The Coverage and Benefits

Last Updated on August 28, 2016

Type 1: Basic Coverage, Supplemental Coverage and Prescription Drug Coverage

• The people covered in this include:
  • Individuals who are or were receiving monthly income support through the Resettlement Assistance Program (RAP) or its equivalent in Quebec including:
    • Government assisted refugees
    • Joint Assistance Sponsorship Program Refugees
    • Certain people whom the authorities are resettling in Canada as a result of as public policy or Humanitarian and Compassionate (H&C) considerations based on the Minister’s own initiative
    • Visa Office Referred Refugees who are part of populations nominated for blended funding arrangements where Citizenship and Immigration Canada (CIC) and private sponsors jointly provide funding support and,
    • Certain refugees sponsored by organisations with whom Citizenship and Immigration Canada (CIC) enters into cost-sharing agreements
  • Victims of human trafficking who have a valid Temporary Resident Permit (TRP) under the provisions specified in section 24 (3) of the Immigration and Refugee Protection Act (IRPA)
  • Children eligible for the Interim Federal Health Program (IFHP) – especially those under 19 years of age

It is worth mentioning that basic coverage under Type 1 includes most services that insured residents have cover from under their provincial or territorial (PT) health insurance plans. As such, this would include cover for hospital services and services received from a doctor. The level of coverage provided through the Interim Federal Health Program (IFHP) for supplemental benefits and prescription medicines remains similar to the level of coverage that provincial or territorial (PT) governments typically provide to certain residents (including residents receiving social assistance).

Basic coverage typically comprises:

• In-patient and outpatient hospital services
• Services of medical doctors, registered nurses and other healthcare professionals licenced in Canada (including pre- and post-natal care) and,
• Laboratory, diagnostic and ambulance services

However, the benefits specified here are subject to certain limits and the prescribed maximum dollar amounts included in the Interim Federal Health Program (IFHP) Basic Coverage Benefit Grid.

In addition, the Interim Federal Health Program (IFHP) provides the following services too under Type 1 coverage. These services comprise certain supplemental healthcare benefits (including both services and products) listed in the Interim Federal Health Program (IFHP) Supplemental Benefit Grid such as:

• Limited dental and vision care
• Home care and long-term care
• Services by allied healthcare practitioners such as clinical psychologists, occupational therapists, speech language therapists and physiotherapists
• Assistive devices, medical supplies and equipment such as:
  • Orthopedic and prosthetic equipment
  • Mobility aids
  • Hearing aids
  • Diabetic supplies
  • Incontinence supplies
  • Oxygen equipment and,
  • Coverage for prescription medications and other products listed on provincial and territorial (PT) public drug plan formularies and certain products included in the Interim Federal Health Program (IFHP) Prescription Drug Coverage

Type 2: Basic Coverage and Prescription Drug Coverage

• The people covered in this include:
  • Pregnant women eligible for the Interim Federal Health Program (IFHP), but who are not eligible for Type 1 coverage and,
  • Rejected refugee claimants whom the authorities cannot remove from Canada because of a deferral of removal for generalised risk

It is worth mentioning that basic coverage under Type 2 includes most services that insured residents have cover from under their provincial or territorial (PT) health insurance plans. As such, this would include cover for hospital services and services received from a doctor. The level of coverage provided through the Interim Federal Health Program (IFHP) for supplemental benefits and prescription medicines remains similar to the level of coverage that provincial or territorial (PT) governments typically provide to certain residents (including residents receiving social assistance).

Basic coverage typically comprises:

• In-patient and outpatient hospital services
• Services of medical doctors, registered nurses and other healthcare professionals licenced in Canada (including pre- and post-natal care) and,
• Laboratory, diagnostic and ambulance services

However, the benefits specified here are subject to certain limits and the prescribed maximum dollar amounts included in the Interim Federal Health Program (IFHP) Basic Coverage Benefit Grid.

In addition, the Interim Federal Health Program (IFHP) provides the following services too under Type 2 coverage:

• Coverage for prescription medications and other products listed on provincial and territorial (PT) public drug plan formularies and certain products included in the Interim Federal Health Program (IFHP) Prescription Drug Coverage

Type 3: Basic Coverage and Public Health or Public Safety (PHPS) Prescription Drug Coverage

• The people covered in this include:
  • Privately sponsored refugees who do not receive and have not received monthly income support through the Resettlement Assistance Program (RAP) or its equivalent in Quebec
  • Refugee claimants, while their refugee claim continues to await a decision from the Immigration and Refugee Board (IRB) of Canada – including any appeals of a negative decision on their claims
  • Individuals who have received a positive decision on their refugee claim made in Canada from the Immigration and Refugee Board (IRB) of Canada and,
  • Individuals who receive a positive decision on their Pre-Removal Risk Assessment (PRRA)

It is worth mentioning that basic coverage under Type 3 includes most services that insured residents have cover from under their provincial or territorial (PT) health insurance plans. As such, this would include cover for hospital services and services received from a doctor.

Basic coverage typically comprises:

• In-patient and outpatient hospital services
• Services of medical doctors, registered nurses and other healthcare professionals licenced in Canada (including pre- and post-natal care) and,
• Laboratory, diagnostic and ambulance services

However, the benefits specified here are subject to certain limits and the prescribed maximum dollar amounts included in the Interim Federal Health Program (IFHP) Basic Coverage Benefit Grid.

In addition, the Interim Federal Health Program (IFHP) provides the following services too under Type 3 coverage:

• Public Health or Public Safety (PHPS) Prescription Drug Coverage, which typically includes prescription medications and related products
  • This is applicable only if required for preventing or treating a disease that poses a risk to public health or for treating a condition of public safety concern and included in the Interim Federal Health Program (IFHP) Public Health or Public Safety (PHPS) formulary
  • The list of benefits finds mention in the Interim Federal Health Program (IFHP) Public Health or Public Safety (PHPS) Drug Benefit List

Type 4: Public Health or Public Safety (PHPS) Basic Coverage and Public Health or Public Safety (PHPS) Prescription Drug Coverage

• The people covered in this include:
  • Individuals whose refugee claims the authorities have suspended
  • Individuals whose refugee claims the authorities determined as being ineligible for referral to the Immigration and Refugee Board (IRB) of Canada, but who are eligible for applying for a pre-removal risk assessment (PRRA) and,
  • Individuals whose refugee claims the Immigration and Refugee Board (IRB) of Canada rejected, with the individuals deciding against appealing the decision or individuals who have exhausted the right to judicial review or any appeal of that judicial review

It is worth highlighting that Public Health or Public Safety (PHPS) Basic Coverage is required only for preventing or treating a disease that poses a risk to public health or for treating a condition of public safety concern. As such, it typically comprises:

• In-patient and outpatient hospital services
• Services of medical doctors and registered nurses licenced in Canada and,
• Laboratory and diagnostic services

This coverage could pay for initial medical services needed for confirming or ruling out a disease that poses a risk to public health or for treating a condition of public safety concern.

However, the benefits specified here find mention in the Interim Federal Health Program (IFHP) Public Health or Public Safety (PHPS) Benefit Grid.

In addition, the Interim Federal Health Program (IFHP) provides the following services too under Type 4 coverage:

• Public Health or Public Safety (PHPS) Prescription Drug Coverage, which typically includes prescription medications and related products
  • This is applicable only if required for preventing or treating a disease that poses a risk to public health or for treating a condition of public safety concern and included in the Interim Federal Health Program (IFHP) Public Health or Public Safety (PHPS) formulary
  • The list of benefits finds mention in the Interim Federal Health Program (IFHP) Public Health or Public Safety (PHPS) Drug Benefit List

Type 5: Coverage for Persons Detained Under the Immigration and Refugee Protection Act (IRPA)

The Interim Federal Health Program (IFHP) provides coverage to people detained by the Canada Border Services Agency (CBSA) under the provisions specified in the Immigration and Refugee Protection Act(IRPA). This coverage continues for as long as the authorities detain these individuals.

This coverage typically includes medical services and prescription drugs provided:

• Onsite in detention facilities or,
• Offsite when medically necessary

The list of benefits finds mention in the Interim Federal Health Program (IFHP) Detainees Benefit Grid.

Type 6: Coverage for the Immigration Medical Examination (IME)

Certain categories of beneficiaries receive their main coverage from the Interim Federal Health Program (IFHP). However, they also receive cover for the cost of:

• The Immigration Medical Examination (IME) and,
• All Immigration Medical Examination (IME) related diagnostic tests required under the Immigration and Refugee Protection Act (IRPA)

The list of benefits finds mention in the Interim Federal Health Program (IFHP) Immigration Medical Examination (IME) Benefit Grid. Readers would need to view the Summary of Benefits for ascertaining the individuals covered for the Immigration Medical Examination (IME).