Healthcare for Refugee Claimants

Will I have access to free healthcare while my refugee claim is being processed?

Yes. Refugee claimants in Canada are eligible for limited free healthcare, education and other social benefits. Health coverage is provided under the Interim Federal Health Program (IFHP). If you have been found eligible for a hearing then you can receive temporary and free healthcare while your claim is processed. You’ll need to apply to get the coverage.

I heard that refugees are no longer eligible for free healthcare. Is that true?

There were cuts made to IHIP back in 2012, but the program was restored in 2016 to ensure that refugee claimants had proper access to medical treatment and services.

You still need to apply for health coverage from the province or territory where you live once you are eligible, which can take up to 3 months or longer. You will have supplemental and prescription drug coverage for as long as you are eligible under IFHP. You just need to meet the requirements and apply for coverage or extended coverage under IFHP.

What Types of Health Services Are Covered?

The IFHP covers basic requirements, including hospital services and medical care, limited vision and urgent dental care, mental health services and most prescription medications. The program also covers one Immigration Medical Exam (and one related diagnostic test) fee. There are maximum dollar amounts for certain areas of coverage.

How Do I Get Coverage?

You must submit an application for IHIP before you are covered. The application can be submitted online or on paper. It is important that you submit all of the required information and documents with your IFHP application so that you are not refused or experience delays in getting the coverage you need.

If you meet the requirements, you will be issued a Refugee Protection Claimant Document (RPCD) or an Interim Federal Health Certificate of Eligibility (IFHP Certificate). You are then covered from the date your IFHP eligibility document is issued.

An RPCD is issued to people with refugee claims that have been referred to the Immigration Refugee Board of Canada (IRB) and people who have been found ineligible for a refugee claim but are eligible to apply for a pre-removal risk assessment (PRRA). If your claim was denied and you are not eligible for a PRRA, then you will not be covered under IFHP.

An IFHC Certificate is issued to other refugees, including resettled refugees, and is your temporary coverage until you are eligible to access coverage from the province or territory where you live.

No matter which document you receive, you must sign it as soon as you receive it. This is important because healthcare providers will not provide covered services and prescriptions without a signed document. Make sure that you bring your document with you whenever you receive medical services.

How Long Does Coverage Last?

Your coverage under IFHP will last until you are no longer eligible, your immigration status changes, you leave Canada or you qualify for provincial or territorial coverage. The provincial and territorial eligibility requirements and wait times depend on where you live. In Quebec, only privately sponsored refugees are eligible for provincial health care, so you will need to apply for IFHP coverage until your claim has been assessed if you live in Quebec.

If your refugee claim is withdrawn, abandoned or determined to be ineligible and you are not eligible for PRRA, your coverage will end immediately.

If you are determined to be a Convention refugee or get a positive decision on your PRRA application, your IFHP coverage will end 90 days after the date the determination is made.

If your claim is approved and you need to wait to apply to your province or territory, you can apply to extend your IFHP coverage until you receive coverage from your province of residence.

Accessing Services Once You Are Covered

Once you are covered and have your eligibility document (do not forget to sign it), you can seek services from healthcare providers registered with Medavie Blue Cross. Medavie administers IFHP claims so it is important to ask ahead of time if a service provider, pharmacy or hospital is registered to make sure that your claim will be covered. Healthcare providers that are not already registered can easily do so and you can discuss this with your doctor or medical provider.

You will need to show your signed eligibility document before treatment is given, just to confirm that you have coverage. After treatment, you might need to sign a claim form. Your medical provider will give you this form if they need it, and you are not required to bring it with you.
You should not be asked to pay for any treatment or services, either up front or after. As long as the treatment or service is included under IFHP, there is absolutely no cost to you and Medavie will reimburse the doctor or service provider directly.

After you receive treatment, you might get a letter in the mail from Medavie asking you to confirm the treatment that you received. You will need to answer their question, sign the letter and send it back to Medavie.

I submitted my refugee claim in Canada and I received a Notice to Appear for my refugee hearing.
What will happen during my hearing?
How can I prepare myself for the hearing?

The refugee hearing is organized in order to determine if you are in need of protection in Canada or if you qualify as a Convention Refugee. Convention Refugee means that you have a well-founded fear of persecution, the danger of torture, a risk to your life or cruel or unusual treatment or punishment in your country, based on your race, religion, nationality, membership in a particular social group, or political opinion. It also means your country of citizenship is unable or unwilling to protect you. In the hearing, you will be given an important opportunity to explain why you believe you need protection and why you are claiming refugee status in Canada.

During your hearing, the Board Member of the Refugee Protection Division (RPD) presiding over your hearing will start the hearing process. She or he will ask you questions about your specific case and about your supporting documentation as well the forms you completed when making your claim. Some questions might be hard, and you might get sad or uncomfortable answering them. However, it is very important that you answer all questions as the hearing is about you, your fear. At the end of the hearing, your lawyer will also have an opportunity to ask you further questions and will also provide with oral submission as to why your claim should be allowed based on the evidence submitted, the case law and the regulations. The hearing can take from 1 hour to 5-7 hours and can be adjourned to another day if not concluded. You might get the decision at the end of the hearing verbally – however, this is rare. Most of the time the decision will be sent in the mail about 30 to 60 days later.

Many refugee claimants decided to have legal representation – we highly recommend this given the administrative process for submitting an adequate and complete refugee claim. Your representative will assist you in preparing for the hearing. This is important as the refugee determination process is complex and involves many different steps and procedures.

A refugee claim may be submitted if you fear that you may be persecuted in your country of nationality or citizenship. You may also submit a claim if you feel that you may be tortured or are at risk of exposure to cruel and unusual treatment or punishment in your home country. These fears must be well-founded in order to present a refugee claim or a protection claim at the Refugee Protection Division.

You must be prepared to provide documentation supporting your fear of returning home and will have to discuss the situation in full detail. The risk that you are facing must be a personal one that applies directly to you and you must show that you have tried to get help from the government in your original country. As well, you’ll need to show proof that there is no other region or city in your home country that you could return to safely.

There are many steps involved with a refugee claim so it is critical to have a lawyer working with you. This is the only way to ensure that all of the steps are followed correctly.

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Depending on a number of factors including your country of origin and whether you made your refugee claim at a port of entry or once you were already in Canada, your Refugee hearing would be scheduled within 30 to 60 days of your claim. 20 days before this hearing, you are required to submit your forms and all documents you would like to rely on in favor of your application. Late submissions can be made but it cannot be guaranteed.

At the hearing, a Board Member, who would have a copy of all the documents you submitted, would ask you questions in order to determine whether or not to grant you protection in Canada. It is rare for Citizenship and Immigration Canada (CIC) to send a representative to these hearings but sometimes there will be a CIC representative present and they will ask you some questions as well.

It is very crucial that your story is clearly presented to the Board Member and that your answers are coherent and consistent. It is highly recommended that you have a lawyer represent you at this hearing so that they can ensure your full story is presented to the Board Member and if there are any apparent inconsistencies in your answers, they can clarify your answers by asking you further questions or by pointing the board member to relevant information in the documents. You can have an interpreter at the hearing so that you understand the questions put to you and answer them clearly and fully without difficulty.

The hearing usually lasts between two hours to half a day. Some hearings do last longer and sometimes a second hearing date may have to be scheduled to complete the hearing. The Board member may either give an oral decision immediately after the hearing or post a written decision letter to you or your lawyer on a later date.

If your refugee claim is refused in Canada and you are not from a designated country of origin you will be able to appeal the decision at the Refugee Appeal Division. In some cases, the Board Member might say that your claim is “manifestly unfounded” in which case you will not be allowed to appeal. The appeals are usually paper based and there are hearings only in exceptional cases. At the appeal, you will have a chance to argue that on the merits of your case, it should have been allowed and you can rely on new evidence that was not available to you at the time of the RPD hearing. The appeal judge will make a fresh decision on the merits of your case.

If the second decision comes out negative as well, you may apply for permission to judicially review the decision.

If you are from a designated country of origin, you will unfortunately not be able to appeal the decision of the RPD Board Member. You can, however, apply for permission to judicially review the decision of the Federal Court. If you are granted permission, a judge at the Federal Court will review the decision of the RPD.

A Judicial Review is different from an appeal. The Federal Court judge will not look at any new evidence and will defer to the original decision maker. This means that only if the original decision maker made an error in law or facts or made a decision that is so unreasonable based on the information submitted to them that it cannot stand will the reviewing judge overturn the decision. The reviewing judge will not make a decision in your case but will return it to the RPD to be decided again by a different Board Member. The arguments made at the hearing are mostly legal and you will need a lawyer to appear on your behalf at the Federal Court hearing.

The process may sometimes take long and it does not automatically protect you from deportation. You risk being deported if your lawyer does not submit a deferral request of your deportation while your judicial review application is in the process.

If you have lived in Canada a long time, you may also apply for Permanent Residence on Humanitarian and Compassionate grounds. If you have received a negative RPD decision, you must wait for at least one year before you can make this application. Your lawyer would have to make very careful submissions on your behalf for a better chance of your application being granted.

If you have received a negative RPD decision at least one year ago and you are about to be deported to a country where the situation has changed since your RPD hearing, making it unsafe for you again, you can apply for a Pre-Removal Risk Assessment which will determine if you will be at risk if deported. Unfortunately, the rate of positive PRRA decisions is very low.

I made a refugee claim and it was refused, do I have to leave Canada?

Following recent changes in Canada’s Refugee application system, applicants from a list of countries known “Designated Countries of Origin” (DCO) do not have a right of appeal following a rejection of their refugee claim. Applicants from all other countries have the option of appealing the refusal at the Refugee Appeal Division within specific timelines.

If your refugee claim is refused and you have no right of appeal, you are expected to voluntarily leave Canada. In most cases, you will not have access to any further legal remedy for up to a year.

If one full year has passed between now and the refusal of your claim, you can submit a Humanitarian and Compassionate (H&C) Application based on your establishment in Canada. In some special circumstances, for example, in the best interest of children, you may make an H&C application without waiting a year. If removal proceedings against you have begun, and your refugee claim was refused more than one year ago, you can apply for a Pre-Removal Risk Assessment (PRRA) where fresh evidence can be admitted to show that you will be at risk in the country that you are being removed too. The risk that you invoke in the PRRA application must be different than the one claimed in the refugee hearing. If you are invoking a similar risk, you must provide the proper explanation as to why the new evidence was not available at the time of your refugee hearing.

Removal proceedings do not begin right after a refusal. Once Canada Border Services Agency (CBSA) decides to issue a removal order, a specific process must be followed and you will be given opportunities to act voluntarily first. If CBSA required you to leave Canada by a specific date, there are legal methods to defer the removal until your situation is properly evaluated under the current law. CBSA will decide to remove you from Canada when they decide to do so. Unfortunately, representatives cannot predict or anticipate when removal will occur but they will be able to advise you of the steps to take before removal arrives in order to increase your chances of remaining in Canada.

If you do not co-operate, make false or misleading statements, or simply ignore to take any actions following communications from CBSA, this may have a disproportionately adverse effect on the process and your status in Canada. It is highly advisable that you consult with a representative so that you may understand your rights and responsibilities and the proper course of action.

The Safe-Third Country Agreement is an agreement between Canada and the United States relating to Refugee Claims. Persons who are claiming refugee status must do so at the first country that they arrive in (either Canada or the United States). However, there are four exceptions to the agreement and are based on family member exceptions, unaccompanied minors exception, document holder exceptions, public interest exceptions.

The Agreement applies when you make a refugee claim at the port of entry at a land border crossing. So, if you arrive in Canada by air or by sea, the Agreement does not apply to you in most cases. For example, if your Asylum claim was refused in the United States and you were ordered deported and you are flying (in-transit) through Canada the Agreement DOES apply to you- so you will not be able to make a refugee claim in Canada. Alternatively, if you enter Canada and make a refugee claim later from inside Canada, the Agreement does not apply to you.

If I made an Asylum claim in the United States, can I make a Refugee claim in Canada?

Generally, yes, if you meet any of the exceptions to the Safe-Third Country Agreement and you are not otherwise inadmissible to Canada. Even as a refugee claimant you must meet all other eligibility criteria for Canadian Immigration.

It is important to know that you will need to prove that you meet the exceptions to the Agreement. At the port-of-entry, you will be interviewed by an officer to ensure that you meet the exceptions. The officer may look into whether the information you provided is true (for example, calling your family member in Canada or looking through immigration records). Sometimes, the officer may ask you to produce documents to show that what you’re saying is true. Even though you may be eligible, you should be well prepared before you get to the border.

The Government of Canada provides some assistance to refugees through the Resettlement Assistance Program to help refugees with special needs. The Program is made available to refugees who made a refugee claim from abroad and have special needs are have been admitted to Canada as government-assisted refugees. The Program pays for expenses such as meeting the refugee at the airport, helping find permanent accommodation, and getting oriented to life in Canada. This program also provides income support for up to one year or until that person becomes self-sufficient.

The Immigration Loans Program is made available to government-assisted and privately sponsored refugees applying from abroad. This will help pay for things such as the cost of medical examinations abroad, travel documents, and transportation to Canada.

Alternatively, assistance loans are available to newcomers to Canada, including refugees, to help cover preliminary expenses and costs associated with an initial settlement like housing rental and tools for your trade or employment.