Health & Wellness

Province-to-Province Health Coverage

A recent addition to the pages of Good Times magazine is “Your Health Questions,” in which we find experts to answer questions submitted by our readers about health, nutrition, and well-being.

By Wendy Haaf


When a senior moves to a new province and develops a serious illness (such as cancer), does the new province pay for treatment or does the province where he or she has paid taxes all his or her life pay? I’ve heard that neither province wants to pay.

In most provinces, there’s a waiting period of about three months before you’re eligible for health coverage. This rule is meant to prevent Canadians moving temporarily to obtain a service that isn’t paid for in their home province to a province where it’s covered. But that doesn’t necessarily mean you have to pay out of pocket for any care you receive during that time. Through a process called reciprocal billing, the public plan in your former province will pick up the tab for certain basics, such as medically necessary doctor care and acute-care hospital visits.

However, there are gaps. The biggest gap is that this arrangement doesn’t apply to home and palliative care, so (with the exception of Ontario—see below) these services aren’t covered at all until two to three months after you’ve relocated to a new province. And again, not all provinces pay for the same list of medical services and health benefits. For example, while some public plans pick up the tab both for some chemotherapy drugs that are taken at home and for those given in hospital clinics, other provinces pay only for the latter. That means if you moved from, say, Ontario to British Columbia and needed oral cancer medications during the waiting period, you could be on the hook for the cost.

“You have to inquire what your previous province will pay for,” says Brenda Legris-Gainfort of Guelph, ON. Lifelong Ontario residents who moved to British Columbia for work, she and her husband returned to their original home province to be near family when he was released from hospital three months after having had a major stroke, still needing out-of-hospital physiotherapy and ambulance transportation.

If you don’t have extended health benefits through an employer, consider purchasing a private plan. If you are covered through an employer, it’s worth checking with the company before using a particular service to ensure that the service is covered—and ask about any cost limits, or you may get stuck with a bill for, say, a $2,000 out-of-province ambulance ride.

Back to the subject of home and palliative care: in spring 2018, residents of Ontario received news that may herald similar changes across the country. Thanks to the advocacy efforts of the Duma family in Windsor, ON, their MPP, and a palliative-care physician, Ontario recently became the first province to remove the waiting period for palliative and home care for people moving or returning there. This means admission to an acute-care bed (at a cost of roughly $1,000 a day) is no longer the only covered option for patients like the late Dan Duma, who returned to Windsor from Alberta to be with family after being diagnosed with terminal cancer.

“It’s a win for patients, it’s a win for government, and it’s a win for the system,” says Dr. Darren Cargill, the medical director of Hospice of Windsor and Essex County.

Now that Ontario has led the way, Cargill hopes that, with a nudge from voters, the rest of Canada will follow suit. “If you’ve ever experienced this gap, tell your MPP, ‘This happened to my dad, this happened to my friend, and this is why the rule should change,’” he suggests. “When a patient or family tells a story, people listen.”

Photo: iStock/AlexLMX.