The words on the policy, demystified

More terms, explained in full

• Affidavit (translated documents)

  An affidavit is a written statement sworn under oath before an authorized person. For IRCC applications, it is what makes a translation acceptable when the translator is not certified: the translator swears an affidavit confirming their language skills and the accuracy of the translation. In Canada, an affidavit is usually sworn before a notary public or a commissioner for taking affidavits.

• Annual maximum and lifetime maximum

  An annual maximum is the most a plan pays for a benefit, or for all benefits, in one benefit year. A lifetime maximum is the most it pays over the whole time you are covered. Once a maximum is reached, you pay the rest yourself. Health, dental and drug plans commonly use both, often with different maximums for different services.

• Annual multi-trip plan

  An annual multi-trip plan is travel medical insurance that covers every trip you take during a year, up to a maximum length for each trip. A trip longer than that per-trip limit is not fully covered unless you add a top-up, which extends coverage for the extra days. Long winter stays commonly need either a matching per-trip limit or a single-trip policy.

• Assistance line and pre-authorization

  Travel and visitor medical policies usually give you an emergency assistance phone line to call when you need care. Many require you, or someone with you, to call before treatment or as soon as reasonably possible so the claim can be pre-authorized. If you do not call when the policy says to, the insurer may pay less of the claim or limit where you can be treated.

• Benefit year

  A benefit year is the 12-month period a health or dental plan uses to count deductibles and annual maximums. It may follow the calendar year or start on the plan's anniversary date. When a new benefit year starts, deductibles and annual maximums reset; lifetime maximums do not.

• Biosimilar and generic substitution

  A generic drug has the same active ingredient as a brand-name drug. A biosimilar is a biologic drug highly similar to one already authorized in Canada. Many drug plans pay only up to the price of the lower-cost version, a rule often called least-cost alternative, so if you choose the brand-name product you may pay the difference unless your prescriber documents a medical reason.

• Canadian Dental Care Plan

  The Canadian Dental Care Plan is a federal program that helps pay for dental care for residents who qualify. It is for households with adjusted family net income under $90,000 that do not have access to dental insurance. What you pay depends on income: under $70,000 the plan covers eligible costs in full at its own fees, and a co-payment applies above that.

• Certified translator

  For IRCC applications, a certified translator is a member in good standing of a provincial or territorial organization of translators and interpreters in Canada. Any document not in English or French has to be submitted with a translation. A certified translator seals or stamps the translation with a membership number IRCC can verify; an uncertified translator's work also needs a sworn affidavit.

• Co-payment and coinsurance

  A co-payment is a fixed dollar amount you pay each time you use a covered service, such as a set fee per prescription. Coinsurance is a percentage of the cost that you pay, with the plan paying the rest. Many plans combine them with a deductible and an annual maximum, so the share you pay can change through the year.

• Co-signer (super visa)

  On a super visa application, a co-signer is a second person who signs the host's letter of invitation and adds their income to help meet the minimum necessary income. Only one relationship qualifies: the host's spouse or common-law partner, and only if they are a Canadian citizen, a permanent resident of Canada or a registered Indian. Siblings and other relatives cannot co-sign.

• Conversion option

  A conversion option lets you move from a group health or dental plan, such as one through work, to an individual policy when the group coverage ends, often without new medical questions. Whether a plan offers one, what the individual policy covers and how long you have to apply are set by the plan, so ask before your group coverage ends.

• Coordination of benefits

  Coordination of benefits is how two health or dental plans that cover the same person share a claim, so that together they pay no more than the eligible cost. One plan pays first, as the primary plan, and the other considers what is left, as the secondary plan. Couples who each have a workplace plan commonly use it to cover more of their costs.

• Dispensing fee

  A dispensing fee is the pharmacy's charge for filling a prescription, separate from the cost of the drug itself. Fees differ between pharmacies. Drug plans may pay only up to a set amount for the dispensing fee, so you can owe the difference, and a public program's co-payment may be separate again. Fewer, larger fills mean fewer fees where a plan allows them.

• Exceptional Access Program

  The Exceptional Access Program is how Ontario's public drug programs consider paying for a drug that is not on the Ontario Drug Benefit Formulary. Requests are decided case by case against funding criteria, and only a doctor or nurse practitioner can apply. Other provinces have similar routes under their own names: Special Authority in British Columbia, special authorization in Alberta and Exception Drug Status in Saskatchewan.

• Formulary

  A formulary is the list of prescription drugs a drug plan pays for, along with any conditions attached to each one, such as requiring a lower-cost equivalent or approval in advance. Public drug programs publish their formularies, and private plans set their own. A drug your doctor prescribes is covered only if it is on the plan's list or approved through an exception.

• Ground ambulance co-payment (Ontario)

  In Ontario, a person with OHIP coverage is billed a $45 co-payment for a medically necessary ground ambulance trip to hospital, for example from home. Trips between Ontario medical facilities are not billed. Some people are exempt, such as those on social assistance or living in long-term care. A $240 charge applies if the trip is found not medically essential, or without a valid Ontario health card.

• Guaranteed-issue vs medically underwritten

  A guaranteed-issue health plan accepts you without health questions, usually with lower maximums, more exclusions or a higher price. A medically underwritten plan asks health questions first, and your answers decide whether you are accepted and on what terms. Guaranteed-issue describes how you get in; it does not mean every claim is paid, and pre-existing conditions may still be limited.

• Host status proof (super visa)

  Host status proof is the document showing that the person inviting a parent or grandparent on a super visa is a Canadian citizen, a permanent resident or a registered Indian. IRCC accepts a copy of proof of Canadian citizenship, a permanent resident document, or a Secure Certificate of Indian Status or status card, and the same for the host's spouse or common-law partner where that applies.

• Instalment payment (super visa insurance)

  IRCC allows super visa medical insurance to be paid in full or in instalments with a deposit. Either way, the policy itself still has to meet the requirements: valid for at least one year from the date of entry, at least $100,000 of emergency coverage, and coverage for health care, hospitalization and repatriation. A quote alone does not satisfy the requirement.

• Interim Federal Health Program

  The Interim Federal Health Program is the federal program that provides health coverage to refugee claimants and protected persons. It includes basic, supplemental and prescription drug benefits. Since May 1, 2026, basic benefits remain at no cost to the patient, while each prescription costs $4 and other supplemental services cost 30% of the eligible amount.

• Letter of invitation (super visa)

  A super visa letter of invitation is the letter the host child or grandchild in Canada writes and signs to invite their parent or grandparent. It is not just an invitation: it has to include proof that the host meets the minimum necessary income, the list of family members counted in that calculation, and each person's name and date of birth.

• Look-back period

  In travel and visitor medical insurance, the look-back period is the stretch of time before your coverage starts during which a pre-existing condition must have stayed stable for the policy to cover it. Each policy sets its own look-back period and its own definition of stable, and the length can vary with your age and the plan you choose.

• Medical questionnaire and misrepresentation

  A medical questionnaire is the set of health questions an insurer asks before issuing some policies, such as travel medical or individual health insurance. Your answers can decide whether you are accepted, what you pay and which conditions are covered. If an answer turns out to be inaccurate, the insurer may refuse a claim or cancel the policy; this is called misrepresentation.

• Minimum necessary income

  For a super visa, the minimum necessary income is the income the host child or grandchild in Canada has to meet or exceed for the size of their family. The host proves it in the letter of invitation. IRCC publishes the dollar thresholds separately, by family size, and updates them, so the current figure should always be read from IRCC for the year you apply.

• National pharmacare

  National pharmacare is the federal program, under the Pharmacare Act in force since October 10, 2024, that pays for certain medications through agreements with provinces and territories. So far it covers specific contraception and diabetes medications, and only in British Columbia, Manitoba, Prince Edward Island and Yukon, the jurisdictions with funding agreements. Elsewhere it does not yet change what you pay.

• OSFI-authorized insurer (Super Visa)

  For Super Visa medical insurance, IRCC accepts a policy from a Canadian insurance company, or from an insurer outside Canada that is authorized by the Office of the Superintendent of Financial Institutions (OSFI) to provide accident and sickness insurance, appears on OSFI's public list and issued the policy while doing insurance business in Canada. A policy from such an insurer must include a statement saying so.

• Panel physician

  A panel physician is a doctor approved by Immigration, Refugees and Citizenship Canada (IRCC) to carry out immigration medical exams. A super visa applicant has to show proof of a medical exam with an approved panel physician. The exam is a separate requirement from the medical insurance policy; having one does not satisfy the other.

• Paramedical services

  In health and dental insurance, paramedical services are treatments from practitioners other than physicians, such as physiotherapists, chiropractors, registered massage therapists and psychologists. Provincial plans generally cover them little or not at all, so this coverage usually comes from an extended health plan. Plans usually set a yearly maximum for each type of practitioner, or a combined maximum.

• Proof of relationship (super visa)

  Proof of relationship is the document showing that a super visa applicant is the parent or grandparent of the host in Canada. IRCC accepts a copy of the host's birth certificate or baptismal certificate naming the applicant as parent or grandparent, or another official document that names the applicant as the host's parent or grandparent.

• Snowbird

  A snowbird is a Canadian who spends part of each winter in a warmer place, often several months in the United States. Two rules shape their coverage: how long their province lets them be away while keeping public health coverage, and how much of a long trip their travel medical insurance actually covers. Provincial plans may cover only a small part of the cost of care in the United States.

• Substantial presence test (US)

  The substantial presence test is the US Internal Revenue Service rule for deciding whether someone who is not a US citizen is treated as a US resident for tax purposes. It is met with at least 31 days in the US in the current year and at least 183 days over three years, counting all current-year days, one third of last year's and one sixth of the year before.

• Trillium Drug Program

  The Trillium Drug Program is an Ontario government program for people with high prescription drug costs. Once a household pays a yearly deductible, usually about 4% of household income after taxes, it pays up to $2 for each prescription on the Ontario Drug Benefit Formulary. It is open to Ontarians whose drug costs are high compared with their income.

• University Health Insurance Plan

  The University Health Insurance Plan is the health coverage Ontario's participating universities require for international students, and for some international employees and their families, because they are not eligible for OHIP. Enrolment is generally automatic and opting out is limited to narrow cases. UHIP covers many of the same services as OHIP but not all of them, so students may also need a separate plan for other costs.

• Visitor record

  A visitor record is the document IRCC issues when it extends or changes a visitor's stay in Canada. You must apply before your current status expires, and IRCC advises applying at least 30 days ahead. If you apply in time, you can stay while the application is decided; this is called maintained status. Your status end date is on your passport stamp, or six months from entry if there is no stamp.