Health care and coverage

The provincial health plan

Canada does not have a single national health plan. Each province runs its own insurance scheme under federal rules set by the Canada Health Act, which is why the card in your wallet has a different name depending on where you live. In Quebec the plan is the Régie de l’assurance maladie du Québec (RAMQ), and the card is the Carte d’assurance maladie.

What the plan covers, and what it does not

Provincial plans cover medically necessary hospital and physician care. They do not cover everything, and the gaps are consistent across the country:

• Prescription drugs — generally not covered outside hospital, except for specific groups such as seniors, people on social assistance and those with very high drug costs. Most working Canadians get coverage through an employer or buy it privately.
• Dental care, vision and hearing — not covered for adults in most provinces. A federal dental plan now covers some lower-income households.
• Ambulance transport — usually billed, often a few hundred dollars, and it varies by province and by municipality.
• Physiotherapy and mental health counselling — covered in hospital, but limited or private in the community.
• Out-of-country care — only a small fraction is reimbursed, far below real costs. Buy travel insurance before leaving Canada.

Using the nurse line properly

The nurse advice line is the most underused number in Canadian health care. Registered nurses assess symptoms by phone around the clock and tell you whether to go to an emergency department, wait for a clinic, or look after it at home. It is not a diagnosis service, and it is not for emergencies.

Free and confidential, 24 hours a day, 365 days a year, for anyone residing in Quebec. Dial 811 and choose option 1 for health, option 2 for psychosocial support, option 3 for a primary-care appointment. Not available in Nunavik and the Cree territory of James Bay.

Finding a family doctor

A large share of Canadians do not have a regular family doctor, and the shortage is worst in the fastest-growing provinces. Most provinces run a registry that puts you in a queue for a doctor taking patients. In the meantime, walk-in clinics and the nurse line cover most non-emergency needs, and hospital emergency departments should be kept for actual emergencies.