Medically Inadmissible to Canada? Your Options and Next Steps
Medical inadmissibility means an officer believes your health condition endangers public health, endangers public safety or would cause excessive demand on health or social services. It can affect a visit, study, work or permanent residence application. If IRCC sends a procedural fairness letter, you have 90 days to answer, and you may be invited to send a mitigation plan.
since 1991
What is medical inadmissibility in Canada?
Medical inadmissibility is a legal bar on entering Canada because of a health condition. It is set out in section 38 of the Immigration and Refugee Protection Act (IRPA). The decision is based on your immigration medical exam.
It affects anyone who applies to visit, study, work or live in Canada. Most refusals come from the excessive demand ground.
What are the three grounds?
IRCC lists three: danger to public health, danger to public safety and excessive demand on health or social services. A health condition is excessive demand if it would hurt wait times for services in Canada, or if treating it would likely cost more than the excessive demand cost threshold. IRCC sets that threshold each year.
How does an officer decide?
- Public health: infectious disease, such as active tuberculosis or active syphilis, and close contact with others who have one
- Public safety: risk of sudden incapacity or unpredictable or violent behaviour
- Excessive demand: the cost of publicly funded health services and social services you would likely need
- Your exam: results from the panel physician and any specialist reports an IRCC medical officer asks for
Is this page for you?
A quick check before you answer IRCC or apply.
Read this if you
- Got a procedural fairness letter about your medical exam
- Were refused for excessive demand or another medical reason
- Have a health condition and plan to apply for a visa, permit or PR
Look elsewhere if you
- Were refused for a criminal record or false information
- Need help booking a medical exam
- Are a refugee, a protected person or an exempt family member
See the inadmissibility and refusals guide, the procedural fairness letter guide and the Canada visa refusal guide.
Five ways to respond to a medical inadmissibility finding
Your best route depends on your condition and your application. Source: IRCC.
Answer the letter
IRCC sends a procedural fairness letter before a final decision. Send your reply within 90 days of the date on the letter, or ask for an extension before it ends.
Send new medical evidence
Show your diagnosis, your treatment and your costs. A change in medication, such as a lower cost equivalent, can change the cost picture.
Submit a mitigation plan
If IRCC invites you, show how the services will be provided and how you will pay for them for as long as you need them.
Check for an exemption
Excessive demand does not apply to refugees, protected persons and certain sponsored family members. See family sponsorship.
TRP or H&C
A temporary resident permit may allow a short stay. An H&C application may be an option from inside Canada.
Got a medical letter?
We read your letter and your medical exam results before you reply.
Rules to know first
90 days to reply
The reply is due within 90 days of the letter date. Ask for more time before it ends.
Exemptions are narrow
Spouses, common-law partners and dependent children sponsored by family are exempt from excessive demand. Parents and grandparents are not on that list.
Plans need proof
A mitigation plan needs credible, detailed proof of services, payment and your finances. Add a signed Declaration of Ability and Willingness.
Public services stay public
You cannot opt out of publicly funded health services. A plan can cover outpatient prescription drugs in some provinces and territories.
Check the page date
The cost threshold and forms change. Check IRCC before you file.
Related pages
These pages cover letters, refusals and other ways to enter Canada.
How to respond to a medical inadmissibility letter
Five actions, in order.
Read the letter
Find the reason, the deadline and what IRCC wants.
Talk to your doctor
Ask for a clear report on diagnosis, treatment and cost.
Price the care
Find out what medication and services would cost.
Build the reply
Answer each concern. Add a mitigation plan if you were invited.
Send before day 90
Use the address in the letter and keep a copy.
Medical inadmissibility, step by step
Six steps from exam to decision.
Take the immigration medical exam
A panel physician examines you and sends the results to IRCC.
Read any fairness letter
If an officer has a concern, IRCC writes to you before a decision.
Gather medical proof
Get a clear report on your diagnosis, treatment and costs.
Prepare a mitigation plan
If invited, show who provides the services and how you will pay.
Send everything within 90 days
Ask for an extension before the date if you need more time.
Five mistakes with a medical letter
These mistakes weaken a case that can still be won.
Missing the 90 days
If you cannot reply in time, ask for an extension before the date passes.
Sending only a doctor note
A short note does not show diagnosis, treatment and cost. Send full evidence.
Skipping the plan
If IRCC invites a mitigation plan and you send none, you lose a chance.
Hiding the condition
False answers at the medical exam can bring a misrepresentation finding.
Guessing about the exemption
Check who is exempt before you rely on it. Parents are not.
Want a second set of eyes?
We read your letter and your evidence before you reply.
Medical inadmissibility facts at a glance
Key facts from IRCC and IRPA, checked October 2026. Last updated: October 2026. Source: IRCC.
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Medical inadmissibility FAQs
What is medical inadmissibility in Canada?
It is a refusal ground for people whose health condition endangers public health, endangers public safety or might cause excessive demand on health or social services. It is based on your immigration medical exam (IRPA section 38).
What is excessive demand?
IRCC treats your condition as excessive demand if the services needed would hurt wait times in Canada, or would likely cost more than the excessive demand cost threshold. The threshold for 2026 is $144,390 over five years, and IRCC updates it each year.
Who is exempt from the excessive demand rule?
Refugees and their dependants, protected persons and certain family members sponsored by a Canadian. Under IRPA section 38(2) that means the spouse, common-law partner or child of a sponsor in the family class. Parents and grandparents are not on that list.
What is a procedural fairness letter for medical reasons?
It is a letter IRCC sends before a final decision when it believes you may be medically inadmissible. It explains the reason and lets you respond. See our procedural fairness letter guide.
How long do I have to reply?
You must send additional information within 90 days of the date on the letter. If you cannot, contact IRCC and ask for an extension.
What is a mitigation plan?
It is a plan that shows how you will arrange and pay for the services your condition needs. It must be credible, detailed and personal to you, and you must sign a Declaration of Ability and Willingness.
Can I pay privately to avoid public health services?
No. You cannot opt out of publicly funded health services, except for outpatient prescription medication in some provinces or territories. A plan can cover private long-term care or drug costs if you can pay.
What can I send to answer the letter?
IRCC gives examples such as your diagnosis, treatment that cured or improved the condition, a change in medication and the cost of the medication or services you need.
Can a family member sponsor me if I am medically inadmissible?
Spouses, common-law partners and dependent children of a sponsor are exempt from excessive demand. Other family class members are not, so check your case first.
What if I am refused for a medical reason?
You can apply again with new evidence, ask for a temporary resident permit for a short stay or look at an H&C application from inside Canada. Federal Court review is also possible, with short deadlines.
Do false medical answers cause a ban?
Giving false information to the panel physician is treated as fraud and can lead to a five-year ban. See our misrepresentation guide.
Where can I get help with a medical inadmissibility letter?
Book a Strategy Consultation with Amir Ismail, RCIC R412319. We read your letter, your medical results and your deadline before you reply.
