Health and Medical Care

Your coverage in Canada

Medical care in Canada is excellent, and Canadians do not pay at the point of care because each province runs its own public insurance plan: OHIP in Ontario, RAMQ in Quebec, MSP in British Columbia, AHCIP in Alberta, and so on. None of those plans cover American visitors. As the State Department puts it, Canada's public system does not offer free treatment to non-Canadians. You will be billed as an uninsured non-resident, often at rates that are higher than what the province pays for its own residents.

Your US health insurance may help, or it may not. Before you go, call your insurer or read your plan documents for these three things: whether care outside the US is covered at all, whether only emergencies count, and whether you pay up front and claim later. Many Canadian hospitals and clinics will not bill a US insurer directly, so expect to pay with a credit card and file the claim yourself.

Medicare and Medicaid

Original Medicare (Parts A and B) generally does not pay for care outside the US. The State Department says Medicare and Medicaid are accepted abroad only in very limited cases. The narrow Medicare exceptions that involve Canada are:

• You are in the US when an emergency happens and a Canadian hospital is closer than the nearest US hospital that can treat you, which can happen near the border.
• You are driving directly between Alaska and another state through Canada without unreasonable delay, and a Canadian hospital is closer than any US one when an emergency occurs.
• You live in the US and a Canadian hospital is closer to your home than the nearest US hospital that can treat your condition.

Outside those cases, a stay at Banff's hospital or a visit to a Montreal ER is on you. Part D does not cover prescriptions filled in Canada.

• Medigap. Most Medigap plans sold today (C, D, F, G, M and N) include foreign travel emergency coverage. It pays 80 percent of emergency care after a yearly deductible, up to a lifetime maximum, for emergencies in the first 60 days of a trip. The lifetime cap is low compared with a serious hospital stay, so many Medigap holders still buy travel insurance.
• Medicare Advantage. Coverage varies by plan. Some include worldwide emergency and urgent care, and some cover nothing abroad. Call the plan and ask how claims for foreign care are paid.
• Medicaid does not cover care in Canada.

What care costs at non-resident rates

Each province, and in some provinces each hospital, sets its own rates for uninsured patients, and they are revised every year (usually on April 1). These figures come from rate sheets published for 2025–2026 and 2026–2027 and show what an American can expect. Doctors' fees, tests and procedures come on top of the facility charges.

A few things to know about these bills:

• Emergency departments will assess and treat you whether or not you are insured, but you will be asked for payment details, and often a credit card payment or deposit before you leave. Quebec's public hospitals publish deposits for non-residents equal to a full day's rate.
• Inpatient rates in Ontario hospitals vary a lot by the kind of care: the Queensway Carleton Hospital lists daily room charges from C$3,612 to C$45,372 (about $2,580 to $32,400).
• Ambulance fees for non-residents vary by province and can be much higher outside Ontario. Air ambulance flights, common in the mountains and the North, can cost tens of thousands of dollars.
• Rates change every year. If you have time, ask the hospital's billing office for the current figure.

Travel medical insurance

A travel medical policy pays for emergency care abroad and, in better policies, for medical evacuation home. For most Americans, it is the simplest fix for the gap in US coverage. The State Department strongly recommends coverage that includes medical evacuation, and for the Arctic it specifically says to confirm air ambulance coverage.

What to look for

• Emergency medical coverage of at least US$50,000, and more if you are older or heading somewhere remote. Policies with US$100,000 to US$500,000 limits are widely sold.
• Medical evacuation and repatriation: transport to an adequate hospital and, if needed, home to the US by air ambulance. Look for US$250,000 or more.
• Primary versus secondary. Primary coverage pays first. Secondary coverage asks you to claim from your US insurer first, which slows things down.
• Pre-existing conditions. Many policies exclude them unless you buy within a set number of days of your first trip payment and the condition was stable. Read the definition.
• Activities. Skiing is usually covered; backcountry skiing, heli-skiing, mountaineering and some water sports may need an add-on.
• Direct billing. Some insurers will pay a Canadian hospital directly for a big bill if you call their assistance line early. Save that number in your phone.
• Trip cancellation is separate from medical coverage. In wildfire season, it is worth having too (see Safety).

Some premium credit cards include limited emergency medical or evacuation benefits when you pay for the trip with the card. The amounts are usually modest, and the conditions are strict, so read your card's benefits guide before you rely on it. People planning a long stay should read Long stays, since provincial plans have waiting periods even for new residents.

Where to get care

Canada's front-line system looks like the US one with different names, and waits are often longer. Choose the level of care that fits the problem.

Nurse advice lines

Most provinces run a free, 24-hour nurse line on 811: HealthLink BC, Alberta's Health Link, Ontario's Health811, Quebec's Info-Santé and similar services in Atlantic Canada and Saskatchewan. A registered nurse will tell you whether you need the ER, a clinic or just rest, and where the nearest open facility is. 811 may not connect from a US cell phone; if it does not, the provincial health website lists a regular toll-free number for the same service.

Virtual care and telehealth

Your US doctor or telehealth app may not be able to treat you while you are physically in Canada, because doctors are licensed by state and province. Check with your provider before you go, and refill prescriptions before you leave. In Canada, some private virtual-care services see patients without a provincial health card for a fee; pricing and eligibility change, so check the service's site.

In Quebec

Most doctors and nurses in Montreal speak English, but the State Department notes that some Quebec providers speak only French, especially outside Montreal. A translation app helps, and you can ask for an English summary of your records for your insurer. See French for travelers.

Dentists and eyeglasses

Dental care is private for Canadians too, and prices are broadly similar to US prices. For a broken tooth or abscess, search for an emergency dentist in the city you are in. Opticians can replace lost glasses quickly if you carry a copy of your prescription.

Pharmacies and pharmacists

You will find pharmacies everywhere: Shoppers Drug Mart (called Pharmaprix in Quebec), Rexall, Jean Coutu, Familiprix, Uniprix, London Drugs in the West, and pharmacies inside Walmart, Costco and grocery stores such as Loblaws and Safeway. In big cities, some locations are open late or 24 hours.

Pharmacists can prescribe

Canadian pharmacists have more authority than their US counterparts. In most provinces, including Ontario, Quebec, British Columbia, Alberta and Nova Scotia, they can now assess and prescribe for a list of minor ailments. The lists vary by province but typically include:

• uncomplicated urinary tract infections
• pink eye and seasonal allergies
• cold sores, canker sores and minor skin conditions
• insect bites and, in several provinces, a preventive antibiotic dose after a tick bite (see below)
• heartburn, nausea and similar day-to-day complaints

Pharmacists in most provinces can also give an emergency supply or renewal of a medicine you already take, in some circumstances. A US prescription is not valid in Canada as written, so bring your pill bottle and your US pharmacy's phone number so the pharmacist can verify it. Controlled drugs such as opioids, ADHD stimulants and benzodiazepines generally need a prescription from a Canadian doctor or nurse practitioner. Residents get many pharmacist assessments free through their provincial plan; as a visitor you pay a fee set by the pharmacy, plus the medicine.

Over the counter

Most familiar brands are on the shelves: Advil, Tylenol, Benadryl, Claritin, Imodium, Pepto-Bismol. A few names differ: aspirin is often labeled ASA, and the usual motion-sickness pill is Gravol (dimenhydrinate, the same drug as Dramamine). Labels list acetaminophen, as in the US. Some products, including certain cold medicines with pseudoephedrine, are kept behind the counter, and the pharmacist may ask a few questions before selling them.

Brand-name drugs are often cheaper in Canada, and some Americans stock up. US rules on bringing medicines home are strict; see Shopping and US customs before you buy more than you will use on the trip.

Bringing your medicines

You can bring prescription medicines for your own use. Health Canada's rules for prescription drugs that contain controlled substances, which covers most opioids, ADHD medications and sleeping pills, set out what to do, and they are a good standard for every prescription:

• Bring no more than a 90-day supply at your usual dose. For longer stays, Health Canada asks you to contact its exemptions section in advance.
• Keep each medicine in the container it was dispensed in, with the pharmacy label showing your name, the prescriber's name, the drug name, the strength, the dose and the quantity.
• Declare the medication to the border officer when you arrive.
• The medicine must be for you, for someone in your care traveling with you, or for an animal traveling with you.
• A doctor's note is not required, but it helps if you carry injectable drugs, needles, or a large or unusual supply.
• Controlled-substance medicines cannot be mailed to you in Canada. Pack enough for the whole trip, plus a few spare days, in your carry-on.
• Cold medicines containing pseudoephedrine are limited to 3 g of pseudoephedrine in total, in retail packaging.

The State Department gives the same basic advice: original packaging plus the prescription. The full list of what you can and cannot bring is on the Entering Canada page.

Cannabis, including medical cannabis and CBD

Recreational cannabis is legal in Canada, but you cannot take it across the border in either direction, and that includes medical cannabis prescribed or recommended in your state. A US medical card is not recognized in Canada. CBD products count as cannabis under Canadian law, so CBD gummies, oils and creams from home are also off-limits at the border. Bringing cannabis into Canada is a serious offense, and lying about it can get you barred.

If you use cannabis for a medical reason, adults can buy it in Canada from provincially licensed stores and websites. The legal age is 19 in most provinces, 18 in Alberta and 21 in Quebec. Rules on where you can use it differ by province, and impaired driving laws apply to cannabis just as they do to alcohol. Finish or leave behind anything you buy before you head home: cannabis remains illegal under US federal law at the border, even if your home state allows it. See Drinks and cannabis.

Vaccines and CDC guidance

The CDC's advice for Canada is mainly to be up to date on routine vaccines before you travel. Canada has no special vaccine requirements for entry, and you do not need shots for yellow fever, typhoid or malaria.

• Measles (MMR). Canada lost its measles elimination status on November 10, 2025, after an outbreak that began in New Brunswick in late 2024 spread widely, especially in Ontario and Alberta, with more than 5,000 cases in 2025. The CDC recommends that travelers have two doses of MMR, and that babies 6 to 11 months old get an early dose before international travel. If you are unsure of your status, ask your doctor.
• Flu and COVID-19 vaccines are worth having for winter travel, especially for older travelers.
• Hepatitis A and B and rabies shots are not needed for typical trips. People who will handle wildlife, work in remote areas or have specific risks should discuss them with a doctor.

Check the CDC's Canada destination page at cdc.gov/travel a few weeks before you go, since recommendations can change.

Rabies

Rabies is present in wildlife across Canada, mostly in bats, foxes, skunks and raccoons, and in Arctic foxes in the North. Do not touch wild animals, including ones that seem tame or injured. If a bat, fox, raccoon or stray animal bites or scratches you, or you wake up with a bat in the room, wash the wound for 15 minutes and get medical care the same day.

Ticks, mosquitoes and blackflies

Ticks and Lyme disease

Blacklegged ticks, which carry Lyme disease, have spread across southern Canada over the past two decades. The highest-risk areas include southern and eastern Ontario (the Ottawa area, the Thousand Islands, Prince Edward County and the Lake Erie shore), southern Quebec (the Eastern Townships and the region south of Montreal), much of Nova Scotia, southern New Brunswick and southeastern Manitoba. A related tick lives in parts of southern British Columbia. Ticks are active whenever the temperature is above freezing, with peaks in spring and fall.

• Use an icaridin or DEET repellent on skin, and consider permethrin-treated clothing from home.
• Wear long pants tucked into socks on overgrown trails, and stay in the center of the path.
• Do a full tick check every evening, including scalp, behind the ears, armpits, groin and behind the knees. Check kids and dogs too.
• Remove ticks with fine-tipped tweezers, pulling straight out. Removing a tick within 24 hours greatly reduces the risk of Lyme.
• If you were bitten in a risk area, ask a pharmacist about a preventive antibiotic dose. Pharmacists in several provinces, including Ontario, Quebec and Nova Scotia, can prescribe it.
• See a doctor if you get a spreading rash, often but not always a bull's-eye, or fever, aches and fatigue within a month of a bite, at home or in Canada. Tell them where you traveled.

Mosquitoes and blackflies

Mosquitoes are thick in the Canadian Shield, the Prairies and the North from late spring through summer. West Nile virus circulates in parts of the Prairies, Ontario and Quebec in July and August, though serious illness is rare. Blackflies are worse in May and June in Ontario's cottage country, Quebec, Atlantic Canada and the North; their bites swell and itch for days. Light-colored long sleeves, repellent, and a head net for northern or backcountry trips make a big difference. Peak bug season is one reason many people prefer late summer or early fall for canoe trips. See When to go.

Cold, heat, altitude and sun

Cold-weather injuries

Frostbite and hypothermia are real risks in a Canadian winter, and not only in the North. Environment and Climate Change Canada reports a wind chill with its forecasts. At a wind chill of about -18°F (-28°C), exposed skin can freeze in 10 to 30 minutes; at -40°F (-40°C), it takes only 5 to 10 minutes, and strong wind speeds that up. Early frostbite (frostnip) shows as white or grayish, numb skin on the nose, cheeks, ears, fingers or toes.

• Cover your face, ears and hands, and keep clothes dry; damp cotton loses its warmth fast.
• Warm frostnipped skin gently against your body or in lukewarm water. Do not rub it or use direct heat, and get care if the skin stays numb, blisters or turns hard.
• Shivering, clumsiness, slurred speech and confusion are signs of hypothermia. Get the person indoors, out of wet clothes, and call 911.
• Alcohol makes you feel warm while you lose heat faster. Watch out on winter festival nights and at outdoor hot tubs.
• Shoveling heavy snow strains the heart. If you have heart disease, let someone else do it.

More on gear in Winter in Canada and Packing. Summer heat waves happen too, and many older buildings lack air conditioning; drink water and find a cool place in the afternoon.

Sun and altitude

The Rockies are higher than many visitors realize. The town of Banff sits at about 4,500 ft (1,380 m), Lake Louise village at about 5,000 ft (1,540 m) and Moraine Lake at about 6,200 ft (1,885 m), and gondolas take you above 7,000 ft (2,130 m). True altitude sickness is uncommon at these heights, but some people get headaches and shortness of breath on the first day, especially coming from sea level. Take it easy the first day and drink plenty of water.

The sun is stronger at altitude, and snow and water reflect it. Wear sunscreen, sunglasses and a hat on glaciers, ski hills and lakes, even when it is cool. Long summer days in the North mean many hours of exposure. Environment Canada includes a UV index in its forecasts.

Wildfire smoke and the AQHI

In recent summers, wildfire smoke has blanketed large parts of Canada for days at a time, sometimes far from any fire. Canada reports air quality with the Air Quality Health Index (AQHI), which runs from 1 upward:

The AQHI is not the same scale as the US Air Quality Index (AQI) you see at home, so do not compare the numbers directly. Check it on the WeatherCAN app or weather.gc.ca, which also post special air quality statements during smoke events. The State Department also points travelers to NASA's air quality forecasts.

• People with asthma, COPD or heart disease, pregnant travelers, children and older adults are most at risk. Bring your inhaler and medicines.
• Pack a few well-fitting N95 masks in summer. Cloth and surgical masks do little against smoke.
• On smoky days, swap a big hike for museums or a drive to a clearer area, keep car windows closed with the air on recirculate, and ask your hotel whether it has filtered air.
• Seek care for chest pain, severe shortness of breath or an asthma attack that does not ease.

For fire evacuations and closures, see Safety.

Water and food

Tap water in Canadian cities and towns is treated and safe to drink, and you do not need bottled water. Smaller communities sometimes issue a boil-water advisory after a main break or a test failure; your hotel or campground will usually post it, and local news and the municipality's website carry it. When one is in effect, boil water for one minute before drinking it or using it to brush teeth, or use bottled water.

Some First Nations communities have lived under long-term drinking water advisories for years. Many have been lifted since 2015, but some remain. If you visit an Indigenous community or stay at an Indigenous-owned lodge, follow local guidance. See Indigenous Canada.

• Backcountry water from lakes and streams can carry giardia ("beaver fever") and other parasites, however clear it looks. Filter, treat or boil it.
• Beaches in cities such as Toronto are tested in summer and can close after heavy rain. Check the posted signs or the city's beach water updates.
• Blue-green algae blooms appear in some lakes in late summer, especially in the Prairies and Ontario. Do not swim in, drink or let dogs into water that looks like pea soup or has a scum on top.
• Shellfish. On both coasts, harvesting areas close for toxins and contamination. Do not gather your own mussels or clams without checking Fisheries and Oceans Canada closures and licence rules. Restaurant seafood is inspected and safe.

Food safety standards are similar to those in the US. Unpasteurized-milk cheeses are legal and common in Quebec; pregnant travelers may want to ask before ordering. See Food.

If you get sick or hurt: step by step

1. For an emergency, call 911. For anything else, call 811 or ask a pharmacist where to go.
2. Call your travel insurer's assistance line as early as you can, ideally before treatment for anything non-urgent. They may pay the hospital directly or steer you to a facility they work with.
3. Bring your passport, insurance card or policy number, a list of your medicines and allergies, and a credit card with a high limit.
4. Before you leave, get an itemized bill, receipts for every payment and a copy of your records or a discharge summary, in English if possible.
5. Keep receipts for prescriptions, taxis to the clinic and any extra hotel nights. Some policies reimburse them.
6. File claims with your travel insurer, then with your US health plan for any remaining costs, within their deadlines. Make copies of everything.
7. Back home, follow up with your own doctor and share the Canadian records.

For crime, wildlife, wildfire and consulate information, see Safety. For border rules on medicines, see Entering Canada.