In most cases the answer is no, but in some cases a health condition can make a person inadmissible to Canada. The grounds are narrower than many people assume. Section 38 of the Immigration and Refugee Protection Act (IRPA) sets out two medical grounds for inadmissibility: a danger to public health or public safety, and excessive demand on health or social services. The vast majority of common conditions, such as controlled diabetes, well-managed hypertension, asthma, or a cancer in remission, generally do not lead to a finding of inadmissibility. What matters is whether the condition is communicable and dangerous, or whether the publicly funded cost of the services a person is reasonably expected to need would exceed an annually-updated cost threshold. For temporary residence (a visitor visa, work permit, or study permit), the assessment usually only arises when an immigration medical exam is required in the first place. This guide explains what the law says in plain language. It is educational and is not legal advice: an IRCC or visa officer assesses each application and decides, and individual situations should be reviewed by a licensed immigration lawyer or a CICC-regulated consultant.
IRPA s.38: The Two Medical Grounds
Section 38(1) of IRPA renders a foreign national inadmissible on health grounds if their health condition:
Ground 1: Danger to Public Health or Safety, s.38(1)(a) and (b)
A person is inadmissible if their condition is likely to be a danger to public health (s.38(1)(a)) or a danger to public safety (s.38(1)(b)). This ground is relatively narrow and has historically applied to conditions that are:
- ! Communicable and pose a risk to others (e.g., active, infectious tuberculosis; untreated syphilis)
- ! Conditions that could make the person a danger to others (e.g., serious untreated mental illness combined with a history of violence, a rarely-applied ground)
Note on HIV: Historically, HIV was assessed under the public health danger ground. However, IRCC policy evolved significantly: HIV-positive individuals whose condition is managed and non-transmissible through ordinary contact are not automatically inadmissible on public health grounds. The "danger to public health" assessment is condition-specific and evidence-based.
Ground 2: Excessive Demand, s.38(1)(c)
The most commonly applied medical ground is excessive demand on health or social services. A foreign national is inadmissible if their health condition is reasonably expected to cause excessive demand on services, defined as anticipated costs or service utilization that would:
- ✓ Exceed the excessive demand cost threshold in any one of the next five years; OR
- ✓ Materially affect the waiting lists for health or social services in a way that endangers the lives or safety of Canadian citizens or permanent residents waiting for those services
The Excessive Demand Cost Threshold Explained
The excessive demand threshold is set annually by IRCC. It is based on the average Canadian per-capita cost of publicly funded health and social services, calculated as three times that average and projected over five years. If the anticipated cost of the services a person is reasonably expected to need is likely to exceed this threshold, an officer may find that the person would place excessive demand. The key idea to understand is that the test looks at projected publicly funded cost, not at the diagnosis itself: two people with the same condition can receive different assessments depending on the services each is realistically expected to use.
Current threshold (2026): For 2026, IRCC set the excessive demand cost threshold at about $28,878 CAD per year, or about $144,390 CAD over five years (effective in early 2026; the 2025 figure was about $27,162 per year). IRCC updates this number annually, so confirm the current threshold on canada.ca or with a licensed immigration professional before relying on any figure.
A medical officer, supported by panel physician findings, reviews the immigration medical exam results and prepares an estimate of anticipated health and social services costs. The estimate can cover the full range of expected services: hospital care, medication, specialist services, home care, and social supports such as specialized institutional placement. What this means for you in practice is that an officer is weighing realistic, evidence-based projected costs against the threshold, not simply reacting to the name of a condition.
Who is exempt from the excessive demand ground: The excessive demand ground does not apply to everyone. Refugees and protected persons are exempt, and so are most family-class sponsored spouses, common-law partners, and dependent children. These groups can generally still be assessed for the danger to public health or public safety grounds, but not for excessive demand. Temporary residents (visitor visa, work permit, study permit) are generally subject to the excessive demand assessment only where their application triggers a medical exam requirement. Eligibility for an exemption depends on the specific category, so confirm your situation with IRCC or a licensed professional.
Who Needs an Immigration Medical Exam?
Not all applicants are required to undergo an immigration medical exam (IME). The requirement depends on:
- ✓ Country of residence: Applicants who have recently lived in a country that IRCC designates (generally countries with higher rates of certain communicable diseases) may be required to have a medical exam; whether it applies also depends on how long you intend to stay, so check IRCC's current rules and designated-country list
- ✓ Length of stay: Temporary residents (visitors, workers, students) intending to stay more than 6 months in Canada must have a medical exam in most cases
- ✓ Occupation: People working in certain occupations (healthcare, childcare) require a medical exam regardless of country or stay length
- ✓ Permanent residence: All permanent residence applicants and their dependants must undergo a medical exam
IMEs must be performed by an IRCC-designated panel physician, not your own family doctor. Results are generally valid for 12 months from the date of the exam, and the clock does not pause while an application is processed. What this means for you: if processing runs long, an officer may ask for an updated exam before finalizing the application. An IME identifying a condition is not itself a finding of inadmissibility; it is the start of an assessment.
Which Conditions Typically Trigger Review
Conditions that commonly trigger an excessive demand or public health review include:
Communicable diseases
Active tuberculosis (pulmonary), untreated syphilis, other conditions on IRCC's designated conditions list. Note: HIV is no longer automatically inadmissible, treatment and non-communicability are assessed.
Conditions requiring ongoing high-cost care
End-stage renal disease (dialysis), severe intellectual or physical disabilities requiring intensive support services, certain cancers in active treatment, multiple sclerosis with high care needs.
Mental health conditions
Only trigger inadmissibility in rare cases where (a) they constitute a danger to public safety or (b) they require expensive ongoing institutional care. Most mental health conditions do not result in inadmissibility.
Conditions requiring social services
Conditions requiring ongoing specialized institutional placement, extensive home support, or social assistance services that would exceed the threshold.
Most health conditions do NOT result in inadmissibility. Common chronic conditions (controlled diabetes, hypertension, asthma, depression, anxiety), past cancers in remission, and many disabilities do not exceed the excessive demand threshold and do not trigger the public health/safety ground.
Mitigation Plans and Procedural Fairness
If a medical officer determines that a condition may cause excessive demand, IRCC must provide a procedural fairness letter before making a final inadmissibility determination. You have the right to respond with:
- 1
A mitigation plan
A written plan demonstrating that you will not place excessive demand on Canadian services. This typically includes: evidence of private health insurance coverage, documentation that a condition is managed and unlikely to require the projected services, commitments from family members to provide care, pre-arranged private funding for services.
- 2
Challenging the cost estimate
You can challenge the panel physician's projected cost estimate with expert medical opinion and evidence that the projected services would not actually be required or would be privately funded.
- 3
Humanitarian and compassionate (H&C) considerations
If you have strong establishment in Canada, Canadian family, or other compelling circumstances, H&C considerations may be weighed alongside the medical inadmissibility determination.
Timing is critical. Procedural fairness responses have strict deadlines, often around 60 to 90 days from the date of the letter, though the exact period is stated in the letter itself. A response that misses the deadline is generally treated as confirming the inadmissibility finding, so the letter is time-sensitive. Many applicants choose to consult a licensed immigration lawyer or CICC-regulated consultant quickly after receiving one, because preparing medical evidence and a credible mitigation plan takes time.
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Explore Your AdmissibilityFrequently Asked Questions
Does having diabetes, cancer history, or HIV make me inadmissible to Canada?+
Not automatically. Controlled diabetes, past cancers in remission, and HIV with effective management and low transmission risk do not typically result in medical inadmissibility. The excessive demand assessment is based on the projected cost of services you would actually need, not simply the existence of a condition. IRCC policy on HIV has evolved significantly; HIV-positive individuals are not automatically inadmissible.
What is the immigration medical exam, and where do I get it?+
The immigration medical exam (IME) must be performed by an IRCC-designated panel physician, not your own doctor. It includes a physical examination, chest X-ray (for adults), urine testing, and blood testing depending on your age and country of residence. Results are submitted directly to IRCC by the panel physician. IME results are valid for 12 months.
I received a procedural fairness letter about excessive demand. What happens next?+
A procedural fairness letter gives you a limited window, often cited around 60 to 90 days, to respond with evidence challenging the cost projection or presenting a mitigation plan, and missing the deadline is generally treated as accepting the inadmissibility finding. Because the response is technical and time-sensitive, many applicants choose to consult a licensed immigration lawyer or CICC consultant promptly. A CBSA officer at a port of entry cannot advise on procedural fairness responses for immigration applications.
Can I be refused a visitor visa because of a health condition?+
Yes, if your application triggers a medical exam requirement and a condition is identified. Visitors staying less than 6 months and not working in healthcare/childcare generally do not require a medical exam. Visitors staying longer than 6 months in most cases require an exam.
What is the excessive demand threshold for 2026?+
For 2026, IRCC set the excessive demand cost threshold at about $28,878 CAD per year, or about $144,390 CAD over five years (the 2025 figure was about $27,162 per year). IRCC updates this number annually, so always confirm the current threshold at canada.ca or with a licensed immigration professional before relying on any figure. The threshold is not a fee you pay; it is a benchmark an officer uses to estimate whether projected publicly funded costs would be excessive.
Who is exempt from the excessive demand medical ground?+
Refugees and protected persons are exempt from the excessive demand ground, and so are most family-class sponsored spouses, common-law partners, and dependent children. These groups can still be assessed under the danger to public health or public safety grounds, but generally not for excessive demand. Whether a particular exemption applies depends on the specific immigration category, so confirm your situation with IRCC or a licensed professional.
Is the excessive demand assessment based on my diagnosis or on cost?+
It is based on the projected publicly funded cost of the health and social services you are reasonably expected to need, not on the diagnosis alone. That is why two people with the same condition can be assessed differently: a medical officer estimates realistic anticipated costs, including treatment, medication, and any social services, and compares them to the annual threshold. Conditions that are well managed and unlikely to require costly publicly funded services often do not exceed it.
Can I use private health insurance to overcome excessive demand?+
Evidence of private coverage or pre-arranged private funding can form part of a mitigation plan in response to a procedural fairness letter, alongside medical evidence that the projected services will not actually be required at public expense. Whether a particular plan is accepted is decided by the officer based on the strength and credibility of the evidence. A licensed immigration lawyer or CICC-regulated consultant can advise on what a workable plan looks like for an individual case.
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This page is based on law and policy published by the Government of Canada.