Medical Inadmissibility to Canada

All individuals applying for permanent residency, and many temporary residents, are required to complete an immigration medical exam (IME) before they can come to Canada.

This exam exists so that newcomers do not pose a risk to public health or safety, and do not place an excessive burden on Canada's publicly funded health and social services.

People applying to visit, study, work, or immigrate to Canada permanently can be found medically inadmissible for one of three reasons: being a danger to public health, being a danger to public safety, or causing excessive demand on health or social services.

If you are planning to apply to Canada, it is worth understanding these rules before you submit your application, not after you receive a procedural fairness letter.

Book Free Assessment

Conditions for Medical Inadmissibility

To be granted a visa, permanent residence, or most temporary resident permits, you must undergo a medical exam and meet Canada's health standards. If you don't, your health condition may prevent you from getting the status you're applying for.

There are three grounds that can make an applicant medically inadmissible:

• Being a danger to public health
• Being a danger to public safety
• Causing excessive demand on health or social services

Below, we explain each of these grounds, who is exempt, and how to respond if you're found inadmissible.

Being a Danger to Public Health

IRCC works with public health agencies to minimize the risk of communicable disease entering Canada.

Your application may be refused if your IME shows a health condition that could endanger public health, such as an infectious disease that spreads easily and has serious health consequences — for example, active tuberculosis or untreated syphilis.

IRCC looks at how easily the disease can spread, how well it is currently controlled, and whether treatment is available. Applicants may be asked for extra tests to show their condition is responding to treatment. In some cases, applicants with a controlled condition can still be admitted, sometimes subject to ongoing health monitoring after arrival.

Being a Danger to Public Safety

Your application may be refused if your IME shows a health condition that could endanger public safety — for example, a risk of unpredictable or violent behaviour.

Conditions IRCC reviews under this ground include severe, treatment-resistant epilepsy or seizure disorders, and severe mental health conditions such as untreated schizophrenia, severe bipolar disorder, or certain personality disorders that can affect judgment and behaviour.

IRCC considers the nature and severity of the condition, any history of loss of control or violent behaviour, and how the condition could interfere with daily activities. Effective treatment matters: an applicant whose condition is stable and well-managed under medical supervision, with accessible treatment in Canada, has a much better chance of being found admissible. Some applicants are admitted subject to regular medical check-ups.

Excessive Demand on Health or Social Services

Your application may be refused if your IME shows a health condition likely to place excessive demand on Canada's publicly funded health or social services — meaning it would either negatively affect wait times for other Canadians, or cost more than the excessive demand cost threshold.

2026 update: effective January 2, 2026, IRCC raised the excessive demand cost threshold to $144,390 over five years (roughly $28,878 per year) — up about 6.3% from the 2025 threshold of $135,810 ($27,162/year). This is the figure IRCC's medical officers now use to assess every new file.

Conditions most often reviewed under this ground are typically long-term and require ongoing care, for example:

• Chronic diseases: diabetes, kidney disease, and heart disease, which usually require regular medical management
• Severe disabilities: physical or intellectual disabilities that may require special education, rehabilitation, or personal support workers
• High-cost conditions: conditions such as HIV/AIDS, hemophilia, or cancer that can involve significant treatment costs

Who Is Exempt from Excessive Demand

Not everyone is assessed against the excessive demand cost threshold. Under IRCC rules, the following applicants are exempt from the excessive demand ground (though they can still be assessed for danger to public health or public safety):

• Refugees and their dependants, and protected persons
• Spouses and common-law partners being sponsored under family or spousal sponsorship
• Dependent children being sponsored by a parent

This exemption exists so that families are not separated purely because of the cost of a family member's medical condition. If you are sponsoring a spouse, partner, or child, this is one of the first things worth confirming with a licensed consultant before you file.

Overcoming Medical Inadmissibility

A finding of medical inadmissibility is a serious obstacle, but it isn't necessarily the end of your application.

As noted above, spouses, common-law partners, and dependent children being sponsored, along with refugees and protected persons, are exempt from the excessive demand ground entirely.

For everyone else, if you're flagged for excessive demand, you still have a real opportunity to respond — through a mitigation plan and a procedural fairness letter, explained below.

Applying for a Temporary Resident Permit to Overcome Medical Inadmissibility

If you've been found medically inadmissible, you may still be able to apply for a Temporary Resident Permit (TRP).

A TRP can let you enter Canada to visit family, work, study, or access medical treatment not available in your home country, provided you can demonstrate a sufficiently compelling reason to enter. A stable medical condition, private insurance, and proof of financial resources all strengthen a TRP application.

Procedural Fairness Letter

A procedural fairness letter lets you respond directly to IRCC's concerns and present a mitigation plan before a final decision is made. Under current IRCC policy, you have 90 days from the date of the letter to respond (you can request an extension if you can't meet that deadline).

A strong response can include:

Private healthcare arrangements: evidence that you can pay for the needed health or social services yourself — for example, private insurance, or enrolling a child who needs special education in a private school, so the service isn't drawn from the public system.

Proof of financial stability: documentation showing you can cover any extra costs your condition may require.

A healthcare treatment plan: a detailed plan from your physician showing your condition is being actively managed and won't require the level of public services IRCC projected — common for conditions like diabetes or epilepsy that are controlled through regular medication.

You can also request a re-evaluation of your medical assessment if your condition has improved since your exam, or if you believe the medical officer's assessment was too cautious or based on an incomplete picture.

If your procedural fairness letter response is unsuccessful and your application is refused, you may still have options: an appeal through the Immigration Appeal Division, a Federal Court review, or in some circumstances an application based on humanitarian and compassionate grounds.

2026 Updates to Medical Inadmissibility Policy

1. Higher excessive demand threshold. As of January 2, 2026, IRCC's excessive demand cost threshold is $144,390 over five years ($28,878/year), up from $135,810 ($27,162/year) in 2025. This is the number medical officers now use to assess every excessive demand file.

2. Extended use of previous immigration medical exams. IRCC has confirmed that applicants already living in Canada can continue using a previous IME, as long as it was completed within the last 5 years and showed low or no risk to public health or safety. This exemption is now in place until October 5, 2029, reducing the need to repeat medical testing for many in-Canada applicants.

3. Core grounds unchanged. The three grounds — danger to public health, danger to public safety, and excessive demand — remain the same. Active tuberculosis and untreated syphilis are still the primary public health concerns; severe, uncontrolled mental health conditions remain the focus of the public safety ground; and long-term, high-cost conditions continue to be assessed carefully under the excessive demand standard, with the mitigation plan process unchanged for applicants who are flagged.

Why Choose Us?

We've helped applicants from nearly 20 countries navigate medical inadmissibility and become permanent residents, and our founder, Sepehr Falahati, is a CICC-licensed Regulated Canadian Immigration Consultant (RCIC #R533959). We know how IRCC's medical officers assess these files, how to build a mitigation plan that actually addresses their concerns, and how to keep your file moving instead of stalling at a procedural fairness letter.

If you've received a procedural fairness letter, or you're concerned a health condition could affect your application before you even apply, contact us or fill out our free assessment form and we'll get back to you with your options. You can also book a consultation directly with our team.