Guide 5568 - Application for Interim Federal Health Program Coverage (IFHP)

Table of Contents

This is not a legal document. For legal information, refer to the Immigration and Refugee Protection Act and Regulations or the Citizenship Act and Regulations, as applicable.

This publication is available in alternative formats upon request.

Overview

Application package

This application package consists of:

  • an instruction guide and
  • the required forms

The instruction guide is a tool that provides:

  • the information you must know about this application before sending it to Citizenship and Immigration Canada (CIC) and
  • assistance with how to fill out the forms and the required supporting documents

Read the instruction guide thoroughly and then fill out each of the applicable form.

The forms are specifically designed with questions that will assist the processing of your application.

Symbols used in this guide

This guide uses the following symbols to indicate information of particular importance.

Required step
What you must do to have your application processed.
Important information
Important information that you need to be aware of in order to avoid delays or other problems.
Get more information
Where to get more information.
Note:
Tips that will assist you with this application.

The application process

The instructions provided in this guide follow the basic steps you will need to know to complete your application.

  1. Gather documents
  2. Complete the application
  3. Pay the fees
  4. Mail the application

Before You Apply

Application for Interim Federal Health Program coverage

The Interim Federal Health Program (IFHP)

The Application for IFHP coverage (5564) is for persons who are eligible for the Interim Federal Health Program (IFHP) and who want:

  • to apply for health-care coverage under this program, or
  • to extend their existing IFHP coverage, or
  • to request a confirmation of an existing IFHP coverage if their original IFHP eligibility document has been stolen, lost or destroyed.

Read the following instructions carefully. Forms that are incomplete or illegible, or that are not accompanied by the required documents may take longer to process or be returned.

Important information about IFHP eligibility documents

The IFHP eligibility document, such as the Refugee Protection Claimant Document (RCPD) or the Interim Federal Health Certificate of Eligibility (IFHP Certificate), is an important document which identifies you as someone who may have IFHP coverage to health-care providers (i.e. doctors, hospitals, pharmacies).

Once you show your IFHP eligibility document to your health-care providers, they must confirm your coverage with the IFHP Claims Administrator every time you visit them.

  • If you receive a new eligibility document, read it carefully and sign it in the area entitled “Signature of Holder.”
  • If you do not receive a new document, your coverage may have been extended electronically in CIC’s computer system only, in which case you may continue using your existing IFHP eligibility document.

Note: Your eligibility document will not be accepted by health-care providers without your signature.

Am I eligible?

You may only apply for an IFHP coverage if you:

  • do not have financial resources to pay for your healthcare,
  • are not covered by a public or private health insurance plan, and
  • belong to one of the following categories in the table below:

Categories

Resettled Refugee Selected Abroad

You are a Resettled refugee or a person in similar circumstances chosen for resettlement from outside Canada and you receive assistance under the Resettlement Assistance Program (RAP) or a private sponsorship.

Refugee Protection Claimants

You claimed refugee protection status in Canada and have not yet received a decision from the Immigration and Refugee Board (IRB). Note that your coverage can be cancelled without notice if your immigration or financial status changes.

  • If your IFHP coverage expires before the IRB’s decision, you may need to apply for an extension.
  • If the IRB determines your status to be a Convention refugee, your IFHP coverage will automatically expire in three (3) months. Then, you must contact the provincial/ territorial health plan in your residence area and apply for coverage, or ask when you can apply.
  • If your claim is rejected, your coverage will continue until you leave Canada voluntarily or are removed.
  • If you did not comply with a removal appointment and a warrant is issued for your removal from Canada, or if your departure from Canada is confirmed, IFHP coverage will expire immediately.
Victims of Trafficking in Persons

You received a 6-month Temporary Resident Permit as a victim of human trafficking. As such, you are eligible for IFHP coverage for a period of up to 180 days.


Important information

In some provinces /territories, refugee claimants can apply for provincial/territorial health coverage as soon as they receive a positive decision. But if you are required to wait longer than 3 months, you may need to apply for an extension of your IFHP coverage.

When should I apply?

CIC centres process applications for IFHP eligibility extensions as quickly as possible, depending on the condition of the application and the services required.

If you meet the eligibility requirements and your situation requires that you continue to have access to the IFHP. Then, you should submit an application for an extension no later than four weeks before the expiration date of your most recent eligibility period for this program.

Note: If the “Valid Until date” box on your new IFHP Certificate is empty, you can find the first expiry date of your coverage in the body of the text above your signature. You must apply to extend your coverage (not the Certificate) before this date, and then annually if you remain eligible. If you are not sure when your IFHP coverage expires, you can verify it by calling the CIC Call Centre at 1-888-242-2100.

How to apply?

Each eligible person 14 years of age and older must complete and sign a separate application form.

For children younger than 14 years old, a parent (or legal guardian, where present) must complete and sign the application form. The parent or legal guardian must print their name, sign the application form and check the box to indicate their relationship to the child.

Step 1. Gather Documents

What documents are required?

Collect the documents you need to support your application. Your application must include:

  • The Application for IFHP Coverage (IMM 5564)
  • The Use of Representative(IMM 5476), if applicable

A recent photograph of the person whose name appears on the application, or two (2) photographs if you are applying to request a confirmation of your existing IFHP coverage. Photographs must have been taken in the six months preceding your request and must meet the attached specifications (see Appendix B). The name of the person appearing in the photograph must be written on the back of the photograph.

  • A clear and legible photocopy of the most recent of the following documents that CIC issued to you and to your dependants:
    • Refugee Protection Claimant Document (RCPD)
    • Interim Federal Health Certificate of Eligibility (IFHP Certificate)
    • Any other document issued to you and your dependants, if applicable, by Canadian immigration authorities.

Note

If your original IFHP eligibility document was destroyed, include what is left of it with your application to request a confirmation of an existing IFHP coverage.

If your original document was lost or stolen and later recovered, you must return it immediately to a CIC office.

Step 2. Complete the Application

Filling out the application

Follow the step-by-step instructions below to complete the application forms.

The following are the forms that must be filled out and submitted for all applicants:

  • Application for IFHP Coverage (IMM 5564)
  • Use of a Representative (IMM 5476), if applicable.

Note

It is a serious offence to give false or misleading information on these forms. The information you provide on your application may be subject to verification.


Important information

Be complete and accurate

Complete all sections. Answer truthfully and to the best of your knowledge. Be sure to sign your application form and attach the required supporting documents. Your application may be returned if any information or documents are missing.

Application for IFHP Coverage (IMM 5564)

Who needs to fill out this application form?

This form must be completed by:

  • Each eligible person 14 years of age and older,
  • A parent or legal guardian for children younger than 14 years old.
Section A - Personal Details

In this section, provide your personal information, such as family name, date of birth, address, etc.

Note: You can find your client Identification number (Client ID) on your immigration document, issued by the CIC office, the Case Processing Centre, or the visa office where you filed your claim. Your client identification number consists of four numbers, a hyphen (-) and four more numbers. (Example: 0000-0000).

Section B – Your Status in Canada

In this section, you should describe your immigration status in Canada. Your answers in this section will be used to determine your IFHP eligibility. Answer truthfully and to the best of your knowledge.

Section C – Means for Health care

In this section, you should indicate if you have means for your potential health-care expenses in Canada. Your answers in this section will be used to determine your IFHP eligibility. Answer truthfully and to the best of your knowledge.

Section D – Information for Document Replacement

Complete Section D only if your IFHP eligibility document was lost, stolen or destroyed and you are applying to request a confirmation of existing IFHP coverage.

Section E – Declaration of Applicant

Read the declaration. Then sign and date in the boxes provided.


Note

Be sure to attach your photos and the supporting documentation listed in the instructions accompanying this form.

Use of a Representative (IMM 5476)

Who may use this form?

Complete this form only if you:

  • used the services of a representative to help you prepare or submit your application; or
  • are appointing a representative; or
  • are cancelling a representative’s appointment.

If you have dependent children aged 18 years or older, they are required to complete their own copy of this form if a representative is also conducting business on their behalf.

What is a representative?

A representative is someone who has provided advice, consultation, or guidance to you at any stage of the immigration application process, or in an immigration proceeding. If someone represented or advised you to help you submit your application, then that person is your representative. A representative is also someone who has your permission to conduct business on your behalf with Citizenship and Immigration Canada (CIC) and the Canada Border Services Agency (CBSA).

When you appoint a representative:

  • you also authorize CIC and CBSA to share information from your case file with this person;
  • your application will not be given special attention nor can you expect faster processing or a more favourable outcome;
  • the representative is authorized to represent you only on immigration matters related to the application you submit with this form;
  • you can appoint only one representative for each application you submit;
  • you are not obliged to hire a representative. We treat everyone equally, whether they use the service of a representative or not.

Important information. You must notify us if your representative’s contact information changes or if you cancel the appointment of a representative.

Types of representatives

Family, friends, and non-profit groups often help applicants who feel the need for support and advice on immigration matters. You can appoint a representative who does not charge fees or receive any other compensation for providing immigration advice or services to represent you before CIC or the CBSA.

There are two types of representatives.

Uncompensated representatives include:

  • friends and family members who do not, and will not, charge a fee or receive any other consideration for their advice and services;
  • organizations that do not, and will not, charge a fee or receive any other consideration for providing immigration advice or assistance (such as a non-governmental or religious organization);
  • consultants, lawyers and Quebec notaries, and students-at-law under their supervision, who do not, and will not, charge a fee or receive any other consideration to represent you.

Compensated representatives:

Compensated representatives charge a fee or receive some other form of consideration in exchange for the advice and representation that they provide. If you want us to conduct business with a compensated representative then they must be authorized by CIC.

It is important to know that anyone who represents or advises you for payment — or offers to do so — in connection with immigration proceedings or applications is breaking the law unless they are an authorized representative or they have a specific agreement or arrangement with the Government of Canada that allows them to represent or advise you. This applies to advice or consultation which happens before or after an immigration application is made or a proceeding begins.

Authorized representatives are:

  • immigration consultants who are members in good standing of the Immigration Consultants of Canada Regulatory Council (ICCRC);
  • lawyers and paralegals who are members in good standing of a Canadian provincial or territorial law society and students-at-law under their supervision;
  • notaries who are members in good standing of the Chambre des notaires du Québec and students-at-law under their supervision.

If you appoint a compensated representative who is not a member of one of these designated bodies, your application will be returned. For more information on using a representative, visit our website.

General Application Information

Check one box to indicate if you are appointing or cancelling the appointment of a representative.

Section A – Applicant Information

Question 1

Write your last name (surname or family name) and given name(s).

Question 2

Write your date of birth.

Question 3

If you have already submitted your application, write:

  • the name of office where the application was submitted;
  • location of office;
  • type of application you are sending.
Question 4

Write your Citizenship and Immigration Canada Identification (ID) or Unique Client Identifier (UCI) number (if known).

Section B – Appointment of Representative

Question 5

Write your representative’s full name.

If your representative is a member of the Immigration Consultants of Canada Regulatory Council (ICCRC), a law society or the Chambre des notaires du Québec, print his or her name as it appears on the organization’s membership list.

Question 6

Check one box to indicate if your representative is unpaid or paid.

If your representative is paid, write the membership ID number of:

  • the Immigration Consultants of Canada Regulatory Council (ICCRC); or
  • a Canadian provincial or territorial law society; or
  • the Chambre des notaires du Québec.
Question 7

Write your representative’s contact information.

Note: By indicating your representative’s e-mail address, you are hereby authorizing CIC to transmit your file and personal information to this specific e-mail address.

Question 8

Your representative must sign and date the declaration in order to accept responsibility for conducting business on your behalf.

Section C – Cancel the Appointment of a Representative

Question 9

Fill in this section if you wish to cancel the appointment of a representative. Write the representative’s full name.

Section D – Your Declaration

Question 10

By signing, you authorize CIC to complete your request for yourself and your dependent children under 18 years of age.

If your spouse or common-law partner is included in this request, he or she must sign in the box provided.

Release of information to other individuals

To authorize CIC to release information from your case file to someone other than a representative, you will need to complete the form Authority to Release Personal Information to a Designated Individual (IMM 5475) which is available:

  • on our website; or
  • from Canadian embassies, high commissions and consulates abroad.

The person you designate will be able to obtain information on your case file, such as the status of your application. However, they will not be able to conduct business on your behalf with CIC.

Step 3. Mail the Application

Mailing instruction

Follow the instructions below to determine where to submit your application.

  • Put the completed forms, supporting documents in a 23 cm x 30.5 cm (9″ x 12″) envelope.
  • Be sure to use sufficient postage
  • Send your completed application to the nearest CIC centre listed in Appendix A (at the end of this guide).
Affix sufficient postage (top right of the envelope)
Sender (top left of the envelope)
 (Your name)
(Your Address)
(Your Postal Code)
Recipient (centre of the envelope)
 Citizenship and Immigration Centre
(Refer to the addresses shown in Appendix A for the closest office).

Note

Sign the form

The application must be signed and dated before it is mailed. If your application is not signed and dated, it will be returned to you.

What Happens Next

The application process

Submission

Once you have submitted your application, CIC will evaluate your eligibility to determine that have been properly completed and submitted and that all requested supporting documentation has been provided.

The CIC centre may also contact you if you need to provide:

  •  more information,
  • additional documents, or
  • appear for an interview.

Processing

  • If you are applying to extend your IFHP eligibility document and you meet the requirements, then CIC will:
    • issue a new Interim Federal Health Certificate of Eligibility to you, or
    • extend your coverage electronically in CIC’s database only and send you a confirmation letter
  • If you are applying to request confirmation of an existing IFHP coverage, then CIC will:
    • Send you a confirmation letter
  • If your application for IFHP coverage is denied CIC will inform you in writing.
The content below is offered in PDF format. For more information or to download the appropriate viewer, check the Help page.

Note: Your eligibility period will be determined based on your particular situation and will be no more than 12 months. CIC may also send you the IFHP Information Sheet for Recipients (PDF, 206 KB) which provides detailed information for program recipients and health-care providers. This document is also available in multiple languages on our website.


Important information

Note that when you signed your original document that provided you with IFHP coverage or when you sign a new such document issued as a result of this application, you agree that your medical and personal information will be shared with CIC, IFHP claims administration and other appropriate third-parties for the administration of the Interim Federal Health Program and that your personal information may be shared with other government institutions and other third-parties in accordance with the Privacy Act and the Immigration and Refugee Protection Act (IRPA).

Factors that facilitate processing

There are certain things you can do to help ensure that your application is processed as promptly as possible by the office:

  • make sure that all the documentation and information requested is provided at the time your application is made.
  • make sure that you notify the CIC centre promptly of any and all changes to your mailing address, family situation, or any other information that is important to your application.

Change of Address

If you change your address after you submit your application, notify us immediately by:

  • e-mail, using the CIC on-line service (consult our website and follow the instructions on how to complete and send the electronic change of address form); or
  • calling the Call Centre.

Protecting your information

Your personal information is:

  • only available to Citizenship and Immigration Canada (CIC) and Canada Border Service Agency (CBSA) employees who need to see it in order to provide the services to you, and
  • not disclosed to anyone else except as permitted under the provisions of the Privacy Act.

For more information. You can obtain additional information on the protection of your data by visiting the “Frequently Asked Questions” (FAQ) on our website.

Quality Assurance Program

Our quality assurance program randomly selects applications for a special review. If selected you will be asked to attend an interview with a Citizenship and Immigration official so that we can:

  • verify the documentation you submitted is accurate,
  • verify that your application has been completed properly.

Note: You will be notified in writing should your application be selected.

Online services

For more information on the programs offered by Citizenship and Immigration Canada, visit our website.

How to contact CIC

Within Canada

CIC Call Centre:
1-888-242-2100 (toll-free)

Hours of operation:
Monday to Friday 8 a.m. to 4 p.m., your local time

If you are deaf, deafened or hard of hearing, or you have a speech impediment and use a text telephone, you can access the TTY service from 8 a.m. to 4 p.m. your local time by calling: 1-888-576-8502 (in Canada only).

Appendix A - List of Citizenship and Immigration Centres

Atlantic

Quebec

Ontario

Prairies/Northern Territories

British Columbia/Yukon

Atlantic

Charlottetown
191 University Avenue
Charlottetown, PE  C1A 4L2

Fredericton
495 Prospect Street
Fredericton, NB  E3B 9M4

Halifax
1741 Brunswick Street, Suite B110
Halifax, NS  B3J 3X8

Moncton
860 Main Street, 6th Floor, Suite 602
Moncton, NB  E1C 1G2

Saint John
189 Prince William Street
Saint John, NB  E2L 2B9

St. John’s
North Atlantic Building, 2nd floor
31 Pippy Place
P.O. Box 13667, Station “A”
St. John’s, NL  A1B 4G1

Quebec

Gatineau
259 St-Joseph Blvd, Suite 109
Gatineau, QC  J8Y 6T1

Montréal
1010 St-Antoine Street West, 2nd floor
Montréal, QC  H3C 1B2

Québec
Complexe Lebourgneuf
825 Lebourgneuf Boulevard, Suite 110
Québec, QC G2J 0B9

Sherbrooke
76 Place de la Cité
Sherbrooke, QC  J1H 4G8

Trois-Rivières
55 des Forges Blvd., Room 012
Trois-Rivières, QC  G9A 6A8

Ontario

Greater Toronto Area, including Etobicoke, Mississauga and Scarborough
25 St. Clair Avenue East, Suite 200
Toronto, ON  M4T 1M2

Outside the Greater Toronto Area
Send your application to the closest CIC as follows:

Barrie
48 Owen Street, Suite 312
Barrie, ON  L4M 3H1

Hamilton
55 Bay Street North
Hamilton, ON  L8R 3P7

Kitchener
Waterloo/Wellington CIC
29 Duke Street East
Kitchener, ON  N2H 1A2

London
417 Exeter Road
London, ON  N6E 2Z3

Niagara Falls
6080 McLeod Road, Unit 12
Niagara Falls, ON  L2G 7T4

Oshawa
78 Richmond Street West, 2nd floor
Oshawa, ON  L1G 1E1

Ottawa
(includes Kingston)
200 Catherine Street, Suite 101
Ottawa, ON  K2P 2K9

Sault Ste. Marie
22 Bay Street
Sault Ste. Marie, ON  P6A 5S2

Sudbury
40 Elm street , Suite 281
Sudbury, ON  P3E 3L4

Thunder Bay
221 Archibald Street North, Suite 108
Thunder Bay, ON  P7C 3Y3

Windsor
1250 Walker Road
Windsor, ON  N8Y 4T4

Prairies/Northern Territories

Calgary
Harry Hays Building, Room 210
220 4th Avenue S.E.
Calgary, AB  T2G 4X3

Edmonton
(including residents of Northwest Territories)
Canada Place
9700 Jasper Avenue
Suite 240,
Edmonton, AB  T5J 4C3

Regina
1783 Hamilton Street, Room 220
Regina, SK  S4P 2B6

Saskatoon
410 22nd Street East
Suite 660
Saskatoon, SK  S7K 5T6

Winnipeg
(including residents of Nunavut)
Johnston Terminal, Room 400
25 Forks Market Road
Winnipeg, MB  R3C 0S9

British Columbia/Yukon

Kelowna
1635 Abbott Street
Suite 202
Kelowna, BC  V1Y 1A9

Nanaimo
60 Front Street, Room 201E
Nanaimo, BC  V9R 5H7

Prince George
177 Victoria Street
Suite 250
Prince George, BC  V2L 5R8

Vancouver
1148 Hornby Street
Vancouver, BC  V6Z 2C3

Victoria
816 Government Street, Room 377
Victoria, BC  V8W 1W9

Whitehorse
300 Main Street
Suite 215
Whitehorse, YT   Y1A2B5

Appendix B — Photo specifications

Notes to the applicant

TAKE THIS WITH YOU TO THE PHOTOGRAPHER

  • Immigration photographs are not the same as passport photographs.
  • Make sure that you provide the correct number of photographs specified in this guide.

Notes to the photographer

The photos must:

  • show a full front view of the person’s head and shoulders showing full face centered in the middle of the photograph;
  • have a plain white background;
  • be identical (black and white or colour) produced from the same untouched negative, or exposed simultaneously by a split-image or multi-lens camera;

The photos must:

  • measure between 25 mm and 30 mm (1″ and 1 1/5″) from chin to crown
  • have a 35 mm x 45 mm (1 3/8″ x 1 3/4″) finished size

Image described above