Section 38 — Health grounds
Text of provision
(1) A foreign national is inadmissible on health grounds if their health condition
(a) is likely to be a danger to public health;
(b) is likely to be a danger to public safety; or
(c) might reasonably be expected to cause excessive demand on health or social services.
(2) Paragraph (1)(c) does not apply in the case of a foreign national who
(a) has been determined to be a member of the family class and to be the spouse, common-law partner or child of a sponsor within the meaning of the regulations;
(b) has applied for a permanent resident visa as a Convention refugee or a person in similar circumstances;
(c) is a protected person; or
(d) is, where prescribed by the regulations, the spouse, common-law partner, child or other family member of a foreign national referred to in any of paragraphs (a) to (c).
Plain English
Section 38 provides that a foreign national is inadmissible on health grounds if their health condition:
- is likely to be a danger to public health;
- is likely to be a danger to public safety; or
- might reasonably be expected to cause excessive demand on health or social services.
Health inadmissibility is assessed by Immigration Medical Officers (IMOs) as part of the immigration medical examination (IME) process. The assessment is prospective — it looks at the expected demand over a five-year period (or in some cases longer).
Section 38(2) exempts Canadian citizens and permanent residents from health inadmissibility. Section 38(2)(b) provides that Convention refugees and persons in similar circumstances are exempt from the excessive demand ground.
Practical effect
Excessive demand inadmissibility is assessed against the average per-capita cost of health services in Canada multiplied by five (the five-year threshold). If the expected cost of a condition exceeds this amount, the person is inadmissible unless an exemption applies.
Persons found inadmissible on health grounds receive a procedural fairness letter (PFL) giving them an opportunity to respond before a final decision is made. Common responses include mitigation plans demonstrating that services will be privately funded.