08 March 26 
US/Canada Health Care If you’re planning a move to Canada and need help with the cross-border tax and financial planning side of things, please feel free to reach out. We work with Americans making this transition every day.
One of the most common questions I get from Americans planning a move to Canada is about healthcare. And I get it – the Canadian system is fundamentally different from what you’re used to, and there’s a lot of confusion about how it actually works in practice.
I should note upfront that I’m a cross-border tax and financial planning specialist, not a healthcare expert. But over the years I’ve helped hundreds of Americans navigate this transition, and I’ve learned that understanding the healthcare system is just as important as understanding the tax implications of your move.
In this guide, I’ll walk you through what you need to know about transitioning from the US healthcare system to the Canadian one. I’ll cover the practical stuff – like how to get your provincial health card, what’s actually covered, and how to find a family doctor – as well as some of the bigger picture differences that might catch you off guard.
Please keep in mind that healthcare in Canada is administered at the provincial level, so the specific rules and wait times will vary depending on where you settle. I’ll try to provide general guidance that applies across the country, but you’ll want to verify the details with your specific province.
Before we get into the logistics, it’s helpful to understand the fundamental difference between the two systems.
In the United States, most people access healthcare through a combination of employer-sponsored insurance, private plans, or government programs like Medicare or Medicaid. It’s essentially a market-based system where your access to care is often tied to your employment status or ability to pay.
Canada takes a very different approach. The system is publicly funded through general taxation and administered by each province under the framework of the Canada Health Act. This federal legislation establishes five key principles that all provincial health plans must follow:
1. Public Administration – Plans must be managed on a non-profit basis by a public authority
2. Comprehensiveness – All medically necessary hospital and physician services must be covered
3. Universality – All residents are entitled to the same level of care
4. Portability – Coverage continues when you travel between provinces
5. Accessibility – No financial barriers like user fees or extra-billing for insured services
What this means in practice is that once you’re enrolled in your provincial health plan, you generally won’t see a bill for doctor visits, hospital stays, or medically necessary procedures. The trade-off, as many Americans discover, is that you also give up some of the choice and immediacy that the US system provides.
I always tell clients that it’s helpful to think of it as shifting from being a “consumer of health services” to a “resident of a health system.” Clinical necessity – not your insurance plan – determines the priority of your care.
Here’s something that catches a lot of Americans off guard: provincial health insurance doesn’t kick in the moment you cross the border.
In most provinces, there’s a mandatory waiting period – typically three months – before your coverage becomes active. During this time, you’re essentially uninsured from the provincial system’s perspective.
The waiting periods vary by province:
| Province | Wait Period | Application Method |
|---|---|---|
| Ontario (OHIP) | 3 months | In-person at ServiceOntario |
| British Columbia (MSP) | 3 months | Online at Health Insurance BC |
| Alberta (AHCIP) | No wait | In-person at registry agent |
| Quebec (RAMQ) | 3 months | Online at RAMQ |
| Saskatchewan | No wait | Online application |
In British Columbia, for example, the wait period is calculated as the remainder of the month you arrive plus two additional months. So if you land on October 15th, you wouldn’t be covered until January 1st.
Canadian hospitals charge “non-resident” rates to those without a valid provincial health card, and these costs can add up quickly. Based on published hospital fee schedules, here are some typical fees you might encounter if you needed care during the gap period:
A single hospitalization for something like appendicitis could easily run into tens of thousands of dollars if you’re uninsured.
I always advise clients to purchase private “Visitors to Canada” or “Newcomer” insurance before they arrive. These plans are specifically designed to cover the provincial waiting period.
Several companies offer this type of coverage, including Manulife, Sun Life, Blue Cross, and GMS. Monthly premiums typically run between $75-150 CAD depending on your age and the coverage level, which is a small price to pay for peace of mind.
One important caveat: most of these plans have pre-existing condition clauses. If you have a chronic condition that wasn’t “stable” (meaning no changes in symptoms, medication, or treatment) for 90-180 days before the policy starts, it generally won’t be covered. If you have ongoing health issues, look for “Guaranteed Acceptance” plans – they cost more but provide broader coverage.
One of the biggest misconceptions Americans have about Canadian healthcare is that it’s “all-inclusive.” In reality, the public system covers less than you might expect.
Under the Canada Health Act, provincial plans must cover “medically necessary” services provided by physicians and hospitals. This generally includes:
For these services, you typically won’t pay anything at the point of care.
Here’s where it gets tricky for Americans used to comprehensive employer plans:
Prescription Medications – Unlike most US health plans, outpatient prescriptions are generally NOT covered by provincial health insurance. You’ll either pay out-of-pocket or need private supplemental insurance. Some provinces have programs for seniors or low-income residents, but most working-age adults are on their own for medication costs.
Dental Care – Almost entirely private for adults. The federal government recently introduced the Canadian Dental Care Plan for seniors and low-income families, but most working-age people need private insurance.
Vision Care – Eye exams and glasses are generally not covered for adults.
Mental Health – This is nuanced. Visits to a psychiatrist (who is an MD) are covered. But psychologists, therapists, and counselors are generally private and require out-of-pocket payment or supplemental insurance.
Physiotherapy, Chiropractic, Massage – Not covered unless part of a hospital-based recovery program.
If you’re coming from a job with good US benefits, you’ll likely want to secure supplemental health insurance in Canada to cover these gaps. Many employers offer group plans, or you can purchase individual coverage.
This is probably the most important piece of practical advice I can give you: finding a family doctor should be a day-one priority when you arrive in Canada.
Canada is facing a significant shortage of family physicians. Current estimates suggest that 13-15% of the population is “unattached” – meaning they don’t have a regular family doctor. In some regions, particularly rural areas, the shortage is even more severe.
In the Canadian system, your family doctor is the gatekeeper to everything else. Unlike in the US where you might be able to call a dermatologist or orthopedic surgeon directly (depending on your insurance), Canadian specialists almost always require a referral from a primary care provider.
No family doctor = no referrals = significant delays in accessing specialist care.
Each province has different mechanisms for matching patients with available doctors:
Ontario – Register with Health Care Connect. This provincial service attempts to match you with accepting physicians based on your location and clinical needs.
British Columbia – Use the Health Connect Registry and check with local Divisions of Family Practice.
Alberta – The Alberta Find a Doctor service maintains lists of accepting physicians.
In the meantime, you can use walk-in clinics for non-urgent care. These clinics can also provide referrals to specialists if needed, though having a consistent family doctor is much better for ongoing care management.
Virtual care platforms like Maple and Tia Health have also become popular options for minor issues while you’re waiting to find a permanent doctor.
I’m not going to sugarcoat this: wait times for specialist care and elective procedures in Canada are often longer than what Americans are accustomed to.
The Fraser Institute publishes annual data on wait times, and recent estimates have shown a median wait of roughly 27-28 weeks from GP referral to treatment completion nationally.
Here’s how some common specialties break down (data from CIHI and the Fraser Institute):
| Specialty | Median Wait Time |
|---|---|
| Medical Oncology | 4.7 weeks |
| Radiation Oncology | 4.2 weeks |
| Orthopedic Surgery | 49 weeks |
| Ophthalmology | 32 weeks |
| Gynaecology | 41 weeks |
| MRI Scan | 18 weeks |
| CT Scan | 9 weeks |
Before you panic, some important context:
Urgent care is prioritized. If you have a suspected cancer, cardiac emergency, or other acute condition, you’ll generally be seen quickly – often within days or weeks. The Canadian system does a good job of triaging based on medical necessity.
The long waits are primarily for elective procedures. Joint replacements, non-urgent ophthalmology, cosmetic procedures – these are where the backlogs build up.
Provincial variation is significant. Ontario generally has shorter wait times than other provinces. Where you settle matters.
The system isn’t perfect, but it’s important to understand that urgent and emergency care remains prompt. It’s the “quality of life” procedures where patience is required.
One area where Americans can take comfort is emergency care. Canadian emergency rooms operate on a triage system based on medical urgency, not ability to pay or insurance status.
When you arrive at an ER, you’ll be assessed by a triage nurse who assigns a priority level based on the severity of your condition. Life-threatening emergencies are seen immediately. Less urgent issues may involve a wait – sometimes a long one – but you will be seen.
Most Canadian hospitals use the Canadian Triage and Acuity Scale (CTAS):
If you’re a Level 4 or 5, expect to wait. Bring a book. But know that if your condition changes, you can ask to be reassessed.
For issues that need same-day attention but aren’t true emergencies – think stitches for a minor cut, a possible sprained ankle, or a bad infection – many provinces now have Urgent Primary Care Centres (UPCCs) as an alternative to the ER.
These centers are designed to handle urgent but non-life-threatening issues with shorter wait times than a hospital ER. They’re particularly common in British Columbia and are expanding to other provinces. It’s worth identifying the UPCCs in your area when you first arrive.
Because healthcare is administered provincially, there are meaningful differences in coverage, wait times, and processes depending on where you settle. Here are some highlights:
Ontario’s health plan (OHIP) is often cited as having some of the shortest wait times nationally. The province has invested heavily in expanding capacity. The Health Care Connect service is relatively efficient at matching patients with family doctors, though waits can still be several months in high-demand areas like Toronto.
One thing to note: Ontario’s OHIP covers a bit more than some other provinces, including annual eye exams for those under 20 or over 65.
BC has been aggressive about expanding the role of pharmacists and nurse practitioners. You can now get treatment for over 20 minor ailments directly from a pharmacist, which is helpful when you’re waiting to find a family doctor.
The province also has a robust network of Urgent Primary Care Centres. The HealthLink BC website is an excellent resource for finding care options.
Alberta is notable for having no waiting period for health coverage – you’re eligible from day one of establishing residency. This is a significant advantage for Americans making the move.
The province has also experimented with allowing some private healthcare options that don’t exist in other provinces, though the public system remains the primary option for most residents.
Quebec operates somewhat independently from the rest of the Canadian healthcare system and has its own distinct processes. The RAMQ card is required for coverage, and wait times – particularly for family doctors – can be longer than in other provinces. French language proficiency, while not required for healthcare, certainly helps navigate the system.
I want to spend a moment on mental health, because this is an area where the Canadian system often disappoints Americans who had good coverage back home.
As mentioned earlier, psychiatrists (who are MDs) are covered by provincial health insurance. However, the wait to see a psychiatrist can be 6-12 months or longer for non-urgent cases.
Psychologists, therapists, counselors, and social workers are generally NOT covered by provincial health plans. You’ll either pay out-of-pocket (typical rates are $150-250 CAD per session) or need private insurance.
If you or a family member has ongoing mental health needs, this is one area where I’d strongly recommend securing supplemental insurance that includes mental health coverage. Some employer plans offer this, or you can purchase individual coverage.
Virtual therapy platforms have become more common in Canada and can sometimes offer more affordable options, but the coverage gap remains a significant issue for many Americans making the transition.
If you’re on ongoing medications, this section is critical.
According to Health Canada regulations, you can generally bring:
The medications should be in their original pharmacy packaging with your prescription information attached.
In practice, most pharmacies will not ship US prescription medications internationally, so if you need more than what you brought, you’ll typically need to see a Canadian doctor and get a new, local prescription.
Not all US medications are approved in Canada, and brand names often differ. Before you move, I’d suggest searching the Health Canada Drug Product Database for each of your medications to confirm a Canadian equivalent exists.
If your medication isn’t available in Canada, talk to your US doctor about alternatives before you leave.
Canada is famous for lower drug prices, but this primarily applies to brand-name medications that are subject to government price caps. Interestingly, generic medications can sometimes be cheaper in the US due to the highly competitive generic market there.
Your US medical history won’t automatically follow you to Canada. The healthcare systems don’t share data, and Canadian doctors often won’t have the capacity to request records from foreign institutions on your behalf.
I recommend creating both a physical folder and a secure cloud backup containing:
If you’ve received care at US hospitals that use the Epic electronic health record system, you may be in luck. Several Canadian hospitals also use Epic, including The Ottawa Hospital, Hamilton Health Sciences, and Alberta Health Services.
Through Epic’s “Share Everywhere” feature, you can generate a temporary access code in your MyChart app that may allow some Canadian physicians and hospitals using Epic to view your records. This can be particularly useful for walk-in clinics or new family doctors when the receiving provider is able to access it.
Before you leave the US, make sure your MyChart account is active and that you’re opted into the “Care Everywhere” data sharing protocol.
The Canadian healthcare system is evolving, and there are some changes coming in 2026 that may affect newcomers:
Historically, Canadian “Medicare” covered only physician and hospital services. That’s changing. Provincial and federal agreements are expanding coverage for services provided by Nurse Practitioners, midwives, and pharmacists.
In many provinces, pharmacists can now prescribe medications for minor ailments like urinary tract infections, allergic rhinitis, and certain skin conditions. This can be a faster option than waiting for a walk-in clinic appointment.
Through the Working Together agreement announced in February 2023, the federal government committed $25 billion over 10 years across four shared priorities: family health services, health workers and backlogs, mental health and substance use, and a modernized health system. This should help address some of the systemic pressures over time, though the effects won’t be immediate.
Based on everything we’ve covered, here’s what I’d recommend:
The transition from US to Canadian healthcare requires some adjustment, but it’s entirely manageable with proper preparation.
The biggest shifts for most Americans are psychological: accepting that you can’t self-refer to specialists, adjusting to longer wait times for non-urgent care, and understanding that “comprehensive” coverage doesn’t mean everything is covered.
On the positive side, you’ll never again have to worry about a medical bill bankrupting you, fight with an insurance company over a denied claim, or make healthcare decisions based on what’s “in network.” Clinical necessity, not your ability to pay, determines your care priority.
If you’re planning a move to Canada and need help with the cross-border tax and financial planning aspects, please don’t hesitate to reach out. Healthcare is just one piece of the puzzle – there are also significant tax, investment, and estate planning considerations that come with this transition.
You can also join our Americans in Canada Facebook group where members share their experiences and answer questions about all aspects of life as an American in Canada.
Cheers,
Phil
This article is for informational purposes only and should not be construed as medical or legal advice. Healthcare regulations vary by province and change frequently. Please verify current requirements with your provincial health authority. Large language models were used to help research and write this report.
This commentary reflects the personal opinions, viewpoints and analyses of the Beacon Hill Wealth Management Ltd. partner providing such comments, and should not be regarded as a description of advisory services provided by Beacon Hill Wealth Management Ltd. or performance returns of any Beacon Hill Wealth Management Ltd. client. The views reflected in the commentary are subject to change at any time without notice. Nothing in this commentary constitutes investment advice, performance data or any recommendation that any particular security, portfolio of securities, transaction or investment strategy is suitable for any specific person. Any mention of a particular security and related performance data is not a recommendation to buy or sell that security. Beacon Hill Wealth Management Ltd. manages its clients’ accounts using a variety of investment techniques and strategies, which are not necessarily discussed in the commentary. Investments in securities involve the risk of loss. Past performance is no guarantee of future results. Any discussion about taxation is for educational purposes only and should not be viewed as professional advice. Consult your tax professional for tax advice on your particular situation.
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