Canada health insurance: waiting periods and coverage by province

Your provincial health card may not work the day you land: in Canada, the province you settle in is what insures you, and each one has its own rules. In Quebec, the RAMQRégie de l’assurance maladie du QuébecThe agency that runs public health insurance in Quebec. Its French equivalent is the Assurance maladie, the “Sécu”. (Régie de l’assurance maladie du Québec, the counterpart of your French CPAM) imposes a 3-month waiting period, but if you were insured in France you can skip it by bringing the right form. Ontario and Alberta have no wait at all; in British Columbia, it’s the rest of your arrival month plus 2 months.

This applies to French people settling in Canada with a work permit, a study permit, a Working Holiday (PVTPermis vacances-travail (Working Holiday permit)The French name for the Working Holiday permit: an open work permit for French citizens aged 18 to 35, issued under International Experience Canada.) or permanent residence. If you’re only visiting, what you need is travel insurance, not a provincial card. For the rest of the health system, see the Healthcare in Canada page.

Who is entitled to provincial health insurance?

In Canada, Ottawa sets broad principles (the Canada Health Act) and transfers money, but it’s the provinces that insure people, issue the card and decide who qualifies. A province is a bit like a French région with its own Sécurité sociale: when you move from Montreal to Toronto, you change systems.

Every province sets the same two basic conditions: making the province your main residence and being physically there for most of the year (183 days in Quebec and Alberta, 153 days in any 12 months in OntarioSource: Ontario.ca). After that, it all depends on your status:

• Permanent resident: eligible in every province.
• Work permit: eligible if it’s valid for at least 6 months in Quebec and British Columbia; in Alberta, it must not expire within 6 months; in Ontario, you must also work full time for an Ontario employer for at least 6 months.
• Working Holiday (PVTPermis vacances-travail (Working Holiday permit)The French name for the Working Holiday permit: an open work permit for French citizens aged 18 to 35, issued under International Experience Canada.): an open work permit under International Experience Canada. Excluded from the RAMQRégie de l’assurance maladie du QuébecThe agency that runs public health insurance in Quebec. Its French equivalent is the Assurance maladie, the “Sécu”. in Quebec. Elsewhere, it can get you covered if you work: in Ontario, full time for an Ontario employer for at least 6 months; in British Columbia, if your permit is valid for at least 6 months and you work at least 18 hours a week for 6 consecutive monthsSource: BC Gov; in Alberta, like any open permit that doesn’t expire within 6 months.
• Study permit: most international students go through their school’s mandatory insurance, except French students in Quebec, who are covered by the RAMQ thanks to the agreement (see below).

If you haven’t yet decided between a Working Holiday, an employer-specific work permit and permanent residence, factor health into the choice: the Canada visa finder helps you find the status that fits your plans, and that status decides whether you get a card.

How long is the waiting period in each province?

The waiting period is the gap between settling in and the start of coverage. Until it ends, you pay the full price of any care, and the RAMQRégie de l’assurance maladie du QuébecThe agency that runs public health insurance in Quebec. Its French equivalent is the Assurance maladie, the “Sécu”. points out that a single day in hospital can cost over C$3,000, before doctors’ fees. Depending on the province, the wait runs from nothing to three months:

Ontario dropped its 3-month wait in 2020, at first as a temporary measure, and its official page spells it out in 2026: “there is no longer a waiting period for OHIP”Source: Ontario.ca.

British Columbia keeps its wait, and it’s counted person by person: each family member’s clock starts on their own arrival date. The province can also bill you back for care if you leave within 6 months of registering.

In Quebec, the RAMQ sets the date your wait starts and tells you in its reply to your application. Registering late can push it back, so apply in your first few days with all your documents.

During those 3 months, the RAMQ pays for almost nothing. The exceptions are narrow: pregnancy and childbirth, care for victims of domestic violence or sexual assault, and certain infectious diseases. For everything else, you need private insurance from day one, or the form that cancels the wait.

The France–Quebec agreement: who skips the waiting period?

This exemption is for people insured in France, and it only applies in Quebec. Under the social security agreement between France and Quebec, your years of French coverage count, so the RAMQRégie de l’assurance maladie du QuébecThe agency that runs public health insurance in Quebec. Its French equivalent is the Assurance maladie, the “Sécu”. covers you as soon as you register, with no 3-month wait. It hinges on one form you request from your French health fund before you leave:

• Employees and permanent residents who were covered by a mandatory French scheme when they left: form SE 401-Q-207, issued by your CPAMSource: Cleiss (or your fund, such as the MSA for farm workers). It also works for Young Professionals and other employer-specific work permits.
• Family members of an insured worker: they can also present the SE 401-Q-207 to avoid the wait.
• Students: SE 401-Q-102 for a full degreeSource: Cleiss, SE 401-Q-106 for an exchange, a double degree or a joint PhD.
• Working Holiday (PVTPermis vacances-travail (Working Holiday permit)The French name for the Working Holiday permit: an open work permit for French citizens aged 18 to 35, issued under International Experience Canada.): not covered by the agreement. The RAMQ excludes this open permit, and the SE 401-Q-207 doesn’t change that.

Example (fictional case): Julie, 29, employed in Lyon until August, moves to Montreal on a 2-year employer-specific work permit. She asks her CPAM for the SE 401-Q-207 in July, shows it to the RAMQ the week she arrives, and is covered immediately. Her friend Thomas, on a Working Holiday in the same city, gets nothing: he keeps his private insurance for the whole length of his permit.

What does the card cover, and what doesn’t it?

The provincial card pays for doctors and hospitals with nothing up front: the doctor bills the province directly, with no patient co-payment and no claim form. On the other hand, everything you’d file under “la mutuelle” in France (your top-up insurance) is yours to pay.

For prescriptions, Quebec is the exception: drug insurance there is mandatory. If your employer offers a group plan, you have to join it; if not, you’re enrolled in the RAMQRégie de l’assurance maladie du QuébecThe agency that runs public health insurance in Quebec. Its French equivalent is the Assurance maladie, the “Sécu”.’s public plan, whose premium can reach C$789 a year, paid with your Quebec income tax return.

At the pharmacy, from July 1, 2026 to June 30, 2027, you pay a monthly deductible of C$21.25, then 30% of the price, which the RAMQ calls coinsurance. What you pay out of pocket that way is capped at C$1,263 a yearSource: RAMQ.

Elsewhere, nothing is automatic: Ontario covers under-25s who have no private plan (OHIPOntario Health Insurance PlanOntario’s public health insurance, the equivalent of RAMQ for that province.+), British Columbia scales its deductible to income (Fair PharmaCare), and Alberta offers an optional plan with a premium. To see these amounts next to France’s, check the healthcare card in France vs Canada.

How do you cover the first months without a card?

You need private cover in three situations: the Quebec waiting period without the form, the roughly 3 months in British Columbia, and your entire Working Holiday in Quebec, or in another province where you don’t meet the conditions.

• Private health or expat insurance: buy it before you leave, covering medical and hospital costs in Canada plus repatriation. It’s the only complete option for a Working Holiday in Quebec.
• Caisse des Français de l’étranger (CFE): a voluntary scheme that extends French social security-style cover abroad. It reimburses on French rates, which are far below Canadian prices: useful as a top-up, rarely enough on its own for a hospital stay.
• Employer insurance: some employment contracts include cover from day one. If yours does, get it in writing before you sign.

If you’re coming with International Experience Canada (Working Holiday, Young Professionals or International Co-op), this insurance is a requirement of Immigration, Refugees and Citizenship Canada (IRCCImmigration, Refugees and Citizenship CanadaThe federal department that handles visas, work and study permits, permanent residence and citizenship.), the federal immigration department. It has to cover medical care, hospitalization and repatriation for your whole stay, even if a province covers you later, because the provincial card doesn’t pay for repatriation. The border officer can ask for proof and limit your permit to the policy’s end date. To choose a policy, see the guide to travel insurance and the Working Holiday.

In the policy itself, check that it covers Canada without a high deductible and doesn’t exclude pre-existing conditions. Your credit card’s travel insurance, limited to 90-day trips, won’t do for a move.

How do you register in each province?

Whatever the province, you register once you’ve arrived, with original documents: immigration papers, passport and proof of address (a lease or a utility bill). They’re the same ones you’ll need for your Social Insurance Number (SIN) and other arrival paperwork, so keep them handy in your first week.

Once your card arrives, keep an eye on its expiry date: the RAMQRégie de l’assurance maladie du QuébecThe agency that runs public health insurance in Quebec. Its French equivalent is the Assurance maladie, the “Sécu”. doesn’t update your file on its own when your permit is renewed or you become a permanent resident. Report every change of status, or the card expires with the old permit. And if you haven’t picked a province yet, add health to your criteria in the guide to choosing a province in Canada.