Yes — a health condition can make you inadmissible to Canada, though 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: danger to public health or public safety, and excessive demand on health or social services. Understanding which category applies — and whether mitigation is possible — is critical. This guide explains what the law says. Your specific situation requires analysis from a licensed immigration lawyer and a CBSA officer at a port of entry.
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
The excessive demand threshold is set annually by IRCC. It represents the per-capita cost of government-funded health and social services in Canada, averaged across all Canadians, multiplied by a factor. If the anticipated annual cost of your health condition exceeds this threshold, you may be found to place excessive demand.
Approximate threshold: As of recent IRCC figures, the excessive demand threshold is approximately $27,162 CAD per year. This is an approximate figure — IRCC updates it periodically. Always verify the current threshold with IRCC or a licensed immigration lawyer before relying on this number.
The cost assessment is conducted by a panel physician who examines immigration medical exam results and prepares an estimate of anticipated health and social services costs. The estimate covers the full range of expected services — hospital care, medication, specialist services, home care, social supports.
Exemption for Canadian citizens and permanent residents: Persons applying for permanent residence who are accompanying or joining a Canadian citizen or PR spouse or parent are not subject to the excessive demand ground in some categories. Temporary residents (visitor visa, work permit, study permit) are subject to the excessive demand assessment if their application triggers a medical exam requirement.
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 resided for 6 months or more in a country designated on IRCC's list (generally countries with higher rates of certain communicable diseases) must have a medical exam regardless of stay length
- ✓ 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 doctor. Results are valid for 12 months.
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 — typically 60 days. Missing this deadline is treated as confirmation of the inadmissibility finding. Engage a licensed immigration lawyer immediately upon receiving a procedural fairness letter.
Concerned about medical inadmissibility?
Screen your situation with our free Admissibility tool, or get a detailed report analyzing how IRPA s.38 applies to your specific case.
Screen 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 do I do?+
Engage a licensed immigration lawyer immediately. The procedural fairness letter gives you an opportunity to respond — typically 60 days — with evidence challenging the cost projection or presenting a mitigation plan. Missing this deadline is treated as acceptance of the inadmissibility finding. 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?+
The threshold is updated periodically by IRCC. As of recent IRCC figures, it is approximately $27,162 CAD per year — but this is subject to change. Always verify the current threshold with IRCC at canada.ca or with a licensed immigration lawyer before relying on any figure.
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View Reports → From $49.99Important: This tool provides general information based on publicly available Canadian immigration law (IRPA). Results are not a determination of admissibility. Only a CBSA officer at a port of entry can make admissibility decisions. For complex legal situations, professional guidance may also be beneficial.