European Observatory on Health Systems and Policies


Health Systems in Transition (HiT) profile of Canada

3.4 Out of pocket payments

Since universal medicare in Canada precludes extra billing or user fees, OOP payments are only relevant to the mixed and private health sectors. Informal payments are almost non-existent in Canada: they have not been documented in any provincial or territorial health system.

OOP payments make up more than 50% of expenditure on privately financed health services and products. In particular, OOP payments form the chief source of funding for vision care, over-the-counter pharmaceuticals and CAM.

The British Columbia government has announced its plan to invest $105 million in its prescription drug program - Fair PharmaCare -  over the next three years to eliminate deductibles for families with net incomes under $45,000. The aim of this reform is to reduce cost-related medication non-adherence. Co-payments will also be eliminated for families with a senior aged 79 years and older with net incomes below $13,750. Effective January 1st, 2019, this marks the first change to cost sharing in British Columbia in 15 years.