(CANADA) — Immigration, Refugees and Citizenship Canada announced on Tuesday that it will require refugees and asylum seekers to make co-payments for some health services under the Interim Federal Health Program, starting May 1, 2026.
IRCC said it introduced the change to manage growing demand and ensure the program’s sustainability while keeping core services free, and it tied the move to Budget 2025.
What the change means
The shift means some people who rely on the IFHP will face out-of-pocket costs at the pharmacy counter and for certain non-basic services, even as basic health care remains fully covered.
Refugees and asylum seekers who expect to use supplemental benefits can plan ahead by asking clinics and pharmacies about co-payments before receiving non-basic services and by keeping receipts.
IRCC announced the policy change on January 27, 2026, and said it applies to refugees and asylum seekers using the IFHP.
Who the IFHP covers
The IFHP provides temporary health coverage for eligible groups until they can access provincial or territorial insurance.
- The program covers asylum claimants awaiting Immigration and Refugee Board decisions
- Protected persons
- Resettled refugees
- Victims of family violence with temporary resident permits
- Detainees
Basic benefits vs supplemental benefits
Basic health services remain fully covered with no co-payments, including doctor visits, hospital care and ambulances.
Co-payments apply to supplemental benefits rather than basic care. The structure uses two different models: a flat amount for eligible prescription medications and a percentage share for certain supplemental services.
Those supplemental services include dental care, vision care, counselling and assistive devices. When a provider gives a price or an estimate, beneficiaries can ask which portion is the patient-paid share and which portion the IFHP covers.
Co-payment models and examples
For prescriptions, IRCC provided an example: three prescriptions costing $10, $25, and $100 for a total of $135. In that scenario, the beneficiary pays $12 and the IFHP covers $123, based on a co-payment of $4 “for each eligible prescription medication filled or refilled.”
For other supplemental services, IRCC set the co-payment at 30% of the IFHP-covered cost, and listed dental care, vision care, counselling and assistive devices as examples.
IRCC’s emergency-care example worked differently because those services fall under basic benefits. A $1,000 hospital visit and doctor appointments incur no co-payment, IRCC said, because those are basic benefits fully covered by the IFHP.
Beneficiaries can use the examples to check whether a receipt or invoice makes sense. For prescriptions, the patient share depends on how many eligible medications were filled or refilled, while the IFHP-paid share reflects the remaining eligible amount after the co-payment.
Payment flow and provider role
The payment flow under the new rules runs through registered providers at the point of service. Beneficiaries pay the co-payment directly to the provider when the service is provided.
Providers then handle the rest through the IFHP billing process. Under IRCC’s described approach, a provider verifies eligibility, confirms the coverage category, calculates the co-payment, and bills Medavie Blue Cross for the remainder.
That process makes eligibility checks central to how the system will work day to day. Beneficiaries can expect providers to ask for documentation to verify IFHP eligibility and should keep proof of payment and related paperwork, particularly when receiving supplemental services.
Situations where co-payments do not apply
IRCC set out situations where co-payments do not apply. Services received before May 1, 2026 do not trigger the new rules.
Pre-departure medical services outside Canada remain outside the co-payment requirement. Immigration medical examinations also remain fully covered under IRCC guidance.
Registered providers and tools
The rules put added emphasis on using registered providers. IRCC told beneficiaries to use the IFHP Provider Search tool to find providers registered for the program.
IRCC said registration matters because registered providers can verify coverage and submit claims through the IFHP process. Before providing non-basic services, providers can confirm eligibility and explain the co-payment to the beneficiary.
Beneficiaries can expect that conversation to happen before receiving care, particularly for supplemental services where charges apply.
Receipts, documentation and toolkit
Receipts and documentation become more important once co-payments begin. IRCC said beneficiaries should keep receipts and related paperwork.
IRCC also said it provides an information toolkit for beneficiaries, stakeholders and providers to help explain the new requirements and processes.
Eligibility activation and coverage duration
The co-payment rules sit within a program where eligibility and coverage can change as immigration status changes. IRCC said eligibility activates automatically based on immigration status, including upon receiving an Acknowledgment of Claim.
Coverage under the IFHP ends in several common situations. IRCC said it ends when someone qualifies for provincial coverage, leaves Canada, or abandons a claim.
Those transitions can affect whether someone remains covered between appointments or from one month to the next. Beneficiaries can reduce surprises by confirming eligibility before appointments and by telling providers if coverage has shifted.
IRCC also described how coverage duration can vary across groups. It gave an example of 90 days post-approval for protected persons.
For resettled refugees, IRCC linked coverage duration to when Resettlement Assistance Program support ends. Those timelines shape when people may need to rely on provincial or territorial health insurance instead of IFHP coverage.
Context and reaction
The policy change arrives as the federal government frames co-payments as a form of demand management and a way to preserve core free services while controlling program pressures.
IRCC pointed to Budget 2025 in describing the change and said the goal is to keep core services free while ensuring sustainability.
Migrant Rights Network, responding to Budget 2025, cited a decrease in federal funding for asylum seeker health services from $598 million to $411 million. IRCC did not describe that figure as part of its announcement in the details provided, but the funding context has become part of the wider debate.
Practical impact for beneficiaries and providers
For beneficiaries, the practical impact depends on what care they need and when they receive it. Basic care such as doctor visits, hospital care and ambulances remains covered without co-payments, while prescriptions and other supplemental benefits can bring point-of-service costs once May 1, 2026 arrives.
For providers, the shift turns co-payments into a front-desk and point-of-care task as well as a billing task. IRCC’s model requires providers to verify eligibility, determine whether the benefit is basic or supplemental, collect the co-payment from the beneficiary, and then bill Medavie Blue Cross for the remaining amount the IFHP covers.
For refugees and asylum seekers, the change also adds a budgeting step to staying healthy in Canada during a period when many still wait for provincial coverage or immigration decisions. IRCC’s examples show that emergency and basic care stays free under the IFHP, while pharmacy visits and other supplemental services can bring new out-of-pocket costs under the program’s co-payment rules.
