Policy responses for Canada - HSRM


Policy responses for Canada

4.2 Entitlement and coverage

Health coverage is under the purview of each of the 13 provincial and territorial (PT) governments; thus, each has its own application process and list of insured services for its universal health coverage program. Generally, non-residents and newcomers to Canada are not covered until they have resided in the country for a minimum of three months, at which point they can apply for coverage through their PT health insurance program (Canada, 2009). Notably, certain refugee newcomers are provided health insurance through the federal government immediately upon arrival to Canada (ibid). Residents moving from one Canadian jurisdiction to another PT are covered for this three-month wait period by the originating PT government (ibid).

Some provinces have waived the wait period for new residents moving to Canada from other countries in response to the COVID-19 pandemic (Canada, 2009). For example, on March 20, 2020, the Government of Ontario waived its three-month wait period for newcomers and extended coverage for COVID-19 screening, testing, and treatment to individuals who do not qualify for provincial coverage to better control the spread of COVID-19 (Ministry of Health, 2020b).  In British Columbia (BC),  COVID-19 testing is provided free of charge for all who need it, whether or not they are BC residents; treatment still requires individuals to have a BC health insurance card (Ministry of Health, 2020c). The usual coverage wait period (i.e., three months) has also been waived for those arriving from a COVID-19 affected area who intend to stay in BC (Ministry of Health, 2020c).

While most out-of-hospital mental health services are generally not covered by provincial health insurance plans, the Government of Canada released a mental wellness portal designed to support individuals who are facing mental health challenges as a result of the pandemic on April 15, 2020. This website, “Wellness Together Canada”, features free modules for mental health education and connects Canadians to counsellors and psychologists (Health Canada, 2020b). Other national services have reported increased demands over the pandemic and have called on the federal government for additional financial supports. For example, on April 27, Crisis Services Canada, which operates the country’s only national suicide prevention hotline, reported receiving a 30-50% increase in calls since the pandemic began, as well as a decline in volunteer and donor supports; thus, the service requested additional funding from the federal government to meet the increased demand and ensure the organization would not need to close any of its distress centres during the pandemic (Wright, 2020a).

Temporary changes have been made to the health coverage program for eligible First Nations and Inuit for services not included in the PT universal health coverage programs (e.g., dental care, prescription drugs, vision care) – the Non-Insured Health Benefits (NIHB) program (Canada, 2019). In March 2020, Indigenous Services Canada (ISC) published their first COVID-19 pandemic update on the NIHB communicating that services may be delayed due to the pandemic, and described temporary changes to expedite access to services (e.g., removing needs for prior approvals for certain prescription medications). Since then, 3 subsequent COVID-19 related updates have been released, two in April and one in May 2020 (Canada, 2020ba). In the second COVID-19 pandemic update (April 2020), the ISC acknowledged delays in renewing status cards but noted that an expired status card should not lead to a denial of health services for eligible NIHB clients. The third update (April 2020) announced the postponement of non-emergency dental services, and temporary coverage for virtual dental consultations to assess need for emergency care (Canada, 2020ba). The NIHB extended health benefits coverage of unregistered infants from 18 months to 24 months, due to possible delays in registering an infant for First Nations status (Canada, 2020ba). The fourth update (May 2020) described the resumption of some health care services, and some additional funds available for sanitation (Canada, 2020ba).

ISC has announced that they will continue to support First Nations children through the ISC First Nations Child and Family Services for those who reach the age of majority during the COVID-19 pandemic for at least 6 months or for the duration of the outbreak (Canada, n.d.).

Specific provincial and territorial measures are reported by the North American Observatory on Health Systems and Policies on their dedicated COVID-19 page (https://ihpme.utoronto.ca/research/research-centres-initiatives/nao/covid19/).

See full reference list under ‘Key links and articles: Full list of references’.