Healthcare in Canada: provincial insurance, the waiting period and what it does not cover

Yes, as a resident of Canada you are insured free of charge for family doctor and hospital. But the insurance is provincial, and so is the moment it starts. In Ontario and Alberta that can be the day you settle; in British Columbia you wait the rest of the month of arrival plus two months. What it costs lies in what is not covered: prescriptions from your family doctor, the dentist and your glasses you pay yourself, or through supplementary insurance. And the trap: a Dutch route via the CAK does not exist for Canada.

Why can't I stay insured via the CAK?

The CAK's scheme for people abroad only applies in countries with which the Netherlands has agreements on medical care, the treaty countries. Canada is not on that list. Anyone who goes to live in Canada and cannot keep their Dutch health insurance takes out insurance in the new country of residence; also with a Dutch pension. How to end the Dutch policy cleanly is in cancelling your health insurance without a gap.

When does the provincial insurance start?

Province	Waiting period	Where you register	With a work permit
Ontario (OHIP)	none	in person at ServiceOntario, with three original documents	only with full-time work for an Ontario employer, for at least 6 months
British Columbia (MSP)	rest of the arrival month plus two months	online, by post or in person; photo at an ICBC office	possibly, with a permit of six months or more, including working holiday
Alberta (AHCIP)	none, provided you apply within 3 months	at a registry office	"may be eligible", depending on your situation
Québec (RAMQ), temporary workers	no cover in the first three months after arrival	with the RAMQ, right after arrival	generally a permit of more than six months

Ontario has abolished the waiting period: if you are eligible, you are covered immediately. In return there is a presence requirement: at least 153 days in Ontario in the first 183 days, and after that 153 days in any twelve months. If you are away for more than 212 days in a twelve-month period, you may have to reapply. Every family member, including a child, needs their own immigration document from IRCC.

British Columbia itself writes that as a newcomer you should apply straight away, and that you should get private insurance while you wait. If family members arrive later, their waiting period starts on their own arrival date.

Alberta lets your cover start on the day you settle when you move from abroad, provided you apply within three months. If you are later, the processing date determines when you are covered.

The gap between two insurances. As a rule you cannot keep your Dutch basic insurance when you emigrate, and the Canadian one starts months later in British Columbia and Québec. If you come on a working holiday visa or a temporary permit, you may fall outside OHIP entirely in Ontario. Take out private or international insurance for that period before you leave. Québec puts it sharply: take out private insurance no later than the first five days after arrival, after that it becomes more difficult.

What does the provincial insurance not cover?

Ontario lists it: no cover for prescription drugs outside hospital, such as antibiotics from your family doctor, no dentist in the practice, and no glasses or contact lenses. For medication each province has its own scheme.

In Ontario everyone aged 24 or younger without a private plan gets more than 5,900 medications free at the pharmacy through OHIP+; no separate enrolment is needed, the health card number is enough. If you have private cover through your employer, you are not eligible for OHIP+.

In British Columbia you pay a deductible through Fair PharmaCare that depends on your family income; after that the province pays 70% of the costs, and above the family maximum everything. The scheme uses your income from two years earlier, which the Canadian tax agency does not yet have for a newcomer. For new residents there is therefore a separate income affidavit. Return the consent form for the income check within thirty days: otherwise the deductible is set at $10,000.

What about the dentist?

Dental care in the practice falls outside the provincial insurance. Federally there is the Canadian Dental Care Plan, but for a newcomer it only comes within reach later: your family income must be under $90,000, you must be a resident for tax purposes, you must have filed a tax return in Canada, and you may not have access to private dental insurance. In your first year, supplementary insurance, usually through your employer, is therefore the normal route.

How registering in the first weeks fits with your SIN, your bank and your driving licence is in your first weeks in Canada. The full order is at /canada.

In Vertrekklaar this is phase 5 of 5 of the journey, step 5.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Canada or go straight to step 5.2 in the open plan.