Medical Inadmissibility
1. Legal basis and objectives
According to the Immigration and Refugee Protection Act (IRPA), a person may be denied entry into Canada for health reasons if:
- It has the potential to pose a danger to public health.
- Potentially poses a danger to public safety.
- This could create an excessive burden (excessive demand) on Canada's healthcare or social services system.
Official source:
Medical inadmissibility - Canada.ca
IRPA - Section 38
2. Three main reasons for medical inadmissibility
2.1 Danger to public health
IRCC considers whether your health condition could be contagious or pose a risk to others. For example, active tuberculosis, untreated syphilis.
IRCC bases its assessment on the results of the Immigration Medical Exam (IME) administered by the assigned panel physician.
👉 No illness automatically leads to rejection — every case is assessed individually.
2.2 Danger to public safety
A health condition may be considered a danger to public safety if it could lead to:
- Impaired ability to control behavior,
- The possibility of suddenly losing control, or
- Behavior that causes violence or endangers others.
2.3 Excessive demand
This is the most common reason why applications are rejected due to medical reasons.
According to IRCC, "excessive demand" occurs if:
- Your condition may result in medical or social service costs exceeding the average cost for Canadians; or
- Treatment can negatively impact service wait times in the public healthcare system.
- The Immigration, Refugee and Citizenship Canada (IRCC) has just raised the "excessive demand" threshold for 2026 to CAD 144,390 over 5 years (approximately CAD 28,878 per year). This means that if IRCC predicts that the medical/social costs of treating and managing an applicant's health condition exceed this threshold, the application may be considered "excessive demand".
3. Who is exempt from applying "excessive demand"?
Some people are not rejected simply because of the high cost of treatment:
- Asylum seekers (refugees) and their dependents
- Protected persons
- Those sponsored under the family category include: Spouse, Dependent Children, Common-law Partner
4. Procedures when suspected of being "inadmissible" due to health reasons.
4.1 Request for Explanation (Procedural Fairness Letter)
- If IRCC believes your condition may not meet the medical criteria, you will receive a Procedural Fairness letter.
- This letter explains the reasons and allows you to submit feedback or a mitigation plan.
5. Ways to mitigate or reduce risks
5.1 Prepare clear medical records.
- The latest medical report provides stable treatment results and a good prognosis.
- Clearly explain whether that situation requires public assistance.
5.2 Submit a Mitigation Plan
According to IRCC, you can present the following:
- You will either pay for the treatment yourself or have private insurance;
- You have your own financial resources and don't need public health programs;
- You have a caregiver or private facility that helps cover the cost of social services.
You need to include a “Declaration of Ability and Willingness” to commit to financial responsibility.
6. New policies help protect people with disabilities and children with special needs.
On March 16, 2022, the Canadian government changed its policy to align with its values on diversity and inclusion of people with disabilities.
The changes include:
- Triple the cost threshold for "excessive demand".
- Remove items such as: from the definition of “social services”
- Special education
- Social or vocational rehabilitation
- Personal support services
Changes to medical inadmissibility policy – Canada.ca (March 16, 2022)
7. Children with Down Syndrome and Autism
7.1 Not automatically rejected
IRCC clearly states: “No health condition automatically leads to inadmissibility; each case is assessed individually.” This means that autism or Down syndrome are not considered “automatically disqualifying individuals from immigration.”
Applications are evaluated based on:
- Level of support needed
- Type of service used (healthcare or education)
- Estimated costs over 5 years
- Impact on the public health system
7.2 Impact of the 2022 Policy
Prior to 2022, special education or individual support costs could be counted as “social services,” leading to the rejection of many applications for children with Down syndrome or autism.
After the revision, these services are no longer considered an excessive burden. Therefore, children with Down syndrome or mild to moderate autism – if they only need learning support, early intervention, or basic therapy – are at much lower risk of being turned away.
7.3 Cases with high medical costs
If the child needs:
- Complex medical treatment (surgery, specialized medications, full-time care), or
- Long-term healthcare costs exceeded CAD 135,810 over 5 years.
→ IRCC may require a mitigation plan , in which parents must demonstrate they will cover those costs themselves .
7.4 Exemptions under the Family Sponsorship category
If a child with Down syndrome or autism is a dependent child in a spousal or family sponsorship application, the "excessive demand" rule does not apply.
8. Summary of practice
| Situation | IRCC Regulations |
|---|---|
| People with serious infectious diseases (TB, syphilis) | It may be rejected due to the risk to public health. |
| People with mental illnesses or disorders who engage in dangerous behavior. | It may be refused due to danger to public safety. |
| For those requiring long-term treatment, the cost is >135,810 CAD/5 years. | This could be considered excessive demand. |
| Children with Down syndrome/autism only need learning support and therapy. | Not considered excessive demand (according to the 2022 policy) |
| Children with Down syndrome/autism face high medical costs. | This may be subject to close scrutiny; a mitigation plan is needed. |
| Children who are dependents are sponsored. | Exempt from excessive demand |
9. Conclusion
According to IRCC, the goal of immigration health policy is to balance humanitarian concerns with the sustainability of the public health system.
The changes in 2022 helped to enhance inclusion and reduce barriers for people with disabilities, especially children with Down syndrome and autism.
“ Reducing barriers for people with disabilities is a priority for the Government of Canada .”
