About Canada's health care system

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How the health care system works

Canada has a universal health care system funded through taxes. This means that eligible residents of a province or territory can apply for public health insurance to access publicly funded health care services.

If you're an eligible resident, you may access these services through your provincial or territorial government's health insurance plan. Each province and territory decides who qualifies as a resident to receive coverage under their health insurance plan.

While each province and territory has its own health insurance plan, they all provide basic standards of coverage for insured health services. These include medically necessary hospital, physician and some surgical-dental services.

It's up to the provinces and territories to determine which services they consider are medically necessary and will cover.

The roles and responsibilities for health care services are shared between the federal government and the provincial and territorial governments.

The provinces and territories are responsible for delivering health care services, which includes regulating health care providers such as doctors and nurses. If you have a complaint about a doctor, you should contact your province or territory's:

About the services that are provided

The publicly funded health care system provides coverage for primary health care services, from diagnosis to recovery. These services include first-contact services provided by a physician or other health providers such as a nurse practitioner.

The health care system also covers medically necessary services provided in hospitals.

Learn more:

The provinces and territories also provide additional coverage to certain population groups, such as:

  • seniors
  • children
  • people who receive social assistance

This additional coverage helps pay for health care services that are not fully covered by the publicly funded health care system. Services include:

  • home care
  • vision care
  • dental care
  • prescription drugs
  • ambulance services

People who don't qualify for additional benefits under government plans pay for these services:

  • on their own or
  • through their own private health insurance plans

Health care services that are not insured under a provincial or territorial plan include:

  • cosmetic services
  • private duty nursing services
  • testimony by a physician in court
  • medical certificates for work, school or insurance purposes
  • preferred hospital accommodation unless prescribed by a physician

Canada's role in the health care system

At the federal level, the Government of Canada:

  1. sets and administers national standards for health care
  2. helps fund health care
  3. delivers health care services to specific groups
  4. provides other health-related supports

1. National standards

We set national standards described in the Canada Health Act for provincial and territorial health insurance plans. The provinces and territories must meet these standards to receive their full payment under the Canada Health Transfer.

The standards are:

  • public administration
    • assign a public authority to administer and operate the services on a non-profit basis
  • universality
    • provide coverage for all residents
  • portability
    • provide coverage for residents when they travel within Canada
    • provide limited coverage for travel outside Canada
    • provide coverage for residents who move to another province or territory for up to 3 months until they can register for coverage under the new plan
  • accessibility
    • give all residents reasonable access to medically necessary services
    • give access based on medical need and not on the ability to pay
  • comprehensiveness
  • insure medically necessary services provided by hospitals, doctors and dentists (when dental service must be performed in a hospital)
  • cover the full cost of medically necessary services

2. Health care funding

We give funds to the provinces and territories in 2 ways:

  • direct health care funding through the Canada Health Transfer
  • additional funding through other fiscal transfers

Learn more:

3. Health care services to specific groups

We provide certain health care services to:

  • eligible veterans
  • refugee claimants
  • inmates in federal penitentiaries
  • active members of the Canadian Forces
  • Inuit and First Nations people living on reserves

Learn more about health care services for these groups:

4. Other health-related supports

We support:

  • health research
  • health promotion and protection
  • disease monitoring and prevention

We give tax support for health-related costs, such as:

  • tax credits for:
    • disability
    • medical expenses
    • caregivers and disabled dependents
  • tax rebates to public institutions for health services
  • deductions for private health insurance premiums for people who are self-employed

We also regulate a wide range of products, such as:

  • food
  • cosmetics
  • chemicals
  • pesticides
  • medical devices
  • pharmaceuticals
  • consumer products
  • devices that emit radiation (for example, cellphones)

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