IRCC Minister Transition Binder 2025-05
Migration Health
Context
Immigration, Refugees and Citizenship Canada (IRCC) protects the health and safety of Canadians, facilitates the arrival and integration of newcomers, and supports Canada’s humanitarian tradition of protecting refugees and others in need of protection by delivering the Health Screening Program and Interim Federal Health Program.
Health Screening Program
Immigration Medical Exams
- Immigration Medical Exams (IMEs) are the cornerstone of IRCC’s health screening process. The exams protect the public health of Canadians by preventing the importation and spread of certain infectious diseases, including pulmonary tuberculosis (TB) and syphilis. A standard IME involves reviewing medical history, conducting a health exam, performing lab tests for certain communicable diseases, and taking x-rays to check for active pulmonary TB.
- The Immigration and Refugee Protection Regulations (IRPR) stipulates that IMEs are required for foreign nationals who:
- apply for permanent residence;
- plan to work in healthcare or with children;
- have resided in a country with a high rate of TB for at least six consecutive months within the last year and plan to visit Canada for more than six months; or
- reside in a country with a high rate of TB and plan to work in agriculture.
- A streamlined IME is a lighter-touch exam primarily used when urgent processing is required, potentially in response to a humanitarian crisis. It consists of five medical history questions and a chest x-ray to screen for TB.
- All applicants (except refugees and asylum claimants) pay for their own IMEs.
Medical Inadmissibility
- IRCC assesses the results of IMEs to rule out medical inadmissibility on three health grounds under section 38 of IRPA:
- Danger to Public Health includes active TB and untreated syphilis. Until the applicant has completed sufficient treatment and follow-ups for these conditions, the client’s application will be put on hold. Foreign nationals who are non-compliant with treatment are found inadmissible. After TB treatment, clients are referred to provincial and territorial public health authorities for health monitoring or medical surveillance upon their arrival to Canada;
- Danger to Public Safety includes conditions such as severe mental health disorders (e.g., an untreated psychotic disorder with a history of violence); and
- Excessive Demand on Health or Social Services includes situations where an applicant’s health condition(s) would exceed three times the annual average Canadian per capita cost for health or social services over five years or impact wait lists in Canada for certain procedures or services.
Health Screening Delivery
- IRCC’s Regional Medical Offices (RMOs) are responsible for delivering the Health Screening Program and supporting the administration of the Interim Federal Health Program’s pre-departure medical services. These activities include:
- Managing a network of close to 3,000 Panel Members (physicians and radiologists) in 170 countries who perform IMEs in Canada and abroad;
- Assessing IME results and providing medical admissibility assessments as part of the immigration decision process;
- Liaising with regional stakeholders, including the International Organization for Migration (IOM) and local health authorities, and helping to facilitate urgent and special movements; and
- Assessing local and regional trends in disease outbreaks and other migration health issues.
- IRCC works closely with the Public Health Agency of Canada (PHAC) and provinces and territories (PTs) on activities relevant to IRCC’s health screening.
- IRCC closely engages PHAC on migration health policy and supports PHAC’s TB Elimination Strategy.
- IRCC contributes migration health content to PHAC’s annual reporting to the World Health Organization and Pan-American Health Organization.
- The medical surveillance program alerts PT health authorities of clients with treated or inactive TB; these clients are required to report to PT health authorities.
Global Panel Member Network
- Panel physicians and panel radiologists are third-party medical professionals who perform IMEs; they submit the majority of IMEs to IRCC electronically.
- IRCC performs regular quality assurance activities of its Global Panel Member Network through its four RMOs (Ottawa, London, New Delhi, and Manila).
Interim Federal Health Program
Overview
- In support of Canada’s humanitarian and settlement objectives, IRCC administers the Interim Federal Health Program (IFHP), which funds the provision of urgent and essential medical care for some of Canada’s most vulnerable migrant groups. The IFHP enables equitable access to health care systems, protects public health and safety, and promotes the long-term integration, inclusion, and full participation of migrants into Canadian society.
- The IFHP covers the cost of care for certain migrant groups during their period of ineligibility for publicly-funded health services. Eligible beneficiaries include resettled refugees, refugee claimants (i.e., pending and failed asylum claimants), protected persons in Canada, victims of human trafficking and domestic violence, immigration detainees under Canada Border Services Agency care and custody, and other federally identified groups granted coverage by the Minister on a discretionary basis, such as humanitarian movements and complementary pathways. The IFHP bridges the gap in health coverage until these beneficiaries are eligible for provincial or territorial health insurance.
- The Minister has discretion to cover health care costs for uninsured foreign nationals and humanitarian groups who normally do not qualify for the IFHP, if they are in a refugee-like situation and facing urgent medical and compelling personal circumstances. This is done either on an individual or group basis.
- Within Canada, the IFHP provides coverage of:
- basic benefits (hospital and physician services, aligned with provincial/territorial healthcare insurance),
- limited supplemental benefits (prescription medication, mental health counselling, assistive devices, urgent dental care and vision care, similar to extended health benefits provided by provinces/territories to social assistance recipients); and IMEs.
- Outside of Canada, the IFHP covers the cost of pre-departure medical services for resettled refugees and other eligible humanitarian groups destined for Canada, including IMEs, treatment for health conditions rendering refugees inadmissible on public health grounds (e.g., active TB), routine vaccinations, outbreak management services (e.g., measures to control disease outbreaks, such as COVID-19, Ebola, Polio, etc.), and medical support in-transit to facilitate safe and timely resettlement to Canada.
- Cost are covered via a third-party claims administrator, Medavie Blue Cross, which is responsible for registering health care providers and processing medical claims. IFHP operates separately from provincial and territorial medical coverage.
- The IFHP’s client base has risen from 90,328 in 2015-2016 to a reported 623,365 beneficiaries in 2024-2025; two thirds of IFHP beneficiaries are asylum claimants.