Interim Federal Health Program Policy

Effective Date: This policy comes into effect on June 30, 2012. This policy may be amended from time to time.

Statement of the scope of this document

The purpose of this document is to set out the eligibility and coverage referred to in the Interim Federal Health Program (IFHP)’s new Order in Council (OIC), entitled the ‘Order Respecting the Interim Federal Health Program, 2012,’ which comes into force on June 30, 2012. This document is aimed at IFHP beneficiaries, providers and the public and may be amended from time to time. This is not a stand-alone document; it should be read together with the OIC.

1. Introduction to the IFHP

1.1. Scope of the IFHP

The primary purpose of this program is to provide limited, temporary coverage of health care costs for specific groups of people including protected persons, refugee claimants, rejected refugee claimants, and certain persons detained under the Immigration and Refugee Protection Act (IRPA). The IFHP offers five types of coverage: expanded health care coverage, health care coverage, public health or public safety health care coverage, coverage of the immigration medical examinations, and coverage for detainees. The OIC also confers, under sections 7 and 8, an authority to pay some costs related to health care in exceptional and compelling circumstances. In addition to this primary purpose, the program helps to protect public health and public safety and to provide coverage that is not more generous than what Canadians receive through government-funded benefit programs.

The IFHP is not intended to cover all migrants who are not covered by provincial or territorial (PT) health insurance plans or programs.

The IFHP is intended to provide coverage on an interim basis. Where a person is eligible to receive coverage under the IFHP, coverage is provided either until individuals are eligible for PT health insurance or until their removal from Canada is enforced, where applicable, whichever occurs first. The IFHP does not cover the cost of health care services and products where a claim can be made under a private insurance plan for those products and services without regard to the amount that may be covered under that plan for those products and services.

2. Authorities pursuant to the OIC

The IFHP policy is referred to within five sections of the OIC. Further to that authority in the OIC, the following are dealt with here:

  • Disease posing a risk to public health;
  • Expanded health care coverage;
  • Health care coverage;
  • Period of coverage for protected persons referred to in subsections 3(1), 6.1(1) and 6.1(2);
  • Governmental resettlement assistance in the form of income support;
  • Detainee health care services and products; and
  • Benefit grids.

2.1. Disease posing a risk to public health

Section 1 of the OIC provides the following definition:

“disease posing a risk to public health means a communicable disease

  1. that is on the list of national notifiable diseases of the Public Health Agency of Canada, as amended from time to time,
    1. which is subject to human-to-human transmission and requires public health intervention in accordance with provincial legislation, or
    2. for which immunization has been recommended under Canadian medical standards; or
  2. that is referred to in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time” (bolding added).

To be classified as a “disease posing a risk to public health,” a disease must meet the criteria of (a)(i) or (a)(ii) or (b).

For the purpose of this definition, the diseases covered by the IFHP are fully encompassed, at this time, within paragraph (a). There are no additional diseases to list under paragraph (b).

2.2. Expanded health care coverage

Section 1 of the OIC states “expanded health care coverage means coverage for the following services and products provided in Canada, as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time:

  1. hospital services;
  2. services of physicians licensed in Canada, registered nurses licensed in Canada and other health care professionals licensed in Canada;
  3. translation services for health purposes;
  4. laboratory, diagnostic and ambulance services;
  5. supplemental services; and
  6. supplemental products” (bolding added).

For the purpose of this section, “hospital services” means the per diem charges, main facility fees and secondary facility fees.

For the purpose of this section, “services of physicians licensed in Canada, registered nurses licensed in Canada and other health care professionals licensed in Canada” includes professional fees charged by a licensed audiologist, dentist, midwife, occupational therapist, optician, registered clinical psychologist, registered nurse, optometrist,  physician, physiotherapist or speech-language pathologist, if the service they provide is listed in the IFHP benefit grids for Expanded Health Care Coverage.

For the purpose of this section, “translation services for health purposes” means translation for psychiatry or psychotherapy and for post-arrival health assessments.

For the purpose of this section, “laboratory, diagnostic and ambulance services” means services listed in the Expanded Health Care Coverage Benefit Grid under the heading of Diagnostic or Therapeutic Procedures and Tests or under the heading of Transportation.

For the purpose of this section, “supplemental services” means audiology care, emergency dental care, home care, long term care, midwifery care, occupational therapy, physiotherapy, post-arrival health assessments, psychotherapy by a registered clinical psychologist, speech-language pathology, and vision care, to the extent set out in the IFHP benefit grids for Expanded Health Care Coverage.

For the purpose of this section, “supplemental products” means immunizations, medications, and medical supplies, to the extent set out in the IFHP benefit grids for Expanded Health Care Coverage.

For a detailed list of services and products covered, refer to the IFHP benefit grids for Expanded Health Care Coverage, as amended from time to time. Some services and products will require pre-approval. This is set out in the grid.

2.3. Health care coverage

Section 1 of the OIC states “health care coverage means coverage for the following services and products provided in Canada only if they are of an urgent or essential nature as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time:

  1. hospital services;
  2. services of physicians licensed in Canada and registered nurses licensed in Canada;
  3. laboratory, diagnostic and ambulance services; and
  4. immunization and medication, only if required to prevent or treat a disease posing a risk to public health or to treat a condition of public safety concern” (bolding added).

For the purpose of this section, Citizenship and Immigration Canada defines “services and products of an urgent or essential nature” as follows:

2.3.1. For the purpose of the IFH Program, services and products, as listed in the OIC, are of an urgent nature are those provided in response to a medical emergency - an injury or illness that poses an immediate threat to a person's life, limb or a function. The services and products shall not be more than what is required to respond to the medical emergency and must be provided to an IFHP beneficiary.

2.3.2. For the purpose of the IFH Program, services, as listed in the OIC, are of an essential nature if they are provided to an IFHP beneficiary:

  1. who is presenting for assessment and follow-up of a specific illness, symptom, complaint or injury;
  2. for prenatal, labour and delivery, and postpartum care (including routine prenatal care and maternal care for up to 28 days after the delivery); or
  3. for the diagnosis, prevention, or treatment of a disease posing a risk to public health or for the diagnosis or treatment of a condition of public safety concern.

2.3.3. For the purpose of the IFH Program, products, as listed in the OIC, are of an essential nature if they are provided to an IFHP beneficiary for the prevention or treatment of a disease posing a risk to public health or for the treatment of a condition of public safety concern and if they are:

  1. prescribed in alignment with Canadian treatment guidelines or immunization guidelines recommended by the National Advisory Council on Immunizations for children and adults with inadequate immunization records or for persons new to Canada;
  2. not for the prevention, diagnosis or treatment of complications of treatment;
  3. the lowest cost generic substitute, where a generic substitute exists unless no substitution is requested by the prescriber; and
  4. included for coverage by the following PT-funded immunization or drug benefit plans or programs:
    1. all PTs, in the case of vaccines;
    2. either Alberta, British Columbia, Manitoba, Ontario, or Quebec, in the case of medications for diseases posing a risk to public health; or
    3. any one province or territory, in the case of medications for conditions of public safety concern.

2.3.4. For the purpose of the IFH Program, services and products are not of an urgent or essential nature where they are:

  1. provided solely for the purpose of screening or prevention of a disease or injury except for screening or prevention of diseases posing a risk to public health or screening of conditions of public safety concern;
  2. for elective purposes or primarily provided to improve quality of life with respect to a condition that causes minimal dysfunction and that is unlikely to deteriorate to a medical emergency within 12 months or the current period of eligibility, if shorter;
  3. for cosmetic purposes or convenience of the beneficiary;
  4. for fertility and sterilization purposes;
  5. for the purpose of rehabilitation, including the cost of rehabilitation hospitals and facilities;
  6. primarily related to research or experimentation;
  7. not paid for by provincial or territorial health benefit programs;
  8. required by or paid by third parties such as insurance companies, business establishments (e.g. automobile insurance), or government agencies, but excluding immigration medical examinations; and
  9. for long term care and home care.

For a detailed list of services and products covered, refer to the IFHP benefit grids for Health Care Coverage, as amended from time to time.

2.4. Period of coverage for protected persons

2.4.1. Period of coverage for protected persons referred to in subsection 3(1).

Subsection 3(1) of the OIC states “The Minister may pay the cost of health care coverage incurred for protected persons, other than resettled refugee referred to in subsection 6.1(2), for a period set out in the Interim Federal Health Policy of the Department of Citizenship and Immigration, as amended from time to time” (bolding added).

For the purpose of this section, protected persons referred to in this subsection receive health care coverage until they are eligible under a PT health insurance plan or program, whether or not an application has been made to the plan or program.

2.4.2. Period of coverage for protected persons referred to in subsection 6.1(1).

Subsection 6.1(1) of the OIC states “The Minister may pay the cost of expanded health care coverage and immigration medical examinations incurred in Canada for the following persons for a period set out in the Interim Federal Health Policy of the Department of Citizenship and Immigration, as amended from time to time:

  1. persons for whom the Minister exercises a power conferred under subsections 25.1(1) or 25.2(1) of the Act, if they are or were in receipt of governmental resettlement assistance in the form of income support as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time; and
  2. persons who have been issued a temporary resident permit under section 24 of the Act if it has been determined, pursuant to ministerial instructions made under subsection 24(3) of the Act, that they are or may be victims of human trafficking” (bolding added).

For the purpose of this section, persons in paragraph (a) receive expanded health care coverage while they receive governmental resettlement assistance in the form of income support, but only for a maximum period of 12 months.

For the purpose of this section, persons in paragraph (b) receive expanded health care coverage for the period of their temporary resident permit.

2.4.3. Period of coverage for protected persons referred to in subsection 6.1(2).

Subsection 6.1(2) of the OIC states “The Minister may pay the cost of expanded health care coverage incurred for resettled refugees, if they are or were in receipt of governmental resettlement assistance in the form of income support as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time, for a period set out in that Policy” (bolding added).

For the purpose of this section, resettled refugees referred to in this subsection receive expanded health care coverage where they receive or were in receipt of governmental resettlement assistance in the form of income support while they either receive governmental resettlement assistance in the form of income support or are under sponsorship under the Immigration and Refugee Protection Regulations, but only for a maximum period of 24 months.

2.5. Governmental resettlement assistance in the form of income support

Section 6.1 of the OIC states:

“The Minister may pay the cost of expanded health care coverage and immigration medical examinations incurred in Canada for the following persons for a period set out in the Interim Federal Health Policy of the Department of Citizenship and Immigration, as amended from time to time:

  1. persons for whom the Minister exercises a power conferred under subsections 25.1(1) or 25.2(1) of the Act, if they are or were in receipt of governmental resettlement assistance in the form of income support as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time; and
  2. persons who have been issued a temporary resident permit under section 24 of the Act if it has been determined, pursuant to ministerial instructions made under subsection 24(3) of the Act, that they are or may be victims of human trafficking.

The Minister may pay the cost of expanded health care coverage incurred for resettled refugees, if they are or were in receipt of governmental resettlement assistance in the form of income support as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time, for a period set out in that Policy” (bolding added).

For the purpose of the IFH Program, “governmental resettlement assistance” means monthly income support received under the Resettlement Assistance Program of the Department of Citizenship and Immigration or from its equivalent in Quebec.

For the purpose of the IFH Program, “income support” means recurring financial payments to individuals to enable them to meet their basic needs including, but not limited to, food and shelter.

2.6. Detainee health care services and products referenced in section 9

Section 9 of the OIC states “The Minister may pay the cost of health care services and products incurred, in accordance with the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time, for foreign nationals or permanent residents who are detained under the Act” (bolding added).

For the purpose of this section, “health care services and products incurred” means the following:

IFHP will provide coverage for the immigration medical examination and for a range of products and services for detainees as determined by a medical professional and to the extent set out in the IFHP benefit grids for Detainees, as amended from time to time. These may be provided both onsite in detention facilities through contracted medical staff and offsite through IFHP registered health care facilities and professionals (e.g. hospitals, physician offices).

2.7. Benefit grids

Section 9.1 of the OIC states “Any payment referred to in sections 3 to 9 shall be made in accordance with the benefit grids referred to in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time” (bolding added).

For the purpose of this section the benefits grids for each type of coverage are:

  1. Expanded Health Care Coverage:
    1. IFHP Benefit Grid - Expanded Health Care Coverage
    2. Expanded Drug Benefits List
  2. Health Care Coverage:
    1. IFHP Benefit Grid - Health Care Coverage
    2. Public Health and Public Safety Drug Benefits List
  3. Immigration Medical Examination:
    1. IFHP Benefit Grid - IME and IME Tests
  4. Public Health or Public Safety health Care Coverage:
    1. IFHP Benefit Grid - Public Health and Public Safety
    2. Public Health and Public Safety Drug Benefits List
  5. Detainees:
    1. IFHP Benefit Grid - Detainees Plan
    2. Expanded Drug Benefits List

These may be changed from time to time. Some services and products will require pre-approval. This is set out in the grids.

List of Acronyms

IFHP
Interim Federal Health Program
IRPA
Immigration and Refugee Protection Act
OIC
Order in Council
PT
provincial or territorial
 
 
 
Date Modified: