Medical Inadmissibility

You may be deemed medically inadmissible to Canada if an officer believes you to be a danger to public health, danger to public safety and excessive demand on health or social services. This process can affect anyone applying to visit, study, work or live in Canada but can be overcome if the applicant can prove they will not be a burden on the Canadian healthcare system.

There are three possible reasons for medical inadmissibility:

  1. danger to public health

  2. danger to public safety; and 

  3. excessive demand on health or social services.

If an officer believes you may be medically inadmissible, you will receive a letter explaining the reasons why. This is called a procedural fairness letter. This process can affect anyone applying to visit, study, work or live in Canada. 

Medical Inadmissibility and Excessive Demand

The most frequent cause of medical inadmissibility is excessive demand. Health services are defined as any health services in which the majority of funds are contributed by the Canadian government—for example, medical specialists, nurses, pharmaceuticals or hospital care. Social services can include home care, specialized residences, and personal support services. Examples of medical conditions that have previously resulted in a finding of medical inadmissibility are renal failure, Senile Dementia, Heart Disease, and Hepatitis.

Importantly, as of June 2018, the Government of Canada enacted a Temporary Public Policy which better defines health and social services and certain social services that are no longer counted towards determining medical inadmissibility. Specifically: 

  • Special education 

  • Social and vocational rehabilitation services 

  • Personal, non-professional support services, such as assistance with activities of daily living, meal preparation, and house cleaning 

The public policy also increased the threshold from the Canadian per capita average for health and social services by three times the average. As of January 2020, the cost threshold increased to $21,204 per year or $106,020 over five years. If your treatment exceeds this amount, you may receive a procedural fairness letter. This letter will be received before a final decision is made, and you will have the opportunity to submit information to overcome the officer’s concerns. 

Refugees and their dependents, protected persons and dependent children, spouses, and common-law partners being sponsored are exempt from the rules for excessive demand.

Medical Inadmissibility and Responding to Procedural Fairness Letter

In most cases, a procedural fairness letter will highlight the worst-case scenario. Applicants should not immediately assume they will be rejected if they have received this type of letter. If an applicant can show they will not be a burden on Canada’s publicly funded health and social services systems, they may not be inadmissible to Canada.

While Federal Court cases have established that an applicant’s promise to pay for treatment is not relevant when determining whether someone is medically inadmissible as there are no cost-recovery mechanisms in place, officers are required to consider the cost of outpatient medication, ability to opt-out of publicly funded drug plans, and private health insurance options. You may also provide evidence to show that your health condition is cured, stable or improved, or the cost or kind of medication and services used has changed. One of the main documents to support your response will be a ‘Declaration of Ability and Intent.’ This is a detailed and viable plan to support your medical condition if approved for permanent residence in Canada. 

Receiving an assessment of medical inadmissibility can be overwhelming, but with the right documentation and legal arguments, it can be overcome. It is essential to provide as much favourable evidence as possible.