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When you arrive in Canada, the healthcare system is one of the most vital aspects to understand.
Canada has a universal healthcare system, but it's essential to realize that healthcare administration operates at the provincial and territorial levels. This means that healthcare policies and procedures may vary depending on the province in which you reside. However, the resources provided in this post can offer you a general understanding.
In this post, I will shed light on how the healthcare system functions based on our experiences living in Ontario, where the Ontario Health Insurance Plan (OHIP) is in effect.
Table of contents
1. Provincial Autonomy
Canada's healthcare system follows a cooperative federalism model, giving provinces and territories substantial control over healthcare.
As a result, each province has its unique system for providing healthcare services and coverage. This implies that Ontario's healthcare system may differ from those in other provinces.
To access specific information about each province, I recommend visiting this official page, which lists the provinces along with their respective health cards.
2. Ontario's OHIP
In Ontario, healthcare is administered through OHIP, the Ontario Health Insurance Plan. When you become eligible, you and your family can apply for an OHIP card, which is essential for accessing healthcare services.
We became eligible to apply almost six months after arriving in Canada. You can find a step-by-step guide on how we did it in Health Card for Work Permit Holders in Ontario.
We have friends who obtained their health cards before that time by presenting a letter confirming their permanent employment. As always, it's important to conduct your research and ensure you have all the necessary paperwork when you become eligible. You can check more information by visiting this official page.
Another important detail is that once one household member receives the health card, you can extend coverage to your spouse and children. In Ontario, on the day you apply, if you are accepted, your entire family should accompany you because they will take a photo of you for their records.
3. Coverage and Financing
The Canadian healthcare system is primarily funded through taxes. This means that you won't receive a bill for most basic medical services.
The OHIP card covers visits to walk-in clinics for minor ailments and emergencies and hospital care for more serious health concerns.
However, it's crucial to understand that not everything is included in OHIP's coverage. Dental care, eye exams, and prescription glasses are generally not covered, and prescription medications (coverage varies by province) are not covered.
If your employer doesn't offer additional health coverage, you may need to pay for these services out of your own pocket.
4. Complementary Insurance
Many employers offer supplementary health insurance. This complementary insurance can fill in the gaps left by OHIP, covering expenses like dental and vision care. It's wise to explore such options, especially if your family's health needs go beyond what OHIP offers.
When job hunting, you'll notice that most job postings include health coverage. Of course, always review the details, but this is a valuable addition to your job.
This insurance can even cover paramedical treatments, such as massage therapy, acupuncture, naturopathy, and more. The extent of coverage depends on the insurance provided by your employer.
5. Primary Healthcare
The core of Canada's healthcare system is rooted in primary care. Family doctors and Nurse practitioners serve as the front-line healthcare professionals. If you have a health concern, your first step is to contact one of these practitioners, often at walk-in clinics.
You can visit a walk-in clinic without the need for a family doctor. We did this for two years, consistently using the same walk-in clinic near our home, which meant we were seen by different doctors each time.
However, this year, the clinic emailed us that they had doctors accepting patients, and that's how we obtained our family doctor. More details on acquiring your own family doctor are available in How to find a Family Doctor in Ontario.
Family doctors and Nurse practitioners are responsible for managing your overall health and can refer you to specialists when necessary.
Since acquiring a family doctor, we've gained access to routine testing. In cases where we needed specialized care, our family doctor referred us to the appropriate specialists.
6. Our Personal Experience
We understand that healthcare can be a hot topic, with countless opinions and anecdotes out there. However, we can only share our own personal experiences, and we hope that your journey with Canada's healthcare system is as smooth as possible.
Our experience with the Canadian healthcare system, particularly in Ontario, has been mainly positive, but there have been a couple of downsides. Here are some examples of how it has been:
As Walk-In patients without health card
As I mentioned, during the first 6 months in Canada, we didn't have OHIP coverage, so we only had insurance for emergencies.
Nevertheless, we could visit a walk-in clinic close to our home to renew medications and for minor ailments. Each time, we paid approximately 65 CAD for the medical consultation.
So, if you don't have a health card, you can still go to a walk-in clinic, but you'll have to pay.
I recommend checking your neighbourhood. We were fortunate to find a walk-in clinic that allowed us to schedule appointments, making it more convenient for us to go there.
Visit to the ER
Back in 2021, when we still didn't have a health card, my partner Aldo injured his wrist while playing soccer. Initially, it seemed like a minor injury, but two weeks later, he woke up with acute pain in the wrist, making it impossible to move. So, we contacted our private insurance provider, who promptly sent a doctor.
The doctor made a house visit and, upon examining Aldo, decided he needed to go to the Emergency Room (ER) at the nearest hospital for further tests to determine the cause of the pain.
Upon arriving at the hospital, as is the case with most hospitals, Aldo went through a triage process where issues are prioritized based on their severity.
In this instance, we had to wait for six hours in the ER to get the results. Keep in mind that if your injury is not life-threatening, your case may experience delays. After the six-hour wait, Aldo received the necessary tests and consultations. The doctor then referred him to another hospital where he could see a specialist that same week. While the wait was quite long, he eventually received the attention he needed.
Since we didn't have a health card at the time, the cost of this ER visit and subsequent appointments was approximately 3000 CAD, all of which was covered by our private insurance. Notably, the ER visit alone cost more than 700 CAD.
As Walk-in patients with a Health card
Once we obtained our health cards, we continued visiting the same walk-in clinic. The key difference from the first scenario is that we no longer have to pay for medical attention. We simply present our health cards, and that's it.
If any tests or exams are required, they are typically covered by our health card. However, it's important to note that some specific tests, like a Vitamin D analysis, are not covered. Similarly, if a prescription is provided, we are responsible for covering the cost of the medication.
With a family doctor
Having a family doctor has given us access to more comprehensive healthcare. To acquire a family doctor, you typically go through several appointments and undergo various medical tests.
In our case, we were referred for blood tests and other assessments to evaluate our overall health.
Another significant change is that when we need to see a doctor, we can schedule appointments directly with our own family physician, and we are no longer randomly assigned to different doctors.
Referred to a Hospital by our Family doctor
Experience 1:
After we secured a family doctor, one of my test results showed abnormalities. As per standard protocol, our family doctor referred me to a specialist at a hospital.
Once the referral was made, I had to await a call from the hospital to schedule a new test. It took approximately two weeks to receive the call, and the hospital arranged the examination for the following week.
I underwent the test, and the hospital scheduled a call a month later to discuss the results. However, that call didn't come, and when I inquired, they stated that I hadn't responded to the call. As a result, they rescheduled it for two months later due to the doctor's vacation.
I have to admit not getting immediate results was a bit stressful. In my home country, we usually receive our test results quickly and visit a doctor. But here, things work differently, mainly through phone communications.
Ultimately, after three months from the initial test to receiving the final results, I received a call confirming that everything was okay. What a relief that was!
Experience 2:
More recently, Aldo injured his knee while playing soccer (again). The doctor referred him, mentioning that it might take up to two months to receive a call.
This situation is a bit challenging because there isn't another system to request a consultation. So, for now, we're simply in a waiting game, and we'll see how it goes.
As you can see, every healthcare experience depends on your specific case. We're generally healthy individuals without children, and even though we have some pre-existing conditions (like my asthma and hypothyroidism), we haven't had any issues when refilling our medications or getting appointments at our nearby walk-in clinic. But for more unusual cases, it's clear that you might feel a bit less in control when you're referred.
7. Final tips
I understand that this can be a stressful topic, especially if you're moving to Canada with children. So, if you're planning to make the move soon, here's what I'd suggest:
Research the province you've chosen to live in and its healthcare system. You can use this link to find a list of provinces and their health card information.
If you or your family have any pre-existing medical conditions that require attention, consider bringing a stock of necessary medications. I've discussed this more in my post 40 Things to Do Before Moving to Canada. It can be beneficial while you're figuring out how the healthcare system works.
Consider having private health insurance to protect yourself and your family from the moment you arrive until you obtain the local health card.
Some of my friends have chosen to keep their health coverage from their home countries. It's worth exploring if this would make you feel more secure if needed.
Unfortunately, patience is key here. While our experience has been okay, everyone's journey is unique and depends on their specific circumstances.
Personally, I've noticed that the healthcare system in Canada tends to be more reactive than focused on prevention. So, I'd recommend doing your best to keep you and your family as healthy as possible to avoid dealing with the system more than necessary.
I hope this post sheds some light on how the system works, whether you have a health card or not. It's crucial to take precautions and evaluate how important this is for you.
Remember that every process is unique, so while reading as many testimonials as possible can be helpful, your personal experience will truly show you how the system works best for you and whether you can manage it effectively, especially in challenging situations.