One of the great strengths of Canada's health system is portability — your provincial health card provides coverage when you travel to other provinces. However, the coverage is not always seamless, and there are important gaps and differences you need to know about before travelling across provincial borders.
Most provinces participate in the Interprovincial Health Insurance Agreements, which allow billing directly between provinces. Under this system:
This works smoothly for most hospital care. However, it does not always work for physician billing, and Quebec is notably outside the main agreement for many services.
OHIP covers emergency and elective medically necessary services received in other Canadian provinces, but at Ontario rates. If rates in the other province are higher, you may receive a bill for the difference. OHIP does not automatically cover ambulance services in other provinces.
BC's MSP covers insured services received in other Canadian provinces at the BC rate. For emergency services, BC will pay what the other province charges up to the BC amount. Residents are strongly encouraged to carry supplemental travel insurance even within Canada.
Quebec is the most significant exception to interprovincial portability. Quebec residents travelling in other provinces and residents of other provinces receiving care in Quebec often face billing complications because Quebec does not participate in all interprovincial billing agreements. Quebecers may need to pay upfront and seek reimbursement from RAMQ; non-residents receiving care in Quebec may face direct billing.
This is one of the biggest out-of-province surprises. Ambulance services are covered differently in each province, and your home province's coverage rarely extends to ambulance calls in other provinces. Costs can range from $300–$3,000+ for a ground ambulance, and $100–$50,000+ for air ambulance/medical evacuation.
Private travel insurance typically covers emergency ambulance and medical evacuation. If you frequently travel between provinces, consider annual travel insurance that covers all Canadian travel, not just international trips.
If you're travelling to another province specifically to receive medical care (sometimes called "interprovincial medical travel"), your home province may or may not cover the costs. You generally need pre-approval from your home province's health plan for elective procedures sought in another province. Emergency care is always covered. Elective surgery tourism within Canada (e.g., travelling to a province with shorter wait times) is not automatically covered — check with your provincial plan before booking.
Students who move to another province for school are in a transitional coverage situation. The general rule:
Workers who frequently travel between provinces for work should ensure their employer's group benefits plan includes out-of-province coverage (most good group plans do). Employer plans typically cover emergency medical expenses across Canada at the out-of-province rates.
Every dollar you save on banking fees is a dollar for your health. KOHO offers free banking with no monthly fees and no minimum balance. Use code 45ET55JSYA for a bonus when you sign up.
Open KOHO Free — Code 45ET55JSYA