Canada vs. U.S. Healthcare: What Expats Should Know 

Canada operates a publicly funded healthcare system, administered at the provincial level. Most medically necessary services- such as doctor visits, hospital care, and diagnostic tests- are covered through provincial health insurance plans.

Coverage is tied to residency, not citizenship. Once you qualify as a resident of a province, you are generally entitled to public healthcare coverage, subject to any applicable waiting period.

For many expats, this shift away from employer-based insurance is one of the most noticeable changes after moving to Canada.

The U.S. healthcare system is largely private and insurance-driven. Coverage is commonly obtained through employers, private insurers, or government programs such as Medicare or Medicaid for those who qualify.

Costs in the U.S. tend to be higher, but access to specialists and elective procedures is often faster. Choice and flexibility are greater, but navigating insurance networks, deductibles, and coverage limits can be complex- especially for those without employer-sponsored plans.

One of the most common surprises for newcomers to Canada is that public healthcare coverage does not always begin immediately.

Most provinces impose a waiting period- often up to three months- before new residents are eligible. During this time, private or temporary insurance is essential. Even after coverage begins, some services are not included under the public system.

This transition period is a critical planning point for expats.

Canada’s public system covers core medical services, but it does not cover everything.

Typically covered:

• Doctor visits

• Hospital stays

• Diagnostic testing

Typically not covered:

• Prescription drugs (outside hospitals)

• Dental care

• Vision care

• Many mental health services

As a result, many residents- especially professionals and expats- carry supplemental private insurance to fill these gaps.

In Canada, healthcare costs are largely predictable. There are no bills for hospital stays or routine medical visits, which provides peace of mind and financial stability.

In the U.S., costs vary widely depending on insurance coverage, but access is often faster and more customizable. High deductibles and out-of-pocket expenses are common, but wait times are generally shorter.

For expats, the trade-off is often between cost certainty and speed of access.

Wait times are one of the most discussed differences between the two systems.

In Canada, non-emergency specialist appointments and elective procedures may involve longer waits, particularly in larger cities. Emergency care, however, is prioritized and well-managed.

In the U.S., access to specialists and elective procedures is typically faster, provided insurance coverage is in place. For expats accustomed to rapid access, this adjustment can take time.

For families, Canada’s system offers strong long-term stability. Pediatric care, maternity services, and preventive care are generally well-integrated into the public system.

Over time, many expats find that while the Canadian system requires patience, it reduces long-term financial stress- particularly during major health events.

Healthcare differences also affect financial planning.

In Canada, healthcare costs are largely funded through taxation. In the U.S., healthcare costs are often paid directly through premiums, deductibles, and out-of-pocket expenses.

For expats, this shift affects:

• Budgeting

• Retirement planning

• Employer compensation comparisons

• Long-term cost-of-living calculations
  
  

Healthcare should be considered alongside taxes- not separately.

Some common assumptions include:

• “Healthcare is completely free in Canada”

• “You’ll lose access to quality care”

• “Private insurance isn’t needed in Canada”
  
  

In reality, both systems provide high-quality care in different ways. Understanding the structure- not the stereotypes- is key.

Canada and the U.S. offer two very different approaches to healthcare, each with strengths and trade-offs. For expats, the most important factor is not which system is “better,” but which aligns with their needs, expectations, and financial planning.

With proper preparation- especially around transition coverage and supplemental insurance- most expats adapt successfully and appreciate the stability Canada’s system provides.

Canada’s healthcare system is publicly funded, meaning most medically necessary services are covered once you qualify as a resident of a province. However, healthcare is not “free” in the literal sense, as it is funded through taxes and does not cover all services. 

Eligibility depends on the province, but many impose a waiting period of up to three months after establishing residency. During this time, expats should arrange private or temporary health insurance.

Public healthcare typically covers doctor visits, hospital care, and diagnostic tests. Services such as prescription drugs, dental care, vision care, and some mental health services are usually not covered and may require private insurance. 

The U.S. healthcare system is largely private and insurance-based, often tied to employment. While access to specialists may be faster, costs are generally higher and more variable compared to Canada’s publicly funded system. 

In many cases, yes. Private insurance is often used to cover services not included in public healthcare and to provide coverage during provincial waiting periods.

For non-emergency and elective procedures, wait times in Canada can be longer than in the U.S. Emergency care is prioritized, and access to essential services remains strong.

No. Both countries offer high-quality healthcare systems. The difference lies primarily in funding models, access speed, and cost structure- not in the quality of medical professionals or facilities. 

In Canada, healthcare costs are largely predictable and funded through taxes. In the U.S., healthcare costs are often paid through insurance premiums, deductibles, and out-of-pocket expenses, making budgeting less predictable. 

Yes, but access to private healthcare varies by province and service type. Many expats use private insurance to supplement public coverage rather than replace it entirely.

Common mistakes include assuming immediate coverage, not arranging temporary insurance, underestimating out-of-pocket costs for uncovered services, and misunderstanding wait times.