How to Start in Canada

How to Start Getting Provincial Health Coverage as a Newcomer to Canada

Canada has no national health card. Each province runs its own plan, with its own wait period and document list. This guide covers Ontario, British Columbia, Alberta, and Quebec in detail, plus the check every other province requires before you travel.

Written October 30, 2026 · 18 min read

Applies in: across Canada

Canada has no national health card. Health insurance is provincial: the province where you live runs the plan, issues the card, and decides when your coverage starts. A permanent resident card, a work permit, or a study permit gets you into the federal immigration system, but it does not enroll you in a provincial plan. You have to register with the province, and in most provinces you have to wait before coverage starts. The waiting period is the whole point of this guide. Apply in your first week, know your province's wait, and bridge the gap deliberately, because care received before your coverage starts is care you pay for yourself.

This guide is an administrative process guide only. It does not give medical advice, and it does not tell you which doctor or treatment to choose. It tells you how to register, what documents each province asks for, and when coverage starts, on the provinces' own pages.

Step 1: Confirm the rule that governs you — province first, status second

Two questions decide everything, and the province question comes first. The same immigration status can mean immediate coverage in one province and a three-month wait in another, and a rule you read for Ontario does not transfer to British Columbia, Alberta, or Quebec. Within a province, your status decides whether you qualify at all: permanent residents and Canadian citizens settling in the province generally qualify; work and study permit holders qualify in defined cases, usually tied to a permit of six months or more; visitors and tourists do not qualify for the provincial plan in any province covered here.

One caution applies everywhere. British Columbia states that eligibility cannot be confirmed over the phone: Health Insurance BC determines eligibility only after you arrive and your application and immigration documents have been reviewed. Alberta states the same idea in its own terms: not all entry documents qualify, and the documents must be reviewed before a decision on eligibility can be made. Treat every eligibility statement in this guide as the province's published rule, and your own application as the decision.

Step 2: Ontario — no waiting period, in-person application, 153-day presence rules

Ontario's plan is the Ontario Health Insurance Plan (OHIP). The three-month waiting period for OHIP was removed from Regulation 552 in March 2020, and the province's registration guidance describes the removal as a measure to ensure residents had immediate coverage. That does not mean coverage is automatic. You must still apply, and you must still meet the presence rules: be physically in Ontario for 153 days in any 12-month period, be physically in Ontario for at least 153 days of the first 183 days immediately after you began living in the province, and make Ontario your primary residence.

On top of those minimum qualifications, you must meet at least one additional requirement. The list on Ontario's apply page includes Canadian citizenship, permanent residence, an application for permanent residence that Immigration, Refugees and Citizenship Canada has confirmed meets the eligibility requirements to apply and has not yet been denied, and a valid work permit with full-time work in Ontario for an Ontario employer for at least six months. If you meet the work-permit requirement, your spouse and dependants may also qualify. Convention refugees and other protected persons, clergy ministering full time in Ontario for at least six months, and certain Temporary Resident Permit holders are also listed. People granted an emergency authorization for humanitarian reasons, such as the Canada-Ukraine Authorization for Emergency Travel, may be eligible for the duration of the authorization, with no waiting period and no requirement to make Ontario their primary place of residence.

Apply in person at a ServiceOntario centre. People 16 years of age and older must register in person to provide a signature and have a photo taken. Bring a completed Registration for Ontario Health Insurance Coverage form and three separate documents: one original document proving Canadian citizenship or OHIP-eligible immigration status, one document proving residency in Ontario, and one original document proving identity. Photocopies are not accepted for the documents that must be originals. OHIP covers appointments with a family doctor, walk-in clinic visits, emergency room visits, and medical tests and surgeries, and you must have a medical reason to receive a service or treatment: cosmetic surgery, for example, is not covered. If you have been outside Ontario for more than 212 days in any 12-month period, you may have to reapply. Report any change in the information used to establish your entitlement within 30 days.

Step 3: British Columbia — the rest of the month plus two months, and apply on arrival

British Columbia's plan is the Medical Services Plan (MSP), and enrolment is mandatory for all British Columbia residents. New and returning residents must complete a wait period before coverage starts. The wait period is the rest of the month in which you become a resident of British Columbia, plus two more months. The Ministry of Health decides the date you become a resident for MSP purposes, and that date depends on factors including your immigration status. If you arrive as a tourist or visitor and your status later changes to one that qualifies, the wait period starts from that later date, not from your arrival date.

Apply as soon as you arrive. British Columbia's wait-period page says so directly, and adds not to wait until the end of the wait period, because applying early gives the province time to process the application. Apply through the B.C. Application for Health and Drug Coverage, online or on paper. That single application also covers Fair PharmaCare and Supplementary Benefits. To complete enrolment and receive a B.C. Services Card, most adults 18 years and six months of age and older must visit an ICBC driver licensing office with primary and secondary identification, declare British Columbia residency, and have a photo taken. Your Personal Health Number is printed on the card. Children and temporary document holders receive a non-photo card by mail and do not need to attend the ICBC office.

Who qualifies follows the resident definition: a Canadian citizen or a person lawfully admitted to Canada for permanent residence, who makes their home in British Columbia and is physically present in the province at least six months in a calendar year. Certain study and work permit holders whose permits are valid for six or more months may be deemed residents, and Working Holiday permits must include a letter of employment among the accepted identification documents. Tourists and visitors are not eligible. MSP pays for medically required services of physicians and surgeons, and dental or oral surgery performed in a hospital. During the wait period, keep your former province's plan if you moved within Canada. If you arrived from outside Canada, arrange private insurance before you arrive and keep it until MSP coverage starts: most private insurers do not cover pre-existing conditions, including pregnancy, and emergency care received before MSP starts must be paid for in full unless you have other insurance. Each family member has their own wait period, based on their own arrival date.

Step 4: Alberta — from outside Canada, coverage can start on the residency date

Alberta's plan is the Alberta Health Care Insurance Plan (AHCIP). The rule splits by where you came from, and the split matters. If you move, immigrate, or return to Alberta from outside Canada, you might be eligible for coverage from the date you established residency. You must apply within three months of establishing residency and provide all required documents; if the application is not received within three months, the effective date of coverage is determined when the application is processed. If you moved from another province or territory and intend to live in Alberta for 12 months or more, you must apply within three months of establishing residency, and coverage begins on the first day of the third month following the date you established residency. Alberta's own example: establish residency on July 12, and coverage is effective October 1. During that wait, continue using your previous province's health card.

Temporary residents from outside Canada may be eligible if they establish residency in Alberta, intend to live in Alberta for at least 12 consecutive months, and hold an acceptable Canada entry document with at least six months remaining until expiry. Acceptable documents include a work permit for an Alberta employer, a study permit for Alberta with a letter confirming full-time attendance, a visitor record indicating clergy or a spouse, partner, or dependant of an eligible resident, and designation as a Convention Refugee with a Notice of Decision. Refugee claimants waiting for a decision are not eligible for AHCIP and apply through the federal Interim Federal Health Program instead. Alberta also states that you will not be denied emergency medical care in Alberta even without medical insurance, and recommends private insurance until you are eligible.

Apply at a registry agent office. Complete the Application form for AHCIP Coverage, gather supporting documents proving Alberta residency, identity, and legal entitlement to be in and remain in Canada, and bring the completed form and original documents to a registry agent. There is no charge for the registry agent service, processing can take up to five days, and the paper card is mailed to your home. If the documents are not provided, the application cannot be processed. Show your personal health card, paper or mobile, along with photo identification when you access services. Military families are the exception to the waiting period: they are eligible from the date they establish residency, and should apply within three months of arriving.

Step 5: Quebec — up to three months, children exempt, and keep the waiting-period letter

Quebec's plan is administered by the Régie de l'assurance maladie du Québec (RAMQ). If you register for the Quebec Health Insurance Plan upon arrival from another country, your coverage starts after a waiting period of up to three months following your registration. The period applies even if you are a Canadian citizen, and it does not apply to children under age 18. The Régie does not reimburse health care received during the period before the eligibility start date, and it strongly recommends taking out private insurance as soon as you arrive in Quebec.

Registration starts with the Régie's registration form, which asks questions to find the procedure matching your situation. The current processing time stated on the registration page is 60 working days, and in some cases no acknowledgement of receipt is sent, so file early and keep the confirmation. After processing, you receive a letter confirming whether you are eligible and the date from which you can benefit. Keep that letter until you receive your Health Insurance Card: on presentation of the letter, certain necessary services are available free of charge during the waiting period. To remain eligible, you must not be absent from Quebec 183 days or more in a given year, although the rule differs for new immigrants, temporary workers, and students.

Who registers depends on your situation, and the Régie's pages list the situations separately rather than as one rule. People who have obtained refugee or protected person status register and can benefit without a waiting period. Government-assisted refugees are registered through the mandated community organization and also have no waiting period. People holding an approval-in-principle letter as authorized permanent residence applicants register, with coverage starting after a three-month waiting period. Refugee claimants are not eligible for the provincial plan and may be eligible for the Interim Federal Health Program. Quebec has social security agreements with 11 countries, and a person arriving from a signatory country who follows the agreement procedure, including requesting a certificate of coverage from their home country's social security organization, can avoid the waiting period under the agreement's conditions. Confirm your own situation on the Régie's eligibility pages before you assume a waiting period or an exemption applies to you, and ask the Régie about prescription drug insurance: Quebec's drug coverage rules differ from the other provinces, and the registration pages treat drug insurance as a separate check.

Step 6: The other provinces and territories — register, and confirm the wait on the province's own page

Every other province and territory runs its own plan with its own registration route, and this guide states no waiting period for any of them, because no province's official page states one. That is a deliberate gap, not an oversight. Secondary summaries disagree with each other on Manitoba, Saskatchewan, and Nova Scotia wait periods, sometimes on the same page, and a figure carried from a secondary summary into this guide would be exactly the kind of unverified claim this site does not ship. What is safe to state is the procedure: register with your province or territory's health plan as soon as you arrive, with proof of identity, proof of residency, and your immigration document, and confirm the waiting period, the document list, and the card-issue route on that province's official health page before you travel or before you let private insurance lapse. If you move between provinces, the rule from British Columbia and Alberta applies as a general practice: keep the previous province's card until the new plan's coverage starts, and contact the previous province's office about what it covers while you wait.

Step 7: What the plan pays for, and the checks that save a surprise bill

Provincial plans pay for medically necessary physician and hospital services: doctor visits, hospital care, emergency care, surgeries, and tests a physician orders. Ontario's apply page lists family doctor appointments, walk-in clinic visits, emergency room visits, and medical tests and surgeries, and requires a medical reason for the service. British Columbia's application page describes MSP as paying for medically required services of physicians and surgeons, and dental or oral surgery performed in a hospital. Do not assume the plan covers everything else. Prescription drugs outside hospital, routine dental care, and routine vision care are separate checks in most provinces: confirm what your province's covered-services list includes before you need it, and ask about drug coverage specifically in Quebec, where the Régie administers a separate prescription drug insurance plan. If you hold private insurance through an employer, check whether it covers the gap period and the services the provincial plan does not: Alberta's newcomer pages note that private insurance is recommended for services AHCIP does not cover, and that some employers offer plans while self-employed people buy their own.

Related guides

From arrival to provincial health coverage, in five moves

  1. Register in your first weekEvery province in this guide asks you to apply as soon as you arrive. In British Columbia and Quebec the wait period runs from when residence is established, so a late application lengthens the gap, it does not shorten it.
  2. Check your province's wait periodOntario removed its three-month wait in March 2020. British Columbia waits the rest of the arrival month plus two months. Alberta covers arrivals from outside Canada from the residency date when they apply within three months. Quebec waits up to three months for most adults.
  3. Bridge the gapBritish Columbia tells arrivals from outside Canada to arrange private insurance before arrival, and Quebec strongly recommends private insurance on arrival. Keep your previous province's card if you moved within Canada.
  4. Carry the card, and the letterShow your health card at every visit. In Quebec, keep the letter stating your waiting period until the card arrives: some services are free on presentation of that letter during the wait.
  5. Tell the plan when things changeOntario requires changes to entitlement information to be reported within 30 days. A new permit, a new address, or a move to another province is a report to the plan, not a detail to leave until renewal.

Questions people ask

Should I wait until my waiting period is over before I apply for health coverage?

No. Apply as soon as you arrive, in every province covered here. British Columbia's wait-period page says to apply as soon as you arrive and not to wait until the end of the wait period, because applying early gives the province time to process the application. Quebec's registration page carries a processing time of 60 working days, so an application filed on arrival is still being processed well into the waiting period. Ontario has no waiting period to wait out: its three-month wait was removed in March 2020, and the province's own registration guidance says eligible residents can apply as soon as they arrive. Alberta's rule makes early filing decisive in a different way: arrivals from outside Canada may be covered from the date they establish residency, but only if they apply within three months of establishing residency and provide all required documents. Late filing does not preserve the earlier start date.

I am visiting Canada, or I hold a short work or study permit. Am I eligible for a provincial plan?

Visitors and tourists are not eligible. Ontario's registration guidance states it directly: visitors to the province, people whose primary place of residence is outside Ontario, and tourists are not eligible for Ontario health insurance coverage. British Columbia's eligibility pages state the same exclusion for tourists and visitors, and add that study and work permit holders may be deemed residents when their permits are valid for six or more months. Alberta's temporary-resident rules require an acceptable Canada entry document with at least six months remaining, an intent to live in Alberta for at least 12 consecutive months, and Alberta residency. If your permit is short, or you are in Canada as a visitor, the provincial plan is not your coverage: arrange private health insurance for the whole stay, and confirm the position on your province's eligibility page before you rely on any secondary summary.

I hold a work permit. Which provinces cover work permit holders, and on what terms?

All four provinces in this guide cover some work permit holders, but the terms differ and each province decides eligibility after reviewing your documents. In Ontario, a valid work permit plus full-time work in Ontario, for an Ontario employer, for at least six months qualifies, and a spouse and dependants may also qualify on that basis. In British Columbia, study and work permit holders whose permits are valid for six or more months may be deemed residents, and a Working Holiday permit needs a letter of employment among the accepted identification documents. In Alberta, a work permit for an Alberta employer counts as an acceptable Canada entry document, provided the document has at least six months remaining and you intend to live in Alberta for at least 12 consecutive months. In Quebec, confirm your situation on the Régie de l'assurance maladie du Québec eligibility pages before you assume coverage: the registration pages list permanent residents, refugees and protected persons, and approval-in-principle applicants among those who register, with a waiting period that varies by situation. Do not carry one province's work-permit rule into another province's application.

I am a refugee claimant. Which program covers my health care before I qualify for a provincial plan?

The federal Interim Federal Health Program, not the provincial plan. Quebec's registration pages state that a refugee claimant is not eligible for health insurance under the provincial plan but may be eligible for the Interim Federal Health Program, while a person who has obtained refugee or protected person status registers with the Régie and can benefit from health insurance without a waiting period. Alberta's pages draw the same line: refugee claimants waiting for a decision apply through the Interim Federal Health Program and are not eligible for the Alberta Health Care Insurance Plan, while Convention refugees with a Notice of Decision are eligible to apply. The federal program provides temporary coverage for basic services such as hospital and physician care plus limited supplemental services, and it lasts until you become eligible for provincial or territorial health insurance or leave Canada. Keep your Interim Federal Health Program eligibility document and show it at every visit, and register with the provincial plan as soon as your status makes you eligible.

I moved from another province. Do I keep my old health card during the waiting period?

Yes, keep it and use it. British Columbia's wait-period page says that if you move from another part of Canada, you keep your former health plan during the wait period, and that family members who have not arrived yet stay covered by their former province or territory. Alberta's moving page says the same: while you are in the waiting period, continue using your health card from your previous province or territory, and contact that province's health insurance office to find out what services are covered. The wait period itself is per person: in British Columbia each family member's wait period is based on that person's own arrival date, and in Alberta a spouse and dependants who join later are covered from the first day of the third month after they arrive, or the first day of the thirteenth month for the first arrival, whichever comes first. Do not hand back or discard the old card until the new plan's coverage has actually started.

I need medical care during the waiting period. What do I do?

Get the care, and expect to pay unless you have other insurance. British Columbia's wait-period page says you can receive needed medical and hospital care before the Medical Services Plan starts, but you must pay the full cost unless you have other health insurance, and it warns that these costs can be very high. That is why the same page tells arrivals from outside Canada to arrange private insurance before arrival and to keep it until coverage starts, and warns that most private insurers do not cover pre-existing conditions, including pregnancy. In Quebec, keep the letter stating your waiting period: on presentation of that letter, certain necessary services are available free of charge during the waiting period, and the Régie strongly recommends private insurance on arrival because it does not reimburse care received before the eligibility start date. In Alberta, the temporary-residents page states you will not be denied emergency medical care even without medical insurance, and recommends private insurance until you are eligible. A waiver exists in British Columbia for the most serious and exceptional cases only, and it requires that you were found eligible for the plan first. Private insurance is a check before you travel, not a purchase to make after you need care.

Keep going

Sources

  • Government of Ontario, "Apply for OHIP and get a health card" — the minimum qualifications including the 153-day rules and primary residence, the additional requirements including the six-month full-time work-permit rule, the in-person ServiceOntario application with three separate documents, the emergency-authorization eligibility, the reapplication rule after 212 days away, and the covered-services list —
  • Government of Ontario, "Registration of Ontario Health Insurance coverage" — the removal of the three-month waiting period from Regulation 552 in March 2020, the eligibility overview including the 153-day rules, the in-person registration requirement for people 16 and older, the exclusion of visitors and tourists, and the 30-day change-reporting duty —
  • Government of British Columbia, "How to apply for the Medical Services Plan (MSP)" — apply as soon as you arrive, the wait period of the balance of the arrival month plus two months, the B.C. Application for Health and Drug Coverage, the ICBC office step for adults, and the Personal Health Number on the B.C. Services Card —
  • Government of British Columbia, "Coverage wait period for the Medical Services Plan (MSP)" — the wait-period formula, the later start date when status changes after arrival, per-person wait periods for family members arriving on different dates, keeping the former plan during the wait, arranging private insurance before arrival, paying the full cost of care received before MSP starts, and the waiver process for the most serious and exceptional cases —
  • Government of British Columbia, "Eligibility for MSP" and "Apply for B.C. health and drug coverage": the resident definition, study and work permit holders with permits valid for six or more months deemed residents, tourists and visitors not eligible, and eligibility decided only after the application and documents are reviewed
  • Government of Alberta, "Apply for health care coverage if you move to Alberta" — coverage from the residency date for arrivals from outside Canada who apply within three months, the first-day-of-the-third-month rule for arrivals from within Canada with the July 12 to October 1 example, keeping the previous province's card during the wait, the military-family waiver, and the entry documents that could qualify —
  • Government of Alberta, "How to apply for AHCIP" — the registry agent route, the supporting documents proving residency, identity, and legal entitlement, no charge for the registry agent service, processing of up to five days, and the separate form for children of non-eligible parents —
  • Government of Alberta, "Health care coverage for temporary residents" — the 12-month intent and six-months-remaining document rules, the Convention Refugee route, the statement that emergency medical care will not be denied without insurance, and the private-insurance recommendation until eligible —
  • Régie de l'assurance maladie du Québec, "Medical services" — the waiting period of up to three months on registration after arrival from another country, the exemption for children under 18, the no-reimbursement rule during the wait, the strong private-insurance recommendation, and the free necessary services available on presentation of the waiting-period letter —
  • Régie de l'assurance maladie du Québec, "Register for health insurance" — the registration form by situation, the current processing time of 60 working days, and the telephone contact —
  • Régie de l'assurance maladie du Québec, registration and eligibility pages: the situations that register, including approval-in-principle applicants with a three-month wait, refugees and protected persons without a waiting period, refugee claimants not eligible for the provincial plan, and the 183-day absence rule
  • Régie de l'assurance maladie du Québec, "Social security agreements with other countries" — agreements with 11 countries, the certificate-of-coverage procedure for arrivals from a signatory country, and avoiding the waiting period under the agreement's conditions —
  • Government of Canada, Interim Federal Health Program and Interim Federal Health Program pages: temporary coverage for refugee claimants and other groups not eligible for provincial or territorial coverage, basic coverage similar to provincial plans plus limited supplemental and medication coverage, and coverage lasting until provincial or territorial health insurance begins

No waiting period is stated in this guide for Manitoba, Saskatchewan, Nova Scotia, New Brunswick, Newfoundland and Labrador, Prince Edward Island, or the three territories, because no official page states a waiting-period figure for those jurisdictions, and secondary sources conflict on several of them. No fee figure is stated for any provincial plan, and no processing time is stated except Quebec's 60 working days and Alberta's up to five days at a registry agent, because those are the only processing times the official pages state. No statement is made about which specific work-permit or study-permit situations qualify in Quebec beyond the Régie's own situation pages: confirm your situation on those pages. Re-check your province's eligibility and registration pages on the day you apply: they govern over any summary, including this guide.

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