Ottawa will require refugees and asylum seekers to co‑pay for supplemental health care starting in May
From May 1, refugees and asylum claimants will pay 30% for supplemental services and $4 per prescription, while core doctor and hospital services remain covered.
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By Torontoer Staff
Starting May 1, Ottawa will require sponsored refugees and asylum seekers to co-pay for parts of their health-care coverage under the Interim Federal Health Program. The change keeps core medical services covered but asks eligible beneficiaries to pay 30 per cent of costs for supplemental services and a $4 flat fee per prescription.
The policy was first outlined in the federal 2025 budget. It applies to refugees sponsored by the federal government or community groups during their first year in Canada, and to asylum claimants who arrive at the border seeking protection.
What remains covered, and what will now carry co‑payments
The IFHP will continue to cover basic medical needs in full. That includes visits to doctors and specialists, hospital care and diagnostic testing. Co-payments will apply to supplemental benefits such as dental care, optometry, physiotherapy and other allied health services, plus a $4 fee for each prescription.
- Fully covered: doctor and specialist visits, hospital care, diagnostics
- Co-payment: 30 per cent for dental, optometry, physiotherapy and other supplemental services
- Prescription fee: $4 flat rate per prescription
Government rationale
Immigration, Refugees and Citizenship Canada framed the change as a measure to manage rising demand for supplemental services while keeping the IFHP sustainable. The department has pointed to growth in program use and higher costs as reasons for adjusting how some services are funded.
Introducing co-payments will help keep supplemental health care accessible for eligible beneficiaries while responsibly managing growing demand. This change supports the long-term sustainability of the IFHP so it can continue providing essential support to current and future beneficiaries.
Immigration Department
Advocates worry about barriers to care
Health and refugee advocates say supplemental services are often essential to early settlement. Dental care, trauma counselling and chronic disease management can be crucial to a newcomer’s ability to work and to settle. They argue even modest charges can add up for people with low or no income.
Four dollars doesn’t sound like a lot, but we have many patients who are on four or five, six medications because they’re diabetic and hypertensive. All of a sudden, it adds up. When refugees arrive, you want to settle their health down, so they can enter the workforce, be productive and thrive. This will be an ill-advised impediment to that.
Dr. Meb Rashid, medical director, The Crossroads Clinic, Toronto
Legal advocates also caution that introducing payment requirements creates a new financial barrier. Maureen Silcoff, an immigration lawyer involved in earlier litigation over refugee health cuts, said the move revisits questions that courts and advocates have fought before.
It’s surprising to see that this government that dropped the appeal of the former government’s challenge is putting in cuts of their own. Although co-payment doesn’t sound as drastic as eliminating health-care coverage, this creates a new financial barrier for access to care that wasn’t there before.
Maureen Silcoff, immigration lawyer
Program scale and recent cost pressures
The Interim Federal Health Program was created in 1957 to provide temporary, publicly funded health coverage to refugees and protected persons who are not yet eligible for provincial health insurance. Use of the program has expanded sharply in recent years.
- Beneficiaries covered in 2024–25: 623,365
- Program expenses in 2024–25: $896.5 million, up $306.1 million from the prior year
- Claims awaiting decision as of December: 300,163
The department says costs are driven in part by the annual number of asylum claimants and by the backlog of claimants awaiting decisions or removal. Government briefing notes show annual new asylum claims referred to the refugee board dropped from 190,039 in 2024 to 108,060 in 2025.
What this means in practice
For newly arrived refugees and recent asylum claimants, the change means deciding whether to pay out of pocket for services that previously would have been free. For people with multiple prescriptions or ongoing dental and therapy needs, the added costs could be recurring. Clinics and community organisations that serve newcomers may see increased demand for funding supports or subsidy programs.
Providers may also face administrative work to collect co-payments and to explain the new rules, at a time when many clinics report heavy caseloads among refugee patients.
Next steps and time frame
The co-payment rules take effect May 1. Clinics, settlement agencies and legal aid groups are preparing to advise clients on how the changes apply and on potential financial supports. The federal government says the changes are intended to preserve the IFHP for current and future beneficiaries.
Critics say the new fees risk delaying care and worsening health outcomes, particularly for people who arrive with acute needs or chronic conditions and limited financial resources.
The change marks the latest development in a long history of policy debate over how Canada funds care for refugees and asylum seekers, and it will be closely watched by health providers, advocates and legal groups as the new rules take effect.
refugeeshealth-careimmigrationInterim Federal Health Programpublic policy
