Health Insurance in Canada: A Comprehensive Guide to Coverage and Considerations For Employers & Their Foreign Workers
Navigating the healthcare system in Canada can be a complex task, especially for employers and their foreign workers. Understanding how the Canadian healthcare system works and the coverage it provides is essential for both employers and employees. In this comprehensive guide, we will explore the basics of Canada's healthcare system, the eligibility criteria, and the coverage provided by the national health insurance plan. We will also dive into the need for private health insurance, particularly for foreign workers after the 90 day waiting period, and the considerations employers should make when deciding whether it's worth investing in private healthcare coverage for their foreign workers.
How does Canada’s healthcare system work?
Canada's healthcare system operates under the Canada Health Act (CHA), which establishes a publicly funded approach to healthcare. The CHA sets out five essential principles that all provincial and territorial health insurance plans in Canada must adhere to in order to receive full federal funding. Read about these 5 principles below.
The CHA’s 5 Essential Principles
Universality: Healthcare coverage is provided to all Canadian residents, regardless of their income or employment status. Access to medically necessary services is based on need, not the ability to pay.
Comprehensiveness: The healthcare system aims to cover a wide range of medically necessary services, including hospital care, physician visits, and diagnostic tests. However, specific services covered may vary across provinces and territories.
Accessibility: The healthcare system ensures reasonable access to healthcare services without financial or geographic barriers. Canadians should not face significant out-of-pocket expenses for medically necessary treatments.
Portability: Canadian residents have the right to access healthcare services across different provinces and territories. If a resident moves to a different region, their healthcare coverage should be maintained.
Public administration: Healthcare services are primarily administered by the 13 provinces and territories in Canada. Each province or territory has its own health insurance plan and receives federal funding on a per-capita basis.
Provinces and territories have flexibility in how they fund their health insurance plans. They can utilize various sources, including provincial/territorial revenues, payroll and sales taxes, or a combination of these methods. While some provinces and territories may charge health insurance premiums, it is crucial that residents are not denied coverage for medically necessary treatments and services due to their inability to afford premium payments. Provinces and territories that levy premiums must offer income-based financial assistance to ensure that low-income individuals and families can have their premiums reduced or waived.
Are my Foreign Workers eligible for Access to Canada’s Health Insurance?
Generally, to access Canada's national health insurance program, you must be a resident of a province or territory. According to the Canada Health Act (CHA), a resident is someone who is legally entitled to be in Canada, lives there, and is regularly present in a province. However, foreign workers in Canada may have access to the national healthcare system as well, even if they’re not considered residents. The eligibility for healthcare coverage depends on the specific regulations and agreements in place between the Canadian government and the worker's home country.
Canada has reciprocal healthcare agreements with some countries such as Mexico, Argentina, the Philippines, etc., that allow their citizens to access certain healthcare services while in Canada. These agreements typically cover emergency medical care and essential healthcare needs during the worker's stay and provide these foreign workers with access to Canada's national healthcare. It's important to note that the extent of coverage and specific services provided may vary depending on the reciprocal agreement and the worker's home country. It is advisable for foreign workers to check with their country's embassy or consulate in Canada to understand the healthcare coverage available to them.
National vs Private Health Insurance For my Foreign Workers: Which Option Is Worth It?
Foreign workers in Canada have the option to obtain private health insurance coverage in addition to any reciprocal agreements. It is a common misconception among employers that the national healthcare provided by Canada is sufficient to cover all the healthcare needs of their foreign workers, but that is not the case.
Canada's universal healthcare coverage includes essential healthcare services such as diagnostics, regular doctor visits, hospital stays with standard accommodations, surgeries, medically necessary dental surgeries, and eye examinations for certain age groups.
However, each province and territory in Canada has its own rules regarding health insurance coverage, and certain services are typically not covered under the national healthcare system. These services often require private coverage, including ambulance and emergency medical services, massage therapy, medical equipment, outpatient prescription medications, physiotherapy, private hospital room stays, prescription eyeglasses, psychological services, prescription drugs, comprehensive dental treatments, coverage for income replacement, and catastrophic death.
Many Canadians find that their healthcare needs go beyond what the national healthcare system covers, leading approximately 90% of Canadians to pay out of pocket for private healthcare. Similarly, foreign workers, particularly those in higher-risk jobs, may require additional coverage for income replacement and catastrophic death.
It is crucial for both employers and foreign workers to understand the differences between national and private healthcare coverage. After a 90-day waiting period, foreign workers become eligible for Canada's national healthcare system. However, during this waiting period, employers are responsible for providing health coverage that exceeds what the national healthcare system offers. Employers and foreign workers should be aware of the distinctions between national and private coverage, as employers might mistakenly stop paying for private health insurance after the waiting period, assuming that the national coverage is sufficient.
Looking to provide your foreign workers with the necessary healthcare coverage?
Click through the video below to learn about the FWCHP.
Conclusion
Understanding Canada's healthcare system and the coverage it provides is crucial for employers and foreign workers. Navigating the complexities of healthcare in Canada involves considering both the national healthcare system and the option of private health insurance. Foreign workers in Canada may be eligible for access to the national healthcare system but must realize it only covers essential services, certain treatments and services require private health insurance. Employers should be aware that national healthcare coverage may not be sufficient to meet all the healthcare needs of their foreign workers, especially those in high-risk jobs. Especially workers looking for coverage for income replacement and catastrophic situations. Employers and foreign workers should not assume that national coverage alone is enough after the waiting period. And that they should be knowledgeable about the inclusions and exclusions of national and private healthcare coverage. By gaining a comprehensive understanding of the Canadian healthcare system and considering the needs of their foreign workers, employers can make informed decisions about providing adequate healthcare coverage during their workers' stays in Canada.
