Canada has many positive things in common with other developed countries. One of them is its comprehensive healthcare system. Because of its demographics, the Canadian government invests a large sum of its financial resources on health care. Also, to “entice” immigration, the government advertises this fact to many other countries.
Everyone knows that in Canada, there is no need to worry about the occasional flu or stomach cramp. These along with other conditions are included in many provincial health care schemes. But, a question in the mind of any immigrant is about dental coverage.
Figuratively speaking, people fight “tooth and nail” to make it to the Great White North. Some provinces take care of the nails with free podiatry. What about the teeth, then?
Do Immigrants Get Free Healthcare in Canada?
Health care in Canada publicly-funded. Provincial and territorial health care plans take care of 70% of healthcare needs and expenditures of Canadians. But, this benefit is not just for Canadians.
Canadian healthcare is also universal. This means that it covers all people. Citizens. Permanent residents. And even temporary residents. Canadian universal health care is provincial. Provinces and territories are responsible for health care delivery.
Universal health care plans cover a number of health care needs. The coverage includes laboratory procedures like blood work and x-rays. It also includes podiatry, mental health, emergency care, and preventive health services.
Needless to say, there are differences in some provinces. For instance, while podiatry services are present in Manitoba, the Northwest Territories do not cover these services. Also, in some provinces, a physician’s services in-clinic are covered. Yet, in Yukon, coverage extends to doctor’s services regardless of location.
In short, immigrants are eligible to receive free healthcare from the government.
Are Refugees Eligible for Healthcare Coverage?
As mentioned earlier, immigrants could receive health care coverage. But, what about refugees? Do they not count as immigrants?
Let us be clear.
All people who come to Canada to live are technically immigrants. But, what makes refugees different is their circumstances and intentions for leaving their home countries. So, refugees belong to a different class of immigrants in Canada. The reason for this is based on their difference from the average immigrant.
When we think of immigrants, the most common image that comes to mind is the economic immigrant. This is a foreign-born person who comes to Canada to work. Given the demographic a typical economic immigrant’s profile, the following conditions are likely true:
- They flew to Canada.
- They have enough income to sustain themselves.
- They freely chose to make the move to Canada.
In contrast, the assumption about the conditions and circumstances of refugees are the following:
- They made it to Canada on foot or by boat
- They have little to no funds at their disposal
- They traveled to flee oppression and persecution (not necessarily by choice)
These conditions make them different from immigrants. And, for this reason, the Canadian government identifies them as a “vulnerable” population. They belong to a population that needs a different level of protection.
Interim Federal Health Care Program
Upon arrival, refugees are not residents of any province in Canada. So, they cannot receive health care coverage from any provincial or territorial agency or office.
However, refugees and asylum-seekers may receive health care under the Interim Federal Health Care Programme or IFCP. In 1957, the Canadian parliament introduced this program in response to the number of refugees being taken in by the country. The program was an effort to ensure the highest attainable standards of health for refugees.
The Interim Federal Health Care Program covers in-patient and ambulatory care of refugees. It also covers the services of health care professionals. Diagnostic procedures are also part of the program’s coverage.
In addition to these, the program also covers the costs of allied health services, medical equipment, and medication prescriptions. For those admitted into Canada, the costs for the Canadian immigration medical examinations are also covered.
Canada is very particular about its public health. For this reason, the Interim Federal Health Programme also includes vaccinations for immigrants and treatment before admission or deportation.
What Health Benefits Do Newcomers to Canada Get?
New residents or immigrants get limited coverage from provincial or territorial health insurance. In some provinces, new migrants would be able to apply for health insurance immediately and be entitled to coverage. In other provinces, they will not be able to. In these cases, there is a waiting time of up to three months before accessing the province’s health services.
With no coverage during this time, newcomers to Canada may want to consider buying health insurance from a private insurance company to accommodate their needs during this time. Doing this might not be excessive. Canadian Medicare does not cover certain services. Thus, new permanent residents could use private insurance for those.
The degree of provincial coverage and how soon new residents are eligible for full coverage differ between provinces.
In some provinces, new permanent residents are eligible to receive immediate full health coverage as soon as they arrive. The following provinces provide immediate health insurance to new permanent residents:
3. New Brunswick
4. Nova Scotia
5. Prince Edward Island
6. Newfoundland and Labrador
On the other hand, in some provinces, there is a waiting time. Often, the waiting time is about 3 months from the day of registration under provincial or territorial health care. These provinces are:
Besides waiting time, there are also differences in the services covered.
Nonetheless, provincial or territorial health insurance does not provide coverage for all services. This is a fact for all provinces and territories. Whether it is for permanent residents or newcomers.
So, a pretty safe step to take is to purchase additional health insurance for services that may not be covered. This way, more health care needs could be covered. And, you do not need to pay for many services.
Is Dental Care Part of the Health Care Coverage in Canada?
As mentioned earlier, healthcare is provided by provinces or territories to immigrants. For refugees and asylum-seekers, the IFHCP shoulders this responsibility. So, is dental care also subsidized by the Canadian government?
Let us begin with immigrants (not refugees). For newcomers, health insurance will not cover oral health in any province. Again, notwithstanding waiting times for eligibility, most provinces just do not provide extensive coverage for oral health needs.
This is the case even for permanent residents and citizens. Hence, private health insurance is usually the solution to this problem.
Though, some provinces pay for some of the costs of dental care. But, again, the keyword here is “some” and not “most”. Dental care is not provided by the health insurance of the provinces. These provinces are:
- British Columbia
- Newfoundland and Labrador
- Nova Scotia
These provinces do offer permanent residents and newcomers some dental care. But, often, these are very limited. In Saskatchewan, provincial health insurance covers only major procedures done in a hospital setting. But, people need to pay for routine dental procedures and examinations.
What about refugees. Dental care is part of the Interim Federal Health Programme’s supplemental coverage. But, even here, there are restrictions. Based on the provisions of the program, dental care is limited to urgent cases only.
In other words, a refugee would only receive oral health services under the program for dental emergencies.
What are considered dental emergencies?
The Ontario Dental Association identifies four different conditions as dental emergencies. These would qualify patients to receive urgent dental care.
Severe Dental Pain
Toothaches occur regularly. But, the Ontario Dental Association describes severe dental pain as an “unmanageable” toothache. An unmanageable toothache cannot be addressed by over-the-counter pain medications.
This is a medical emergency because it is a sign that nerves and blood vessels have a problem.
Any break, tear, or opening along the gums requires immediate treatment. Trauma makes a patient vulnerable to infection.
Signs of Infection
These include abscesses, cysts, boils, or any abnormal swelling in any part of the mouth or oral cavity. Infections could lead to sepsis, which is life-threatening. For this reason, infection is an emergency for dentists. And, this requires urgent dental care.
In other words, this is uncontrollable bleeding. This occurs due to any of the emergencies mentioned earlier. This could be a sign of trauma or infection.
Also, bleeding anywhere in the mouth means that there is an open wound somewhere in the gums. This could lead to infection.
Reasons Behind the Lack of Dental Coverage for Immigrants and Refugees
Despite a well-developed health care system, Canada shocks many people in its limited dental care subsidy. This tends to baffle many people.
In 2013, a paper by the Network for Canadian Oral Health Research pointed out some reasons for the exclusion of dental care from Canada’s health insurance system.
The first reason is history. During the early 1960s, the Royal Commission on Health Services observed the prevalence of dental disease across the Canadian population. Simply put, most Canadian citizens at the time had tooth decay, gingivitis, and other dental problems. This was during a time when there were many debates on public health.
In particular, debates were about the government’s responsibility for the health of the public. The Commission’s stance on this affected the government’s spending on dental care. To the Royal Commission on Health Services, dental health was an individual’s responsibility. So, from this period on, dental care was something an individual had to pay for.
The Shortage of Dentists
The 1960s was also the time of a (dental) manpower shortage. There were not enough dentists in Canada during that time. The number of dentists was not enough to cater to the increasing demand for dental care. The existing number would be exhausted further with public funding and delivery of dental care.
To prevent this, many dentists did not support public dental care. Having to pay for dental care would make the demand manageable for the dental profession.
Another reason was economics. With many Canadians with dental problems, the demand for publicly-funded dental care increased. But, the Canadian government saw a problem with this.
Government spending on dental care would also rise. When this happens, funds for other projects and health programs would decrease.
There was a socio-cultural reason for the exclusion. The public’s exposure to print media created a desire for clean and straight teeth. This would further increase the demand for dental care.
Many workplaces were quick to recognize this demand. So, many workplaces began giving dental care insurance as part of a non-wage benefit for their employees. Seeing this, the government saw no need to subsidize dental care.
Response to The Prevalence of Dental Problems
Lastly, another reason was the response of the Canadian government. With dental problems at an all-time high in the 60s, the Canadian health authorities needed widespread and economic ways to address the problem. The health authorities promoted health maintaining behaviors in schools and the media. These included brushing one’s teeth and flossing.
But, there was one more step taken. This was fluoridation. Fluoridation is the introduction of fluoride into the water supply. Fluoride is a substance that strengthens teeth.
With these solutions, the government witnessed a decrease in dental caries. So how does this lead to the exclusion of dental care?
Because of its effectiveness, fluoridation would become the government’s long-term solution. And, with the data, the Canadian government no longer saw the importance of publicly funded dental care.
So, could immigrants and refugees receive free dental care from the Canadian government?
With some restrictions and conditions aside, the straightforward answer to this question is “No”. This is why health insurance for additional coverage is still the solution for Canadian dental needs.
And, as with many things in Canada, the reasons for the exclusion of dental care are historical.