Canada’s immigration system includes an excessive demand policy to manage healthcare and social service costs for new immigrants. This policy affects applicants for permanent and temporary residence and is based on the estimated costs of their medical conditions. Understanding this policy can help you navigate potential medical inadmissibility and prepare for a strong application.
What is Excessive Demand?
Excessive demand refers to the estimated healthcare and social service costs for an applicant exceeding a specific threshold set by Immigration, Refugees, and Citizenship Canada (IRCC). The primary concern is that an individual’s medical condition could place a significant burden on publicly funded services.
Excessive Demand Cost Threshold
The annual cost threshold is updated periodically by IRCC. As of the latest update, the excessive demand cost threshold is approximately three times the average Canadian per capita health and social services costs. Applicants can check the latest threshold figures on the IRCC website.
Who is Exempt from Excessive Demand?
Certain applicants are exempt from this policy, including:
- Refugees and protected persons
- Family-sponsored applicants applying under the Family Class, including spouses, common-law partners, and dependent children
However, applicants under the Economic Class and other immigration categories are subject to this assessment.
How Does Excessive Demand Impact Your Application?
If an applicant is found likely to exceed the excessive demand threshold, they may be deemed medically inadmissible. However, there are steps that can be taken to respond to this finding.
What Happens After a Medical Exam?
Once the Medical Health Branch (MHB) records that a foreign national may be inadmissible on health grounds, this information is automatically linked to their permanent or temporary residence application in the Global Case Management System (GCMS).
IMEs Assessed Between June 1, 2018, and March 15, 2022
For immigration medical exams (IMEs) assessed during this period under the Temporary Public Policy Regarding Excessive Demand on Health and Social Services, the following procedures apply:
- If no danger to public health or safety exists, the migration officer should:
- Update the medical admissibility status from “Ready to be Assessed” to “Passed” in GCMS.
- Record the final decision in GCMS and complete final processing steps, including issuing necessary documents.
- If a danger to public health or safety is likely, procedural fairness must be initiated before proceeding.
Processing at a Port of Entry
Border services officers follow section 7.7 of ENF 4 when processing foreign nationals with medical conditions. Key steps include:
- If an IME is required, an MHB medical officer assesses the foreign national’s medical conditions and enters details into GCMS.
- If found likely inadmissible on health grounds, border services officers must review:
- Medical code
- Reason
- Surveillance code
- Diagnosis code
- Temporary and permanent residence applications must be correctly coded in GCMS before granting entry.
Processing IMEs Assessed After March 15, 2022
When a foreign national is found likely to exceed the excessive demand threshold or be a danger to public health or safety, the migration officer must:
- Complete all eligibility, security, and criminality assessments except for medical admissibility.
- Apply the GCMS special program code: XSD.
- Transfer the application to HM Niagara Falls (3950).
- If a danger to public health or safety is identified, initiate procedural fairness before proceeding.
Response to Procedural Fairness Letters
Once a procedural fairness response is received from the applicant, the HMID-NF contacts the responsible regional medical office by email to request a review of the submission. The medical officer should:
- Review all medical documents submitted in response to the procedural fairness letter.
- Assess the medical applicability of any mitigation plan in the context of the Canadian healthcare system.
- Prepare a medical officer consideration letter, detailing:
- Changes to medical diagnoses, prognoses, or required services.
- Other factors affecting the medical admissibility decision.
- Record this letter in the IME notes section of the GCMS.
- Send a copy to HMID-NF in response to their email.
If No Procedural Fairness Response is Received
If the applicant does not respond within the given time frame (including any extensions), the HMID-NF officer will:
- Change the GCMS medical activity status from “Ready to be Assessed” to “Failed.”
- Record non-compliance in the Other Requirements section of GCMS.
- Enter details of excessive demand findings and any medical inadmissibility refusal information.
- Prepare and send a refusal letter with all relevant refusal grounds.
- Record the final decision in GCMS.
Final Decision on the Application
- If the applicant is found medically admissible after review, update their medical status in GCMS as “Passed.”
- If the applicant remains medically inadmissible, record the final decision, and issue a refusal letter detailing all grounds.
- If Humanitarian and Compassionate (H&C) considerations apply, update GCMS accordingly and assess the case under H&C – Medical.
1. Can an applicant challenge an excessive demand finding?
Yes. Applicants can respond to procedural fairness letters with additional medical reports, financial plans, or other mitigating factors.
2. What happens if an applicant’s condition exceeds the cost threshold?
If an applicant’s medical costs exceed the threshold, they may be found inadmissible, unless an exemption applies or their case qualifies under humanitarian and compassionate grounds.
3. Are temporary residents subject to excessive demand assessments?
Yes. Certain temporary residence applicants, such as work permit holders and students, may be assessed for excessive demand if their stay is expected to exceed six months.
4. How can an applicant prove they won’t exceed the threshold?
Applicants can submit evidence, such as private health insurance, a financial plan, or an employer-sponsored healthcare program, to demonstrate that they will not be a burden on Canada’s healthcare system.
Final Thoughts
Understanding Canada’s excessive demand policy is essential for potential immigrants. While exemptions exist for certain applicants, those subject to medical assessments should carefully prepare their case. Seeking legal guidance and preparing a strong procedural fairness response can improve an applicant’s chances of overcoming medical inadmissibility.
For more details on Canada’s medical admissibility rules, visit the official IRCC website.
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Disclaimer: This is for informational purposes only and not legal advice. Always consult experts like us or the official IRCC website for up-to-date details.