Healthcare in Canada

Healthcare in Canada is delivered through provincially and territorially administered public plans (often called Medicare), guided by the federal Canada Health Act. Most medically necessary hospital and physician services are insured for eligible residents. Other services—such as prescription drugs outside hospitals, dental care, and vision care—are covered by a mix of provincial programs and private insurance. Visitors are not covered by public plans.

At a glance — Healthcare in Canada

Who runs it	Provinces/territories run public plans; the federal government sets national principles, funds through transfers, and leads public health and certain populations’ services.
Funding	Primarily tax-funded (provincial/territorial revenue + federal transfers). Most patients do not pay at point of service for insured hospital/physician care.
Canada Health Act principles	Public administration • Comprehensiveness • Universality • Portability • Accessibility
Coverage core	Medically necessary hospital and physician services; some diagnostic/medical procedures
Coverage varies	Out-of-hospital prescription drugs, dental, vision, home/community care, mental health counselling, medical devices (program-specific)

Governance and funding

• Provinces and territories legislate, fund, and administer public health insurance and delivery (hospitals, regional/health authorities, physician payment, and many programs).
• The federal government sets national principles via the Canada Health Act, provides the Canada Health Transfer, leads national public health (surveillance, guidance, emergencies), regulates aspects of drugs and devices, and provides/coordinates services for specific groups (e.g., serving members of the Canadian Armed Forces; certain federal populations).
• Many services are delivered by a mix of public organizations (hospitals, authorities) and private providers (physicians, clinics) under public payment rules.

Canada Health Act (principles)

The Act links federal funding to five principles applied to insured services:

Principle	In practice
Public administration	Each plan is administered on a non-profit basis by a public authority.
Comprehensiveness	All insured hospital and physician services (medically necessary) must be covered.
Universality	All eligible residents are entitled to the plan on uniform terms and conditions.
Portability	Coverage continues during short absences and when moving between provinces/territories, subject to rules.
Accessibility	Reasonable access to insured services without financial or other barriers; no extra-billing or user charges for insured services.

What is covered (typical)

Coverage and program names vary by province/territory, but commonly include:

• Hospital services: inpatient/outpatient care, surgery, diagnostics done in hospital, nursing, supplies.
• Physician services: medically necessary visits/procedures billed to the plan.
• Medically necessary diagnostics/procedures when insured under local policy.

Often not fully insured (varies by jurisdiction):

• Prescription drugs outside hospitals (public drug plans target seniors, low-income, high-cost medicines; some universal/catastrophic models exist).
• Dental care (generally private or program-based for children/low-income/specific needs).
• Vision care (eye exams/devices often age/condition-limited).
• Mental health counselling/psychotherapy (publicly covered when delivered in hospitals/physician settings; community services vary).
• Home and community care, long-term care (program eligibility and fees vary).
• Ambulance, medical devices, allied health (physio, chiro, etc.) — program dependent.

Access and delivery

Primary care

Most Canadians access the system through family physicians or nurse practitioners. Team-based models (interprofessional clinics, community health centres) are expanding.

Hospitals and specialists

Specialist care is typically accessed by referral. Hospitals are publicly funded institutions providing acute, emergency, and many outpatient services.

Emergency and urgent care

Dial 911 for emergencies. Walk-in/urgent care clinics operate in many communities.

Pharmacies

Dispensing, immunizations, and minor-ailment prescribing (scope varies by province/territory). Public/private drug coverage applies at the counter per eligibility.

Drugs, devices, and pricing (overview)

• Health technology assessment: Many new drugs and devices undergo national review to inform public plan decisions.
• Drug price and reimbursement processes: National review informs provinces/territories that then negotiate pricing/coverage collaboratively. A federal board regulates aspects of patented drug prices.
• Formularies: Each jurisdiction maintains a public drug formulary with special authorization processes for some medicines.

Public health and health security

The national public health agency provides guidance on communicable diseases, surveillance, immunization coordination, emergency preparedness, and health promotion. Provinces/territories operate local/ regional public health units that deliver programs (immunization, inspections, outbreak response).

Indigenous health

Indigenous peoples (First Nations, Inuit, Métis) access provincial/territorial systems and Indigenous-led services. The federal government funds or provides additional health benefits and certain community services for eligible First Nations and Inuit, alongside distinctions-based, community-driven programs and self-government/modern treaty health arrangements.

Mental health, addictions, and community services

Hospitals and physicians provide insured services; provinces/territories fund community mental health and addictions programs to varying degrees. Crisis lines, harm-reduction services, and integrated youth/adult programs operate in many areas.

Home, community, and long-term care

Services include home nursing, personal support, rehab, and palliative care; eligibility criteria and client fees/copayments (where applicable) vary. Long-term care homes provide 24-hour support; placement and fees are provincially regulated.

eHealth and virtual care

Electronic medical/health records, patient portals, telehealth, and virtual primary/specialist visits are in widespread use; details and access differ by province/territory and provider.

Quality, safety, and performance

Health systems track indicators such as access, outcomes, patient safety, experience, and wait times. Independent bodies provide data and reporting; accreditation organizations evaluate facilities against quality standards.

Eligibility, cards, and moving provinces

Residents enroll in their province/territory’s health plan and receive a health card. Waiting periods may apply for new residents; rules also govern temporary absences and out-of-country coverage. Keep address information up to date and carry your card to appointments.

Newcomers, temporary residents, and visitors

Eligibility varies for international students and workers until they meet local requirements; many carry private insurance during waiting periods. Visitors are not covered by public plans—see Visitor Health Insurance for Canada (2025).

Complaints and appeals

Each province/territory has processes for billing disputes, patient relations, and quality concerns; professional colleges regulate licensed providers. Independent ombudspersons or review offices may assist with concerns about services or facilities.

See also

• Visitor Health Insurance for Canada (2025) • Provinces of Canada • Government of Canada
• Public safety in Canada • Education in Canada
• Travel in Canada • National Parks of Canada

External links (official)

• Government of Canada — Canada Health Act (Justice Laws): https://laws-lois.justice.gc.ca/eng/acts/c-6/
• Government of Canada — Canada Health Transfer (background): https://www.canada.ca/en/department-finance/programs/federal-transfers/canada-health-transfer.html
• Health Canada — Health system and services overview: https://www.canada.ca/en/health-canada/services/health-care-system.html
• Public Health Agency of Canada — Public health, guidance, emergencies: https://www.canada.ca/en/public-health.html
• Indigenous Services Canada — Health services and benefits: https://www.sac-isc.gc.ca/
• Canadian Institute for Health Information — Health system data and indicators: https://www.cihi.ca/
• Patented Medicine Prices Review Board — Human drug price regulation: https://www.pmprb-cepmb.gc.ca/
• CADTH — Health technology assessment: https://www.cadth.ca/
• Provincial/territorial health ministries and health insurance enrollment: https://www.canada.ca/en/health-canada/services/health-cards/contacts.html

FAQs

What does Medicare cover in Canada?

For eligible residents, medically necessary physician and hospital services are publicly insured. Coverage for drugs outside hospitals, dental, vision, and allied health varies by province/territory and program.

Do I need private insurance if I live in Canada?

Many residents use supplemental insurance (employer or individual) for services not fully covered publicly (e.g., prescription drugs, dental, vision, paramedical). New residents may need temporary private coverage during any waiting period.

Are visitors covered?

No. Visitors must pay for care or carry private insurance. See Visitor Health Insurance for Canada (2025).

Why are there wait times?

Wait times reflect system capacity, demand, referral pathways, and prioritization by medical urgency. Provinces/territories track and publish wait-time information and invest in access initiatives.

Can I use my health card in another province?

Portability applies for insured services during short absences, but rules and billing arrangements vary. If you move, register with your new province/territory as soon as eligible.