Canadians will soon get even more coverage from free healthcare plans

If you find yourself paying out of pocket for certain necessary medical services, a new healthcare plan update could change that next year.

In a statement on Friday, Minister of Health Mark Holland outlined the new Canada Health Act (CHA) Services Policy. This policy directs Canadians' provincial or territorial healthcare plans to cover services considered medically necessary, whether provided by a physician or a physician-equivalent, like a nurse practitioner.

Holland says healthcare delivery in the country has had to evolve to meet Canadians' needs. This includes nurse practitioners now diagnosing, referring, and treating patients, which are tasks historically handled by a primary care physician.

"Unfortunately, far too many Canadians find themselves paying out of pocket for health services that would otherwise be covered by their publicly funded provincial or territorial healthcare plan if provided by a physician," explained the health minister.

"We need to protect our publicly funded healthcare system and ensure Canadians have equitable access to medically necessary care based on their medical needs, not their ability to pay."

Holland says these changes will take effect on April 1, 2026, to give provincial and territorial healthcare insurance systems time to adjust.

Starting April next year, any medically necessary physician-equivalent service provided by regulated health professionals like nurse practitioners should be covered by provincial and territorial healthcare plans.

Any charges to Canadians for these services that occur on or after that date will be considered extra-billing and user charges under the CHA, according to Holland.

"This means every dollar wrongfully taken out of the pockets of Canadians will be deducted from the [provincial and territorial] health transfers," he explained. "[Provinces and territories] will be eligible for reimbursement once patient charges and the circumstances which led to them are eliminated."

The health minister says the federal government will work with provinces and territories to develop measures to collect the information required to implement the new policy.

Holland adds that he's aware of some cases where private surgical clinics offer patients opportunities to jump the queue for procedures that aren't an emergency (cataract surgery, knee or hip replacements, hernia repair) by accessing care outside of their province or territory for a fee.

"I am concerned that this practice could undermine the fundamental principle of Medicare, where access to care should be based on health need rather than the ability or willingness to pay," he said in a letter to provinces and territories. "That is why I have directed departmental officials to continue working with you to closely monitor this issue."