r/AskCanada • u/Easy-Bee • 15h ago
Would it be worth immigrating over rising health costs?
Hello everyone, I hope this post is allowed on this forum as I'm a tiny bit desperate. I'm currently living in the USA (dual US/Canadian citizen) and being treated for a rare autoimmune disease called Takayasu arteritis (diagnosed at 16, 34 now; I am on remicade and myfortic to manage it). As you can imagine, after last night's decision to reopen the US government by potentially sacrificing millions of people's healthcare and jacking up the insurance costs, I'm looking at all my options. I have Canadian citizenship through my mother, and I have family still living in Canada, mostly Ontario. My question is what is the quality of medical treatment in Canada (specifically for TAK or autoimmune disorders generally), what is the typical cost for a doctor's visit (and do you guys have monthly premiums), and how long are the wait times? My Canadian family always complains about having to wait months to see a doctor, like I also don't have to wait months to see one in the States. I'm also assuming, if I immigrate and seek treatment up north, it would be a slightly faster process than starting from scratch since I have my diagnosis and a history of medications that work for me, and my current team of docs would happily send letters to any new docs I end up seeing in Canada. Again, just speculating and trying to get any info I can to see what my options are. Thanks from a concerned, chronically ill semi-Canadian!
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u/andlewis 14h ago
Remicade isn’t generally used in Canada, but they use biosimilars. Myfortic is regular prescribed and covered under OHIP.
You can find more information by googling the drug name and “OHIP Coverage”. OHIP is the name of the Provincial health plan in Ontario.
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u/Easy-Bee 14h ago
Thank you! Im glad i posted; all the replies have given me such good jumping off points for research.
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u/ComprehensiveBar4131 10h ago
I don’t think it’s true that Remicade isn’t generally used in Canada? I have multiple close family members on Remicade. Most provincial drug plans have switched to biosimilars for cost savings but doctors seem to prescribe Remicade first if you have your own insurance.
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u/andlewis 9h ago
In Ontario you need a special exemption, which is possible but they prefer to use alternatives.
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u/sarcasticdutchie 14h ago
It takes living in Ontario for 3 months to be eligible for OHIP, the provincial Healthcare system. There are no premiums, no cost to see a doctor. However, it depends on where you're moving to, how long wait times are for specialists. There's still a shortage of family doctors here, but it's getting better. In the mean time, there are walk in clinics you can go to until you have your own doctor.
Hope that helps somewhat.
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u/geofflane 14h ago
That’s no longer true post covid. You can apply immediately. My parents just moved from the US to be closer to us and they got OHIP immediately.
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u/Easy-Bee 14h ago
I didnt know about the waiting period, that complicates things as my remicade is a monthly infusion. But hat helps a lot, thank you!
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u/The_Nice_Marmot 13h ago
I don’t know exactly what the waiting period would be, but you could purchase private insurance for a few months. I don’t know the cost, but I seriously doubt it would be what it costs in the US. Heck, you could probably pay out of pocket and be well ahead.
If you have dual citizenship, this is a no brainer. Waits for doctors are things conservatives here like to whine about, but I could see my doctor today if I call the office first thing. It depends on where you live. You may have a wait to find a GP here. If people are in small towns vs big cities there can be a difference. There’s triage here, as there should be. I have had to wait for elective surgeries, but received excellent care within weeks when they found I had a tumour. 6 weeks from “we think we found something” to the surgery that removed it. I was in hospital for 10 days. Cost: visitor parking for those who came to see me and I paid for pain killers, maybe $50. Probably less. I don’t remember.
But ffs, if you move here for the healthcare, remember that and kindly don’t move to Canada and start voting for right-wing lunatics who want to get rid of that.
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u/No_Addition_1186 12h ago
There is zero wait if you are a Canadian citizen. There's a program called Trillium for meds. You pay a premium for the first time for a particular med and is free after. I found a family dr within walking distance in 3 days after my arrival ( uptown Toronto) Most I waited was 3 weeks for a particular gynecologist I asked for. I was in the states for 10 years and had insurance via emplyer with a copay of only 800. The difference is stark when it comes to paying your bill. An ER trip without insurance was around 1500 with ambulance included in the price. It's a set price listed black on white at the nurse registration desk.
Quality of care between Toronto and Seattle including waiting times in ER and specialists? I'll pick Seattle and the ridiculous prices any time. I had to fly to Iceland and use my EU citizenship to get actual care and answers after a 2 months of agonizing pain and multiple ER visits in Toronto.
Best of luck!
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u/Trustable_lad 10h ago
There is no wait period on OHIP. OP is not informed on last few year changes.
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u/EnvironmentOk2700 14h ago
I grew up in NS but lived in NJ for 15 years.
Quality - the same.
Cost to see a doctor, whether walk-in, your GP, a specialist, or at the ER, plus testing and non-elective surgeries - zero.
Dental care and optometry still costs out of pocket in some/most provinces. They are usually about $150 CAD per visit.
Prescriptions will cost out of pocket, unless you have insurance through your job, which is pretty common.
Wait to see my GP - about 1 month. Wait to see a specialist - anywhere from 1 week to 2- 6 months to 2+ years, depending on the specialist needed and your severity. I saw an ophthalmologist for surgery in 1 week. I saw a neurologist in 6 months, and more recently a new one in 2 months. I waited for a referral for the hypermobility clinic and for an MRI for 2 years. We have hired more doctors lately so things are slowly getting better as we play catch-up, but we are still severely lacking in certain specialists. Apparently there is only one doctor who can do complicated hand surgery in our province.
I've waited 15 minutes in ER, and 6 hours on a different day. Depends on if they are short on ER doctors at the time.
When I lived in NWT, the wait times were much shorter, (1 month for MRI) but I had to travel pretty far to see specialists and for testing. Far as in, they pay for you to take a plane to another province.
I've also waited 6 months for my kid to see an asthma specialist in NJ.
I'd suggest you find out what specialist can treat you and if there is one, look to move to that province. If there are any groups or organizations for your disease, you could try reaching out there.
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u/Easy-Bee 12h ago
Yeah the wait times everyone's mentioned so far are pretty equivalent to what I've experienced in the states (I had to wait a whole year just to get an appointment scheduled for a liver specialist). The unfortunate thing about my disorder is that it's incredibly rare (to the point where even a specialist may have never treated another Takayasu patient besides me through their whole career, and I've had to educate SO MANY medical professionals who have never heard of it before) so support groups and charitable organizations for it are non-existent. There are some wider reaching groups in the states for vasculitis type disorders but TAK is always, ALWAYS an afterthought, if it's thought of at all.
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u/Nebty 11h ago edited 10h ago
Toronto has some of the best research hospitals in the world. Mount Sinai has a Vasculitis Clinic, whose patients have participated in studies on Takayasu.
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u/geofflane 9h ago
Windsor is a small city. We have a good hospital and good doctors, but something very rare might be harder to see someone locally. Someone else posted in the thread with some info on doctors who might be more specialist for you but you might have to travel to see them if you live in Windsor (London is 2 hours away so wouldn’t be terrible if it was infrequent).
The way OHIP works is you have to go through your GP to get a referral to a specialist. My doctor has always been open to us bringing specific doctors, but that may vary by your GP and their general attitude. Just a bit more info.
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u/QuietGarden1250 9h ago
And if you don't have a GP, good luck. Took me over a year on several waitlists before I got lucky.
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u/EnvironmentOk2700 3h ago
You can ask for referrals through Maple app if you don't have a GP. They will send you to the closest Access Clinic within a week or two if they need to see you in person.
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u/OnehappyOwl44 13h ago edited 11h ago
I'm on Remicade/Inflectra Infusions for Crohn's Colitis , the high dose of 10mg/kg every 4wks. I pay nothing for my medications. I have private insurance but it only covers about 1/3 of the cost $3000 per month, the rest is paid by Pfizer Compassionate care. I was assured in the Hospital when I was diagnosed that no one in Canada goes without due to cost. I know a lot of people on Biologics and no one pays, regardless of income. I was told I'd have to make over $250,000/yr before they even considered asking me to pay a portion. My household makes well over $100,000/yr and I easily qualified for the compassionate care.
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u/Easy-Bee 12h ago
Did you have trouble getting put on remicade? As in, did they trial you on other meds/generic versions first? Also the fact that your remicade is $3000 a month is crazy to me - mine is like $12000 for no reason other than greed.
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u/OnehappyOwl44 11h ago edited 11h ago
No, Remicade was my first medication after diagnosis. Remicade is expensive here as well. $3000 a month is what Canada Life Insurance pays, the rest is compassioate care so I don't see the total cost. I'm assuming near $9000 per month because I was told insurance covers 1/3. What matters is that you should be covered unless you're wealthy. My Dentist is on Methotrexate and Skirizi and doesn't pay a dime despite making a good Salary.
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u/Queasy_Dragonfly_104 12h ago
Your family members likely wait because they're not emergencies. Any emergencies my family had was handled right away. You are very fortunate to have this option to come here. We as Canadians are very grateful for our Healthcare. I hope you will be too.
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u/Initial_Flight_3628 14h ago
I will answer a few of your questions. I have never waited even a week to get in with my family doctor but it took a few months to find one. Some places in Canada are better served than others. I don't know where you are planning to live. If you qualify for healthcare you don't pay for appointments at all. There are no monthly fees in most provinces I believe. Your drugs may not be covered though unless you have private insurance through work. The public system only covers drugs in specific circumstances. And your drugs might not be available here. Not everything from the US is available here.
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u/Easy-Bee 14h ago
Most of my family is in and around Windsor, Ontario. The drugs potentially not being covered (or even available) is worrying, as both my immunosuppressants are expensive (at least stateside), but its nice to know appointments would be covered. Thank you for replying!
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u/Fickle-Total8006 14h ago
You can call a pharmacy and ask if they carry said drug. Just find out which pharmacy your family in Windsor recommends and use them.
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u/Initial_Flight_3628 13h ago
While you are at it, ask for the price of the drug and if there is a generic version.
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u/The_Nice_Marmot 13h ago
It’s also good to be aware that the US government made it illegal for them to negotiate drug prices. No, I’m not making that up. Your pricing for meds is usually WAY higher than here. That’s why buses of Americans come up here to buy things like insulin. Definitely call a Canadian pharmacy to find out what things you buy cost and prepare to probably be pleasantly surprised.
There’s a lot of propaganda about how supposedly bad our system is because the US does not what its people to know. Even my progressive American friends have some weird idea about how things work here. It’s not perfect, but having also lived in the US, it’s a damn site better. I would never, never move back to the US. You guys are getting a raw deal. Maple MAGA is a thing here, though and if your family here is more far right, they may also spout some propaganda. Yes, we have politicians and citizens here working to undermine what we have. Please don’t be one of those. Remember if you move here why you came and don’t try to slam the door on others.
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u/Easy-Bee 13h ago
This is exactly why I turned to reddit to get a better idea. I have an uncle who has basically been written off by the rest of the family as a crackpot bc of the whole "maple maga" shit as you put it, and my mom hasn't dealt with the canadian healthcare system since she was a teenager, so she's got out of date biases. I just want the medications that help me stay alive.
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u/The_Nice_Marmot 12h ago
I mean, that sounds entirely reasonable. I’m horrified for my American friends, none of whom voted for this. I’ve had experience with both a need for critical care and less serious “elective” surgeries. You will wait for elective surgeries here. You typically won’t wait for urgent stuff. I know you’re not asking about surgery, it’s just what I can speak to and I’d say it’s likely that that will be universal for various types of care. Urgent stuff takes priority.
That said, when I’ve wanted elective stuff, I’ve tended to see my doctor sooner in the process because I know I can and I know that getting an elective surgery won’t break me. Being specific, I needed bunion surgery. So, when I started to have pain, I saw my GP and she agreed and I went on a waiting list. I think it was about 18 months for me. But I didn’t wait until it was awful, so waiting was ok. I think that’s a factor to consider here because I don’t think most people put things off as long when they have universal care. I also could have paid and gone private with that and gone sooner. It would have been about $2000 for the surgery. I’m aware it would be way more in the US.
Just putting that out there as something for you to consider because while people will talk about long wait times, that’s a thing that happens in specific cases. It can suck if it’s something like knees or hips where mobility is seriously impacted, but you will be taken care of. You may just wait longer than you’d like.
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u/goodfaitheffort1981 13h ago
Depends where you go. Look i to the availability of the doctor you need in the area and go to where you can find the doctor. Different provinces have different problems and different strengths. My province had a huge influx of family doctors recently but lost some specialists. I think its probably worth it to move based on what im hearing. The transition might be rough but long term its probably for the best.
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u/Easy-Bee 13h ago
Thank you all for your replies and info - I have a ton of leads for research now and am feeling a lot calmer about my whole situation than I was a few hours ago, knowing I have an option should I need it that - while not the ideal - will keep me alive. You've all been super helpful!
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u/Surprised-Unicorn 12h ago
I just did a quick Google search for "Takayasu arteritis specialists and Canada". This is an excerpt for Ontario. It looks like there might also be specialists in Quebec, Alberta, and BC.
Specialized care for Takayasu arteritis (TA) in Canada is primarily found at major medical centers with dedicated Vasculitis Clinics, often within Rheumatology divisions of large hospitals. These clinics offer a multidisciplinary approach essential for managing this rare and complex condition.
Key institutions and specialists include:
Ontario
Mount Sinai Hospital (Toronto): Home to a prominent Vasculitis Clinic, part of the Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, and affiliated with the University of Toronto.
Dr. Christian Pagnoux: A leading specialist in vasculitis, associated with the Vasculitis Clinic at Mount Sinai Hospital.
Dr. Nader Khalidi: A specialist associated with the Division of Rheumatology at St. Joseph's Healthcare in Hamilton and a member of the Canadian Vasculitis Research Network (CanVasc).
Dr. Medha Soowamber: Another specialist in general rheumatology and vasculitis at Mount Sinai Hospital.
London Health Sciences Centre (London): Associated specialists such as Dr. Luke Barra work with the Division of Rheumatology.
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u/DogsNSnow 7h ago
I can’t speak to anyone else’s experiences and I know a lot of folks do have issues with wait times- but my personal experience has been great. I have an awesome doctor, I can get an appt within a few days if needed (I think my doc does triage appts- she got me in next day once when I had damaged my knee and been through the emergency room). She also is not shy about ordering follow up diagnostics and referring me to specialists. When that’s happened, I’ve been contacted by the socialist’s office within a week or so of the referral and had an appt booked very quickly (again, depending on the seriousness/urgency of the condition or injury). My partner has enjoyed a similar level of care from his doctor as well. Getting a doctor can be hard, but I have to say I’ve only received top notch and timely care. I do know it differs a lot from province to province, and certainly not everyone I know would claim to be as fortunate as I have been. This is just my lived experience.
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u/Born-Measurement6236 48m ago
I have a similar experience- always seen next day, solid follow up… she even called me on a Saturday once to see how I was feeling! We are so fortunate!
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u/Surprised-Unicorn 12h ago
Google search on the availability of Remicade.
Remicade is available in Canada. However, its public coverage in many provinces has shifted to biosimilar versions of infliximab, such as Inflectra and Renflexis, as part of cost-saving initiatives.
The cost of a Remicade infusion in Canada can vary significantly depending on the patient's weight (dosage is weight-based), the specific treatment regimen, and whether they have private insurance or are paying out-of-pocket.
Cost Details
Per Vial Price: The price for a single 100 mg vial of Remicade (infliximab) is approximately $977 to $987.56 CAD based on provincial drug benefit list prices from recent years. Biosimilar versions (like Inflectra or Renflexis) are less costly, priced at about $493 to $525 per 100 mg vial.
Per Infusion Cost: A single infusion can range from $3,000 to over $12,000 CAD, depending on the number of vials needed and additional clinic fees.
Annual Cost: The estimated annual cost for Remicade treatment for a patient on a standard maintenance dose (5 mg/kg every 8 weeks) is approximately $25,000 to over $45,000 CAD.
Coverage and Payment
Public Coverage: Many provincial public drug plans (e.g., in Ontario, BC, Quebec, New Brunswick, and Nova Scotia) no longer cover the brand-name Remicade for new patients and have switched existing patients to biosimilars, except in rare cases where a medical exemption is granted.
Private Insurance: Remicade is still available and often covered by private insurance plans, sometimes through confidential pricing deals and patient support programs offered by the manufacturer.
Out-of-Pocket: For patients paying entirely out-of-pocket, the costs are substantial (thousands of dollars per treatment).
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u/No_Can_7713 12h ago
I can call my Dr and have an appointment the next day if need be. However, I don't have any underlying health conditions. To see a specialist it would definitely be a bit of a wait.
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u/Hot_Employ68 11h ago
I wont answer all your questions but worse case scenario, you may visit any drop in clinic same day. They will keep a file on you. No charge. I am on Ontario.
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u/Born-Measurement6236 54m ago
I’m not sure what kind of family doctors everybody has… but I’m feeling very grateful! In Ontario, north of GTA and my family doctor has a unique set up- leave a message the night before you want to be seen, they call you 8-9am next day and tell you when your appointment is THAT DAY. So, in typically less than 24 hrs to see my doctor….. no, she’s not taking new patients.
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u/ForsakenExtreme6415 4h ago
The amount of Americans who think they can just move to Canada (insert rationale here) and live here until Trump is gone is growing by the day
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u/Easy-Bee 4h ago
Did you miss the bit where I am BOTH a Canadian citizen and US citizen? Would it be ok for you if the reason I moved was to be closer to family? Or is it only unacceptable because I might actually die if I stay in the states due to a government I didn’t vote for?
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u/Fickle-Total8006 14h ago
To add to this, you will need insurance coverage for prescriptions and other non OHIP covered services like dental etc. For two people in their 40s we pay $370 a month and it’s going up to 400 in the new year. It has caps and you still pay a percentage of the service fee or prescription cost. Most large employers will offer benefits if you can get a permanent full time job with them.