for Canadian travelers and Visitors to Canada, providing one-stop online service from instant online quotation, comparison to secured online purchase for their customers. Get a quote now or find out more below about each provincial health program in Canada below:

Alberta

http://www.health.gov.ab.ca/ahcip/AHCIP.html

Who is Eligible?

Coverage under the AHCIP is available to all eligible residents and their dependents.; No eligible Alberta resident will be denied coverage. If you are normally in Alberta for 183 days(six months) during the year, you remain eligible for Alberta Health Care Insurance Plan coverage.

If you leave Alberta to go to another province or territory and plan to return within 12 months, or leave for another country and plan to return within six months, you must retain your Alberta Health Care Insurance Plan coverage.

If you are leaving Alberta for a longer period, you may apply for the following extensions of coverage:

  • four years (48 months) if the absence is due to work, business or missionary service.
  • two years (24 months) if the absence is due to travel, personal visits or an educational leave(sabbatical).
  • the time period you are a full-time student at an accredited educational institute.

Waiting Period

Coverage would become effective the first day of the third month following the date they established permanent residence in Alberta (i.e. the date they made the decision to stay in Alberta).

Travel Recommendation

Costs for health care services provided outside the province, especially outside Canada, can be much higher than in Alberta. This could result in personal financial hardship if you have not arranged for supplementary travel health insurance to cover the difference. Therefore, Alberta Health and Wellness recommends that you purchase travel insurance, even for short periods of travel

Medical expense eligible when traveling outside Canada

Physician Services - The Alberta Health Care Insurance Plan will pay benefits for out-of-country physician services at the same rate an Alberta physician receives. You and/or your supplementary travel health insurance provider are responsible for paying the difference between what is charged and what the Alberta Health Care Insurance Plan pays

Hospital Service - The Alberta Health Care Insurance Plan has pre-set maximum, all-inclusive rates for hospital services provided outside of Canada. The maximum rate paid for hospital inpatient care is $100 (CDN) per day, or the amount billed, whichever is less. The Alberta Health Care Insurance Plan will pay for one outpatient visit per day at a maximum benefit of $50 (CDN) per day, or the amount billed, whichever is less. To be eligible for payment, hospital services must be medically necessary and provided in a general or auxiliary hospital. The Alberta Health Care Insurance Plan does not cover hospital costs related to the day of your discharge.

British Columbia

http://www.healthservices.gov.bc.ca/msp/

Who is Eligible?

An individual must be a resident of B.C. in order to qualify for medical coverage under MSP. A resident is a person who meets all of the following conditions:

  • must be a citizen of Canada or be lawfully admitted to Canada for permanent residence;
  • must make his or her home in B.C.;
  • must be physically present in B.C. at least 6 months in a calendar year; and
  • dependents of MSP beneficiaries are eligible for coverage if they are residents of B.C.

Certain other individuals, such as some holders of study and/or work permits issued under the federal Immigration and Refugee Protection Act are deemed to be residents, but tourists or visitors to B.C. do not qualify. If you are uncertain about your eligibility status, contact MSP for assistance.

Waiting Period

New residents or persons re-establishing residence in B.C. are eligible for coverage after completing an eligibility waiting period that normally consists of the balance of the month of arrival plus two months. New or returning residents arriving from outside Canada should contact a private insurance company for coverage during this period.

Travel Recommendation

If you are leaving B.C. temporarily, you need to be aware that there are time limits on out-of-province benefits available to you while you are away. You should purchase additional health insurance from a private insurer before you leave the province, regardless of whether you will be in another part of Canada or outside the country - even if you plan to be away for only a day.

Medical expense eligible when traveling outside Canada

You should be aware that your provincial coverage may not pay for all the health care costs you may incur outside the province, and the difference can be substantial. For example, B.C. pays $75 (Cdn) a day for emergency in-patient hospital care, while the average cost in the U.S. often exceeds $1000 (US) a day, and can be as high as $10,000 (US) a day in intensive care. For this reason, you are strongly advised to purchase additional health insurance from a private insurer before you leave the province, whether you are going to another part of Canada or outside the country - even if you plan to be away for only a day.

Manitoba

http://www.gov.mb.ca/health/mhsip/leavingmanitoba.html

Who is Eligible?

You are legally entitled to be in Canada and live in Manitoba for at least 183 days of the year

  • Work Permit
    • If your Work Permit is valid for at least 12 months in Manitoba, you and any family members listed on the Work Permit, are eligible for coverage as of the date it was issued.
  • Visitor/Student Record
    • You are not eligible for coverage unless you are accompanying a spouse or parent who has a Work Permit valid for 12 months or more.; The Visitor/Student Record must be valid for at least 183 days.; Dependants who reach the age of 18 must be attending a recognized educational institution or have a Work Permit to be eligible for further benefits.

Waiting Period

If you are eligible , coverage will begin on the first day of the third month after your arrival in Manitoba.

Travel Recommendation

You may be charged more than the amount paid by Manitoba Health for services provided outside Canada. The difference above the covered amount may be substantial and is your responsibility.

Medical expense eligible when traveling outside Canada

  • Doctor Bills
    • Manitoba Health will pay for emergency doctors? services outside of Canada at a rate equal to what a Manitoba doctor would receive for a similar service.
  • Hospital Bills
    • Emergency hospital care is paid on an average daily rate established by Manitoba Health.

New Brunswick

http://www.gnb.ca/0051/0394/index-e.asp

Who is Eligible?

  • a Canadian citizen or be legally entitled to remain in Canada;
  • a resident who makes his/her permanent and principal home in New Brunswick

A resident means a person lawfully entitled to be or to remain in Canada, who makes his home and is ordinarily present in New Brunswick, but does not include a tourist, transient or visitor to the Province.

The following individuals are not eligible for coverage:

  • regular members of the R.C.M.P. and the Canadian Armed Forces, (however members of their families are eligible);
  • tourists and visitors to the province;
  • transients;
  • students from another province or on student visas; and
  • inmates of federal penitentiaries.

Students

Students who normally reside in New Brunswick and are in full-time attendance at a recognized university or other institution outside New Brunswick, or Canada, are covered for a 12-month period provided they:

  • contact New Brunswick Medicare on an annual basis;
  • do not establish permanent residence outside New Brunswick;
  • do not receive health coverage in another province;
  • each year, students studying outside Canada must provide New Brunswick Medicare with ?proof of enrollment? from the school or university they are attending.

Waiting Period

If you have moved to New Brunswick, you may be eligible for New Brunswick Medicare coverage on the first day of the third month following the month you have established permanent residence in New Brunswick

Medical expense eligible when traveling outside Canada

New Brunswick Medicare only covers emergency out-of-country physician and hospital services or services for which you have received prior approval.

  • New Brunswick Medicare pays:
  • $50.00 a day for out-patient emergency services, and
  • $100.00 a day for in-patient services resulting from an emergency admission.

These amounts are in Canadian funds and include most laboratory, radiological or interpretation fees billed separately from the hospital claim. Out-of-country emergency physicians? fees are paid in Canadian funds at a rate equal to what a New Brunswick physician would receive for a similar service.

Travel Recommendations

The costs of most out-of-country physician and hospital services are considerably higher than rates paid by New Brunswick Medicare and the difference between the two is your responsibility. That is why out-of-country travelers are strongly advised to obtain additional insurance from private insurers to cover the portion of charges not paid by New Brunswick Medicare.

New Foundland

http://www.health.gov.nl.ca/mcp/

Who is Eligible?

Eligible applicants can be classed into three groups: Canadian Citizens, Landed Immigrants, and Foreign Workers.

Effective June 11, 2007, the Provincial Government will be extending health care coverage under the province's Medical Care Plan (MCP) to international students undertaking post-secondary studies in Newfoundland and Labrador.

Waiting Period

Properly completed applications with all necessary supporting documents, will be processed within two weeks.

Travel Recommendations

It is recommended that residents traveling outside this country ensure that they have adequate private health insurance to supplement their provincial health plan.

Medical expense eligible when traveling outside Canada

The Newfoundland Hospital Insurance Plan pay the following:

Inpatient

  • a maximum of $350 per day in a community or regional hospital
  • a maximum of $465 per day in a tertiary or specialized hospital

Outpatient

  • a maximum of $62 per day

Haemodialysis

  • a maximum of $220 per day

Northwest Territories

http://www.hlthss.gov.nt.ca/

Who is Eligible?

All permanent residents of the NWT are eligible for coverage. "Permanent resident" means a person legally entitled to remain in Canada who makes his/her home in (and is ordinarily present in) the NWT for six months of the year, but does not include a tourist, transient or visitor to the NWT. "Makes his/her home" is defined as where the person receives mail, keeps personal property, and spends the majority of time.

  • permanent residents of the NWT
  • landed immigrants
  • legal residents of Canada
  • individuals holding an employment or student visa that is for one year or more ( note: document must have an NWT address)
  • individuals holding an employment or student visa that is for one year or more. Document must have an NWT address.

Waiting Period

Generally, if you have moved to the NWT from another Canadian province or territory, benefits begin on the first day of the third month following your arrival. Remember to register. During the first three months of residency, benefits are provided by the health care plan of your former province or territory. You must ensure that your previous coverage continues during this period.;

Travel Recommendation

If you receive medical services outside Canada, you may be required to pay for the full cost of the services received up front. It is important that you consider additional medical insurance through a private insurance company before you leave Canada.

Medical expense eligible when traveling outside Canada

In some countries, physician and hospital costs are much higher than in the NWT.; Medically necessary services received outside Canada are reimbursed at NWT rates.; You are responsible for any additional costs.; For example, if you need medically necessary physician or hospital services outside Canada that cost $1,000, and the NWT rate for the same service is $250, you are responsible for the $750 difference.; If the service you receive outside Canada is not medically necessary, you will be responsible for paying the full amount.

Nova Scotia

http://www.gov.ns.ca/health/

Who is Eligible?

To be eligible for Nova Scotia Medical Service Insurance (MSI) benefits you must be:

  • a Canadian Citizen or Permanent Resident (Landed Immigrant)
  • a resident who makes his/her permanent home in Nova Scotia and is present in the province 183 days every calendar year.
  • You must be registered with MSI to be eligible for benefits.

The following individuals are not eligible for coverage:

  • regular members of the R.C.M.P. and the Canadian Armed Forces, (however members of their families are eligible);
  • tourists and visitors to the province;
  • students from another province
  • inmates of federal penitentiaries.

People moving to Nova Scotia from outside the country, who hold a Work Permit, are eligible to apply for MSI upon their arrival in Nova Scotia, provided they will be remaining in Nova Scotia for at least one full year and have signed a declaration. The worker cannot be absent from Nova Scotia for more than 31 days, except in the course of employment. Coverage will begin on the date of arrival in Nova Scotia or the date the Work Permit was issued, whichever is the later date. For continuous coverage, a copy of the renewed Work Permit must be submitted and a new declaration form must be signed each year.

People coming to Nova Scotia from outside the country who hold a Study Permit can apply for coverage the first day of the thirteenth month following the date of arrival in Nova Scotia as a student; providing they have not been outside the province for more than 31 consecutive days except in the course of their studies (for example a person arriving in Nova Scotia in July 2004 cannot apply until August 2005). For continuous coverage, a copy of each Study Permit must be submitted to MSI and a declaration must be signed each year. Persons on Study Permit are Eligible for insurance services in Nova Scotia Only. Services rendered while outside the province would be the responsibilities of the individuals.

Waiting Period

If you are a Canadian or Permanent Resident moving permanently to Nova Scotia from another part of Canada, coverage will generally begin on the first day of the third month following the date you established residency here.

Medical expense eligible when traveling outside Canada

If you are travelling outside Canada for a short period of time MSI will provide coverage for emergency medical services only, in accordance with the Nova Scotia rates. The Children's Dental Program and the Seniors? Pharmacare Program are not insured outside of the province.

Medical expense eligible when traveling outside Canada

  1. If you are traveling outside Canada for a short period of time MSI will provide coverage for emergency medical services only.
  2. Out-of-country in-patient hospitalization as the result of an accident or sudden illness while temporarily absent from Canada , is covered in Canadian funds. The current rate for emergency in-patient services is $525cdn. Per day plus 50% of ancillary fees incurred while an in-patient. Physician Services, as the result of an accident or sudden illness during a temporary absence from Canada are covered in Canadian funds at Nova Scotia rates.

The following services are not payable under the MSI program.

  • Facility and Hospital Out-Patient charges
  • X-Ray, diagnostic tests and laboratory charges from Out-Patient, Emergency or Private Facility
  • Pharmacare and Childrens Dental Programs
  • Routine Vision Analysis

Travel Recommendation

The balance of an account after payment by the Department may be quite large! It is strongly recommended that any resident traveling out of province purchase a Travel Health Plan for the period of absences to cover these balances and other insured services. If you require medical care while traveling, you will be responsible for non-insured services. You will also be responsible to pay the difference between the charge for the insured service and the amount that MSI pays for the service (Nova scotia rates). It is strongly recommended that you purchase travel insurance when you travel outside of the province or country.

Nunavut

http://www.gov.nu.ca/hsssite/hip.shtml

Who is Eligible?

Nunavut residence and student with visa for at least 12 months

Individuals Not eligible

  • visitors, transients nor tourists.
  • Temporary, term and seasonal positions
  • Memeber of the RCMP
  • Inmates
  • Canadian Students ? Attending an educational institute in Nunavut but not intending to establish a permanent residency
  • Students from outside Canada holding a visa of less than 12 months

Waiting Period

Health coverage may become effective on the 1 st day of the 3 rd month

Medical expense eligible when traveling outside Canada

Reimbursement of Physician & hospital services are based on the Nunavut Fee Schedule. ie A physician visit in the USA may cost $100usd but Nunavut will only reimburse approximately $65cnd. A hospital day rate in the USA may be as high as $3000usd per day. Nunavut will cover approximately $1300 cnd per day.

Travel Recommendation

We suggest you purchase extra insurance when traveling. Please note that if you require ground or air ambulance while outside of Nunavut, te cost and any related cost such as return transportation are not covered by the Nunavut Health Care Plan.

Ontario

http://www.health.gov.on.ca/english/public/program/ohip/ohip_mn.html

Eligibility

Ontario residents are eligible for provincially funded health coverage (OHIP). To be eligible for Ontario health coverage you must :

You must have Ontario health insurance to use Ministry of Health and Long-Term Care funded health care services. You are eligible for the Ontario Health Insurance Plan (OHIP) if you are included under 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 Caribbean Commonwealth 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

Waiting Period

OHIP coverage normally becomes effective three months after the date you establish residency in Ontario. The ministry strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period.

Medical expense eligible when traveling outside Canada

  • If you receive medically necessary emergency care from a physician or other OHIP funded health care provider, OHIP will pay to a maximum of what it would have paid had the service been provided in Ontario.
  • Emergency inpatient hospital services eligible for OHIP coverage will be paid as follows :
    • the amount actually billed to a maximum of $400 (Canadian) per day for higher level hospital care, that is rendered in a coronary care unit, an intensive care unit, a neonatal or paediatric special care unit or an operating room of an eligible hospital or health facility
    • up to $200 (Canadian) for any other kind of medical care
  • Emergency outpatient services, with the exception of dialysis, will be the amount payable by OHIP if services had been rendered in Ontario or $50 (Canadian) per day, whichever is less for all outpatient services provided on any given day. Out-of-country dialysis treatment will be paid at a rate of $210 (Canadian) per day.

Travel Recommendation

  • Many health services outside Canada cost much more than coverage by OHIP. You are responsible for any difference in cost.
  • Some health services are not insured by the ministry. You will have to pay the full costs for these services.
  • An accident can happen to anyone, even during a very short business or recreational trip. Extra insurance should be purchased before you leave Ontario. Ask an insurance broker or insurance company for further explanation.

;

Prince Edward Island

http://www.gov.pe.ca/infopei/index.php

Who is Eligible?

The Plans are designed to provide coverage for eligible PEI residents. (A resident of PEI is defined as anyone who is legally entitled to remain in Canada and who makes his or her home and is ordinarily present, on an annual basis, for at least six months plus a day in Prince Edward Island.) PEI residents lose their eligibility if they are absent from the province longer than six months, unless they obtain a waiver of this requirement from the Department.

As a general rule, anyone who has been registered and is ordinarily present in PEI is eligible to receive insured benefits, except those residents who are members of the Canadian Armed Forces, Royal Canadian Mounted Police, inmates of a Federal Penitentiary and those who are eligible for certain services under other government programs such as Workers? Compensation or the Department of Veteran?s Affairs.

If you are in Canada on an Employment Visa, Ministerial Permit or other immigration document, you should contact the Department for information on eligibility. A person who is a foreign student, tourist, transient or a visitor to PEI does not qualify as a resident of the province and so is not eligible for hospital and medical insurance benefits.

Waiting Period

Persons from outside Canada establishing permanent residence in PEI may be eligible on the first day they become residents of the province.

Medical expense eligible when traveling outside Canada

For Island residents travelling outside of Canada, coverage for EMERGENCY or SUDDEN ILLNESS will be provided at PEI rates only, in Canadian currency. The cost for insured services may be considerably higher outside Canada. You will be responsible for paying the difference between the fee charged and the amount paid by the Department. Therefore, residents visiting other countries are advised to obtain private medical insurance for the period they are absent from PEI.

Quebec

http://www.ramq.gouv.qc.ca/index_en.shtml

Who is Eligible?

All Quebec residents are eligible for health insurance plan.

Foreign nationals whose main purpose for being in Quebec is to work, who hold an office or employment for a period of more than 6 months.

Foreign nationals who hold a certificate attesting to their status as a student or trainee in Quebec under an official scholarship program of the Ministere de l'Education ;

Students registered at an educational institution in Quebec or outside Quebec who pursue a study program outside Quebec

Certain persons who spend time in Quebec are ineligible for coverage under the Health Insurance Plan. These include:

  • tourists;
  • students and any other persons from another Canadian province who are in Quebec temporarily.
  • students from countries other than those with which Quebec has concluded a social security agreement providing for student coverage;
  • refugee claimants. These persons may, however, benefit from coverage under the Interim Federal Health Program.

Waiting Period

Generally speaking, if you arrive in Quebec from outside Canada, even if you are a Canadian citizen, you will be eligible for the Quebec Health Insurance Plan after a waiting period of up to three months following your registration.

Max number of days covered

To be covered by the Health Insurance Plan, insured persons must not spend 183 days or more (whether consecutive or not) outside Quebec during a calendar year.

Travel Recommendation

The Regie strongly recommends that you take out private insurance.

Medical expense eligible when traveling outside Canada

During your trip, you may benefit from health care services insured outside Quebec if you remain eligible for the plan. However, as a general rule, the Regie de l'assurance maladie does not reimburse the full cost of these services, and certain services, such as prescription drugs, are not covered at all.

Saskatchewan

http://www.health.gov.sk.ca/out-of-province

Who is Eligible?

If you make your home in Saskatchewan and you ordinarily live in the province at least six months a year, you are eligible for Saskatchewan Health benefits. Everyone must be registered with Saskatchewan Health to be eligible for benefits. Health benefits for members of the Canadian Forces, RCMP and inmates of federal penitentiaries are covered under federal government programs. Their spouses and dependents, however, are eligible for provincial coverage and must register with Saskatchewan Health.

Waiting Period

If you are new to Saskatchewan and have come from another part of Canada, you are required to register for health coverage. As a general rule, coverage will begin on the first day of the third calendar month following the date you established residency here.

Medical expense eligible when traveling outside Canada

As noted, Saskatchewan Health provides only limited coverage for emergency medical care from approved general hospitals outside Canada if the same services would be covered in Saskatchewan. This coverage is up to $100 per day (Canadian) for inpatient services and up to $50 a day (Canadian) for an outpatient hospital visit. Generally, Saskatchewan Health defines

Travel Recommendation

If you receive emergency medical care outside Canada, you will usually find the cost much higher than in Saskatchewan. If the cost is higher, you will be responsible for paying the difference between the full amount charged and the amount Saskatchewan Health pays. For this reason, you should buy additional health insurance if you plan to travel outside Canada.

Yukon

http://www.hss.gov.yk.ca/programs/insured_hearing/outside_coverage/

Who is Eligible?

Yukon residents are eligible for the territorially-funded health coverage. To be eligible you must:

  • Be a Canadian citizen or have immigration status
  • Make your permanent home in Yukon and
  • Be physically present in Yukon and not absent for more than six months, without a waiver from Insured Health Services.

Students must file an ?temporary absence? notice for health care to continue while they are not resident in the Yukon.

Waiting Period

Yukon Health Care Insurance coverage normally becomes effective three months after the date you establish residency in Yukon.

Medical expense eligible when traveling outside Canada

Physician services: doctor fees outside Canada are paid at Yukon rates. The actual rates charged by a physician may be higher. You will be required to pay the difference. Physicians outside Canada are not required to accept your health care card as proof they will be paid. You may be asked to pay in advance.

Hospital charges: American hospitals, especially in Alaska, Hawaii and western states charge a much higher rate than the Yukon for each day of care. The extra amount can exceed $1000 per day.

Travel for the purpose of receiving medical treatment is not insured if an accident or illness occurs while you are out of the Yukon. This applies equally to the United States, Europe or any other Canadian province. If you need an ambulance or air medevac, even to return to Whitehorse from Skagway, the full cost will be your responsibility. An accident or illness in Haines, Alaska could mean a medical evacuation to Whitehorse at a cost to you in excess of $1500.

Travel Recommendation

There are financial limitations to your coverage for medical or hospital services outside Canada. The additional charges are your responsibility. Costs for treating an illness or injury in the United States, Europe or any foreign jurisdiction may be significantly greater than your basic Yukon physician and hospital insurance coverage. The amount you will be responsible for could amount to thousands of dollars. Purchasing additional health care insurance when traveling is a good idea.

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