IRCC Deputy Minister Transition Binder 2026 - Migration Health

Context

Immigration, Refugees and Citizenship Canada (IRCC) protects the health and safety of Canadians, facilitates the safe arrival and integration of newcomers, and supports Canada’s humanitarian and settlement objectives by delivering the Health Screening Program and the Interim Federal Health Program.

Health Screening Program

Immigration Medical Exams

• Immigration Medical Exams (IMEs) are the cornerstone of IRCC’s health screening process. The exams protect the public health of Canadians by preventing the importation and spread of certain infectious diseases, most notably pulmonary tuberculosis (TB). A standard IME involves reviewing medical history, conducting a health exam, performing lab tests for certain communicable diseases, and taking x-rays to check for active pulmonary TB.
• The Immigration and Refugee Protection Act (IRPA) stipulates that IMEs are required for foreign nationals who:
  • apply for permanent residence;
  • plan to work in healthcare or with children;
  • have resided in a country with a high rate of TB for at least six consecutive months within the last year AND plan to visit Canada for more than 6 months; or
  • reside in a country with a high rate of TB and plan to work in agriculture.
• A streamlined IME is a lighter-touch exam primarily used when urgent processing is required, potentially in response to a humanitarian crisis. It consists of five medical history questions and a chest x-ray to screen for TB.
• All applicants (except refugees and asylum claimants) pay for their own IMEs.

Medical Inadmissibility

• IRCC assesses the results of IMEs to rule out medical inadmissibility on three health grounds under section 38 of IRPA:
  • Danger to Public Health includes active TB and untreated syphilis. If a client is diagnosed as having either of these two conditions, their application is put on hold until they complete sufficient treatment and follow-up for their condition. Foreign nationals who are non-compliant with treatment are found inadmissible.If a client receives sufficient treatment for TB, they are then referred to provincial and territorial public health authorities for health monitoring or medical surveillance upon their arrival to Canada;
  • Danger to Public Safety includes conditions such as severe mental health disorders (e.g., an untreated psychotic disorder with a history of violence towards others); and
  • Excessive Demand on Health or Social Services includes situations where an applicant’s health condition(s) would exceed three times the average annual Canadian per capita cost for health or social services over five years, or impact wait lists in Canada for certain procedures or services. Refugees, protected persons, a sponsored member of the family class (spouses, common-law partner, dependent children), and the family members of these clients, are exempt from this provision.

Health Screening Delivery

• IRCC’s Regional Medical Offices (RMOs) are responsible for delivering the Health Screening Program and supporting the administration of the Interim Federal Health Program (IFHP)’s pre-departure medical services. These activities include:
  • Managing a network of close to 3,000 Panel Members (physicians and radiologists) in over 170 countries, who perform IMEs in Canada and abroad;
  • Assessing IME results and providing medical admissibility assessments as part of the immigration decision process;
  • Liaising with regional stakeholders, including the International Organization for Migration and local health authorities, and helping to facilitate urgent and special movements; and
  • Assessing local and regional trends in disease outbreaks and other migration health issues.
• IRCC works closely with the Public Health Agency of Canada (PHAC) and provinces and territories (PTs) on activities relevant to IRCC’s health screening.
  • IRCC closely engages PHAC on migration health policy and supports PHAC’s TB Elimination Strategy.
  • IRCC contributes migration health content to PHAC’s annual reporting to the World Health Organization and Pan-American Health Organization.
  • The medical surveillance program informs PT health authorities of clients who arrive to Canada who have treated or inactive TB; these clients are required to report to PT health authorities.

Global Panel Member Network

• Panel physicians and panel radiologists are third-party medical professionals who perform IMEs on behalf of IRCC; they submit the majority of IMEs to IRCC electronically.
• IRCC performs regular quality assurance activities of its Global Panel Member Network through its four RMOs (Ottawa, London, New Delhi, and Manila).

Interim Federal Health Program

Overview

• The IFHP provides limited and temporary coverage of urgent and essential medical care for some of Canada’s most vulnerable migrant groups. The IFHP enables equitable access to Canada’s healthcare systems, protects public health and safety, and promotes the long-term integration, inclusion, and full participation of migrants into Canadian society.
• The IFHP covers the cost of medically necessary care for certain migrant groups during their period of ineligibility for publicly funded health services. Eligible beneficiaries include resettled refugees, asylum claimants, protected persons in Canada, victims of human trafficking and domestic violence, immigration detainees under the Canada Border Service Agency care and custody, and other federally identified groups granted coverage by the Minister on a discretionary basis, such as humanitarian movements. The IFHP bridges the gap in health coverage until these beneficiaries are eligible for provincial or territorial health insurance.
• The Minister has discretion to cover healthcare costs for uninsured foreign nationals and humanitarian groups who normally do not qualify for the IFHP under the specified immigration categories, if they are in a refugee-like situation and facing urgent medical and compelling personal circumstances. This is done either on an individual or group basis.
• Within Canada, the IFHP provides coverage of:
  • basic benefits (hospital and physician services, aligned with provincial/territorial healthcare insurance),
  • limited supplemental benefits (prescription medication, mental health counselling, assistive devices, urgent dental care and vision care, similar to extended health benefits provided by provinces/territories to social assistance recipients); and
  • Immigration Medical Exams.
• These benefits are comparable to those offered by provinces and territories so that all similarly situated residents of Canada have an equivalent level of public health insurance. This consistency helps to support the transition of IFHP beneficiaries onto provincial and territorial health coverage once they are eligible.
• By providing healthcare coverage, the IFHP helps to prevent serious health issues and costly emergency interventions caused by delays in seeking medical services, thereby reducing health system wait times and pressure on hospital services.

Program Enhancements

• The IFHP’s client base has risen from 90,328 in 2015–2016 to 623,365 in 2024–2025, including 440,537 asylum claimants, with 2024–2025 expenditures totalling $896.5M.
• To support the long-term sustainability of the IFHP, IRCC is introducing a series of Program-level reforms that will help to manage high demand and align IFHP coverage more closely with other Canadian health benefit programs.
• Starting May 1, 2026, IRCC is introducing co-payments and targeted controls on supplemental health benefits. Beneficiaries will pay $4 for each eligible prescription medication filled or refilled, and 30% of the cost of all other eligible supplemental products and services. Basic healthcare benefits, including hospital and physician services, will remain fully covered and free-of-charge to beneficiaries.