The UK has a relatively unique healthcare system and the NHS can feel all too simple setting unrealistic expectations for what healthcare might be when you move abroad. Because Canada offers publicly funded healthcare, there could be the assumption that the systems will feel familiar, but that is not going to be the case.
Understanding the differences between the Canadian system and the NHS is important before you move is essential to avoid unexpected costs and ensure you’re covered from day one.
Disclaimer
The information in this article is intended for general guidance and educational purposes only. It does not constitute legal, financial or medical advice. Healthcare rules and eligibility vary between provinces and can change at short notice. You should always verify information directly with the relevant provincial health authority or seek advice from a qualified professional before making any decisions.
An overview of the Canadian healthcare system
Canada’s healthcare system is publicly funded but administered at the provincial and territorial level, not nationally. This means that while all residents can access essential medical care, the rules, coverage and waiting periods differ depending on where you live.
Each province operates its own health insurance plan, for example:
- Ontario Health Insurance Plan (OHIP)
- British Columbia Medical Services Plan (MSP)
- Alberta Health Care Insurance Plan (AHCIP)
Provincial healthcare plans generally cover:
- Visits to your GP and specialists
- Emergency hospital care
- Medically necessary tests and procedures
However, prescriptions, dental care, physiotherapy and optometry are not included in most provincial plans.
Region-by-region differences in healthcare
Below is a summary of key points across major provinces and territories.
Ontario (OHIP)
- Must register in person at a ServiceOntario centre.
- Coverage begins once physical presence in Ontario is proven (e.g. lease, bills).
- Private insurance strongly recommended for first three months.
- Some prescription drugs covered under the Ontario Drug Benefit Program, but mostly for seniors and low-income residents.
British Columbia (MSP)
- Registration can be done online with proof of status and address.
- Monthly premiums were abolished in 2020, but some services (ambulance, dental, vision) remain excluded.
- Highly recommended to arrange private insurance for early months.
Alberta (AHCIP)
- Requires valid immigration documents and proof of Alberta residency.
- Many expats find Alberta’s system straightforward, but it still excludes most prescription and dental costs.
Quebec (RAMQ)
- Usually imposes a waiting period of up to three months.
- Requires physical presence and proof of residency intent.
- Public coverage includes a basic prescription plan for residents without employer coverage, but costs may apply.
- Services mainly provided in French, English-speaking newcomers may need additional support navigating the system.
Manitoba (Manitoba Health, Seniors and Active Living)
- Typically no waiting period if you move from another Canadian province; up to three months for arrivals from abroad.
- Registration requires proof of immigration status and address.
- Many residents also take private insurance for dental and prescription costs.
Saskatchewan (Saskatchewan Health Card)
- Up to three-month waiting period for new arrivals.
- Straightforward online or paper registration once you have a local address.
- Public plan excludes prescription drugs and most paramedical services.
Nova Scotia (MSI)
- Newcomers may face up to three months before coverage starts.
- Registration forms must be submitted by post with supporting documents.
- Some coverage for prescriptions via additional provincial programs, but most rely on employer or private plans.
New Brunswick (Medicare)
- Three-month waiting period common for new residents.
- Registration requires proof of immigration status and local address.
- Does not cover prescription drugs except through separate assistance programs.
Newfoundland and Labrador (MCP)
- Typically no waiting period for permanent residents; temporary workers may need private insurance initially.
- Coverage includes doctor visits and hospital stays but excludes most non-hospital services.
Other provinces and territories
- Prince Edward Island, Yukon, Northwest Territories, Nunavut: Most follow the three-month waiting rule.
- Each territory operates its own small-scale health plan; access may be affected by geography and available services.
- Travel between remote areas can be costly, so comprehensive private insurance is strongly recommended.
Who is eligible for public healthcare in Canada
As a foreign national in Canada, eligibility usually depends on your immigration or residency status. You typically need:
- To provide a valid work/study permit or proof of permanent resident status
- To be living in the province for a minimum number of days each calendar year (often 183 days)
- To register for the provincial healthcare plan after arrival
Importantly, you’re not automatically enrolled. Registration must be completed in person or online with your local health authority, and you’ll receive a physical health card once approved.
Waiting periods and interim cover in Canada
Most provinces apply a waiting period of up to three months before coverage begins. During this time, you’ll need private health insurance to bridge the gap. Even if your employer offers group insurance, make sure it’s active from your first day in Canada, not after your provincial cover starts.
If you arrive with dependants, ensure each family member is individually registered and insured. Healthcare is not automatically shared between spouses or children under one household registration, as it is under the NHS.
Private and supplementary health insurance
Private insurance is far more common in Canada than in the UK. It fills the gaps left by public plans and typically helps with:
- Prescription medication
- Dental and optical care
- Physiotherapy and chiropractic services
- Private hospital rooms
- Emergency medical evacuation or travel health cover
Employers often include private healthcare as part of a benefits package, but coverage can vary widely. If you’re self-employed or moving without employer support, a standalone expat or local private plan is likely to be required.
Several global insurers (eg Expat Group Healthcare*, Cigna, Allianz, Bupa Global) offer expat-friendly packages that can start before you arrive, ensuring you’re protected from day one.
Accessing care and choosing providers
Once registered, you’ll be able to:
- Choose or be assigned a family doctor (GP)
- Book specialist appointments via referral
- Access walk-in clinics for minor issues
- Attend hospital emergency departments for urgent care
Be aware that availability of family doctors is limited in some provinces. It can take time to register, especially in popular areas such as Ontario and British Columbia. Many expats rely on walk-in clinics for initial care until they secure a permanent GP.
Prescription medication and costs
Prescription drug coverage varies dramatically:
- Some provinces subsidise medication for seniors, low-income households or those with chronic conditions.
- Most people use private insurance or employer plans to cover the bulk of costs.
- Pharmacies will require proof of insurance at the point of sale, or you’ll pay upfront and claim later.
Healthcare for retirees and non-working residents
If you’re moving to Canada as a retiree or without employment, access to public healthcare depends heavily on your visa and residency status. Permanent residents are eligible once they meet the local residency requirement, but temporary visa holders are not. You’ll need a comprehensive private policy that includes emergency, hospital and repatriation cover.
Emergency care and reciprocal agreements
The UK does not have a reciprocal healthcare agreement with Canada. This means you cannot rely on NHS cover abroad and treatment in Canada without insurance can be expensive.
Emergency services are efficient, but non-residents are billed for all costs, which can easily reach thousands of dollars for even minor hospital stays.
Practical steps to get covered from day one
- Check your visa type and confirm your eligibility for provincial healthcare.
- Secure private or expat insurance for your first 3 months (or longer if not eligible for public cover).
- Apply for your provincial health card as soon as you have a local address.
- Find a family doctor or register with a local clinic.
- Understand your employer’s healthcare benefits if applicable.
- Keep all documentation and insurance cards accessible for medical visits.
