Gaps in health care coverage when moving between provinces
The Personal Health Navigator is available to all Canadian patients. Questions about your doctor, hospital or how to navigate the health care system can be sent to AskPaul@Sunnybrook.ca
The question: I am planning to move to Ontario from British Columbia. I looked at the website for the health branch of the Ontario government and discovered I will have to wait about three months before I am eligible to receive health coverage from Ontario. Why is that? I am a Canadian citizen. Shouldn’t I be entitled to immediate medical benefits in my new home province?
The answer: You are correct – there is a three-month delay before your Ontario health coverage takes effect. But that doesn’t mean you will be without public health insurance. BC will continue to pay your basic medical bills during the transition period.
If you need to visit a hospital emergency department during your first few months in Ontario, you won’t have to pay out of pocket. The hospital will ask you to sign some paperwork, stating that you are now an Ontario resident. In turn, the Ontario Ministry of Health will use this documentation to seek reimbursement for your medical expenses from BC.
A similar arrangement exists between all the provinces and territories. In 1991, the provincial and territorial governments agreed to a common policy to deal with migration within Canada.
When Canadians move from one part of the country to another, they have to wait roughly three months before they can get a health card in their new home province. In the meantime, their former province is largely responsible their medical bills.
This agreement provides for continuity of care. “No matter what province you are in, you are entitled to health insurance,” said Maggie Epp, manager of patient accounts at Sunnybrook Health Sciences Centre. “I have never seen a situation where someone falls between the cracks and isn’t covered anywhere.”
Even so, it won’t be a seamless move in terms of your coverage. While basic medical care is covered, some of the “extras” may disappear once you’re outward bound. BC won’t pick up the tab for an out-of-province ambulance ride. The BC Ministry of Health website even advises people leaving the province to “buy additional private health insurance to supplement your basic coverage.”
There are a few exceptions to the three-month wait. Among them, most provinces waive this policy for families of Canadian Armed Forces members.
But, you might wonder, why is there a lag for the rest of us? As you asked in your question, why doesn’t your new home province start paying your medical bills immediately?
The truth of the matter is that not all provinces pay for the same list of medical services and health-related benefits. For instance, BC has a fairly comprehensive drug benefit program that covers the cost of cancer medications – regardless of whether the patient gets the drug intravenously in a hospital or pops a pill at home. In contrast, Ontario covers only the cancer drugs administered in a hospital medical clinic.
If a waiting period did not exist, Canadians could theoretically visit another province that offered more generous health benefits when they needed them, and then head back home – which would essentially be a form of “medical tourism.”
The provinces have a vested interest in making sure newcomers plan to stay before they are permitted to make use of the local health services.
But some health policy analysts and media commentators see it differently. For them, the waiting period highlights certain disparities within Canadian health care. “We should be drawing attention to variations in care at every opportunity, and demanding they be fixed,” André Picard, The Globe and Mail’s public health reporter, wrote in a recent column.
So now, let’s get back to your question. You can rest assured that your basic medical coverage will continue without interruption when you move to Ontario. But bear in mind that you will be leaving behind a generous drug benefit plan in BC.
Paul Taylor is Sunnybrook’s Patient Navigation Advisor. His column Personal Health Navigator provides advice and answers questions from patients and their families, relying heavily on medical and health experts. His blog is reprinted on healthydebate.ca with the kind permission of Sunnybrook Health Sciences Centre. Email your questions to AskPaul@sunnybrook.ca