While companies who provide direct financing for medical procedures and elective surgeries are not common in Canada, there are a few who offer loans for elective surgeries outside of the public health care system. The largest financial providers in Canada are:

• Beautifi
• Medicard
• Credit Medical
• Fairstone
  
  

Each of the above companies will offer financing for Canadians who cannot afford the upfront costs of medical surgeries and procedures. The best way to think about it is like a potential home-owner who applies for a mortgage, but instead, the home-owner is a patient who requires surgery, and the mortgage is a loan to pay for the surgery upfront. The lender acts like the bank, who will provide financing based on the patient’s income and ability to repay the loan, with interest on the loan.

For example, Beautifi offers medical loans so Canadians can access the surgeries and procedures they need, without paying the upfront cost. Loans range from $1,500 to over $25,000, and repayment plans can vary from 6 months to 6 years. Once a patient applies for financing online and is approved, Beautifi will pay the medical professional ‒ who is conducting the operation or procedure ‒ directly. Afterwards, the patient will pay Beautifi monthly installments until the value of the loan is paid in full (plus interest). Beautifi will also provide medical loans for a variety of procedures; from dental care and vision therapy, to complex orthopedic surgeries such as hip and knee replacements.

While the above medical financing companies are a great option for Canadians who cannot afford private surgeries or procedures outright, it is worth noting that the interest payments on such medical loans can be around 7%. As such, it is recommended that Canadians shop around for the best terms and rates when considering a medical loan.

SecondStreet.org is aware of several Canadian companies that specialize in helping patients connect with private health care options – both in Canada and abroad. Effectively, they act as a “concierge” service to help patients find the care they need, as opposed to being health care providers such as doctors or surgeons. They are:

Timely Medical

Timely Medical Alternatives connects patients with doctors and hospitals throughout Canada and the United States so they can receive timely surgeries and procedures. They have an extensive network of certified physicians and health care providers who are able to provide patients with bespoke surgery options, such as the surgery technique they receive, the time when they receive it and who will perform it. Timely Medical Alternatives also negotiate cost-savings on surgeries, sometimes saving the patient up to 80% on medical bills. More details are available here.

Health Vantis

Health Vantis provides a personalized, one-on-one service that is based solely on a patient’s medical needs, and where a surgery or procedure is needed, they send clients to private facilities and doctors in the United States. Health Vantis has over 14 years of experience working with the US health care and insurance industry, and is able to provide Canadians with viable surgical options where they are unable to obtain timely medical procedures on the public healthcare system. More details are available here.

RCM Health Consultancy

RCM Health is a recognized and trusted health care advisory and advocacy company which supports patients with medical requirements of any kind. Their professional advocates represent the interests of patients to access timely, quality care, and will identify medical options available for patients across the world to address their medical issues. Using RCM Health’s services and network of medical professionals, patients are able to know all medical options available to them outside of Canada, which can ensure medical issues are addressed properly and without the need to wait for a specialist in the public health care system. More information is available here.

Epic Health Solutions

Epic Health Solutions provides guidance for patients seeking medical help through the complex health care systems of the Americas, with the goal of ensuring optimum value, performance and service. They coordinate all aspects of a patient’s medical procedure when directing them to a medical professional in the Americas, including referring patients to a top medical facility for procedures (based on cost and quality), assistance with admissions, appointments, and even evacuation and/or repatriation. Epic Health Solutions aim to help clients understand the process of obtaining medical treatment abroad, and answer questions regarding the proposed medical treatment. More information is available here.

Medical Tourism Corporation

Medical Tourism Corporation facilitates contact with overseas doctors and hospitals, and then presents their credentials to patients seeking medical treatment or procedures. They also provide information to patients about the various medical procedures available across the world for their particular medical issue. More information is available here.

Healtheon

This company helps connect patients with specialists from around the world. For example, if you would like a second opinion on the results of an MRI scan, their subscription service could help connect you with a specialist. Alternatively, if you’re on a long waiting list for surgery, their service could connect you with surgical options outside your province. More information is available here.

Governments will sometimes help patients with the cost of surgery abroad – either the full cost or they will make a partial contribution. Based on what SecondStreet.org has observed, reimbursements tend to cover rare conditions rather than common procedures, such as knee and hip operations.

However, you may wish to speak with your provincial government about partial or full reimbursement.

British Columbia

If a patient leaves Canada specifically to obtain medical or hospital care, a medical specialist in B.C. must write to the province’s health care program (called MSP, or “Medical Services Plan”) and provide information regarding the medical necessity for the referral outside of Canada. The specialist needs to provide information about what other treatment options have been explored elsewhere in B.C. and/or Canada. Treatment which is considered to be experimental or still in the developmental (research) stage is not eligible for coverage. Also, if the patient does not obtain MSP approval for elective out-of-country medical care, all costs for services received outside Canada will be the patient’s personal responsibility. Travel and accommodation costs are also not eligible for coverage. This is explicitly detailed on the B.C. Government’s website ‒ click here 

More information about patients obtaining medical care outside of British Columbia is available ‒ click here

Alberta

The Alberta Health Care Insurance Plan (AHCIP) provides coverage for insured physician and hospital services elsewhere in Canada.

Alberta has reciprocal agreements with all provinces and territories (except Quebec) for insured physician services. An Albertan can visit a physician in almost every province or territory, and in most cases, they will not have to pay up front for insured services. Alberta also has reciprocal agreements with all provinces and territories for insured hospital services. A patient can get insured health services at any publicly funded or general hospital in Canada. In most instances, the bill will go straight to the AHCIP.

Furthermore, if a patient chooses to have treatment at a private facility in another province or territory, they are responsible to pay the cost of physician services over the amount covered by the AHCIP. They will also be responsible to pay the facility fees, including laboratory services, MRIs and accommodation. To learn more ‒ click here

Of note, AHCIP coverage is severely limited when it comes to obtaining health care outside of Canada. The government’s website specifically indicates that “hospital services provided in a private health facility will not be reimbursed.” This includes elective treatment and surgery, transportation, ambulance services, prescription medication, medical and surgical appliances, and clinical trials. To learn more ‒ click here

Saskatchewan

Saskatchewan health coverage covers most medically necessary services (hospital and physician) provided in a publicly funded facility in Canada. However, it only provides limited emergency medical care coverage outside of Canada.

Saskatchewan Health provides limited coverage for emergency medical care from approved hospitals outside Canada if the same services would be covered in the province. Saskatchewan Health will pay up to $100 CAD per day for inpatient services, and up to $50 CAD for an outpatient hospital visit.

However, if a specialist refers a patient outside Canada to receive treatment not available in Saskatchewan or other provinces, Saskatchewan health coverage may cover the full cost of the treatment. Of note, prior approval by the government is required. The specialist must ask for prior approval from the Medical Services Branch of Saskatchewan Health or from the Saskatchewan Cancer Agency. If the treatment is approved, the government will pay the full cost of treatment at a rate that the Saskatchewan Ministry of Health considers fair and reasonable after taking into account the location where the insured service is provided. To learn more ‒ click here

Manitoba

Manitoba has agreements with all Canadian provinces (except Quebec) to allow physicians to bill a provincial health plan, although some physicians may choose to bill directly.

Manitoba Health will also pay for emergency doctors’ services outside of Canada at a rate equal to what a Manitoba doctor would receive for a similar service.

Emergency hospital care abroad is paid on an average daily rate established by Manitoba Health. The patient may be charged more than the amount paid by Manitoba Health for services provided outside Canada. The difference above the covered amount may be substantial and is the responsibility of the patient.

When a patient needs medical treatment or care that cannot be provided in Manitoba, the province may cover some of the costs of this care abroad, based on a specific approval process. The patient may be eligible for help with costs related to getting medical care in another province or country when an appropriate physician recommends that they need a necessary, specific medical service, and that treatment is not available in Manitoba.

If the prescribed treatment is not available in Manitoba, the specialist must write a letter to Manitoba Health, and provide certain information about the case. Manitoba Health will review the letter from the specialist, and seek an opinion from a medical consultant if necessary. After reviewing the case, Manitoba Health will write back to the specialist to approve or deny coverage for out-of-province treatment.

Of note, Manitoba Health will pay for care or treatment in the United States only if all Canadian medical resources have been exhausted. In some cases, documentation (e.g, proof) that the patient has seen other Canadian specialists may be required before the request for referral outside the country will be considered.

For medical and hospital services provided in the U.S., Manitoba Health will cover doctor bills at the same rate a Manitoba doctor would receive for similar services, and hospital bills up to 75 per cent of insured hospital services. If the costs for medical and hospital services exceed these coverage limits, it will be the responsibility of the patient to pay the difference, unless the patient qualifies for special assistance based on financial hardship. To learn more ‒ click here

Ontario

Similarly to Manitoba, Ontario will offer support for patients to receive treatment abroad if they are recommended to do so by a physician.

If a physician determines that a patient requires out-of-country hospital or medical treatment, the physician must submit a Prior Approval Application to the Ontario Ministry of Health for consideration. With limited exceptions, applications must include written confirmation from a specialist that the regulatory conditions for funding are satisfied.

The requested services must be performed at a hospital or licensed health facility, not experimental or for research purposes, and either not performed in Ontario by an identical or equivalent procedure, or performed in Ontario but the insured person must receive the services outside Canada to avoid a delay that would result in death or medically significant irreversible tissue damage.

Expenses incurred for non-medical services such as travel, accommodation and meals (except where included as part of insured hospital services) are NOT covered by OHIP. To learn more ‒ click here

Quebec

The Régie de l’assurance maladie du Quebec (RAMQ) will provide for certain health care services abroad that are covered by the RAMQ if the patient has a valid health insurance card. However, in most cases, RAMQ will only reimburse part of the cost. The proportion of services received abroad that are covered depends on several factors: the duration of the patient’s trip outside Quebec, destination, etc. In general, to remain eligible for health insurance, a patient must not be absent from Quebec for 183 days or more, consecutive or not, in a given calendar year (January 1st to December 31st).

The professional services covered by the RAMQ abroad are those rendered by doctors, dentists and optometrists, as long as the same services are covered in Quebec. RAMQ issues reimbursements for professional services at amounts not exceeding Quebec rates, even if the patient paid more.

The hospital services covered are those insured under the Hospital Insurance Plan, specifically, services received during a hospital stay or at a hospital outpatient clinic. These services include nursing care, diagnostic procedures, accommodation in a ward (a room with 3 or more beds), and prescription drugs administered during hospitalization. However, RAMQ will only reimburse the cost of hospital services received as a result of a sudden illness or an accident.

Certain services received outside Quebec are not covered by the Health Insurance Plan. These include:

• Any medical services not covered by Quebec Services rendered by a health professional other than a doctor, a dentist or an optometrist
• The cost of a private or semi-private hospital room
• Emergency transportation, by ground or air
• The cost of bringing a person back to Quebec
• Drugs purchased outside Quebec, even if prescribed by a physician

To learn more ‒ click here

Newfoundland and Labrador

Claims for certain medical services obtained outside Canada, that are available in Newfoundland and Labrador, are paid at Newfoundland and Labrador Medical Care Plan (MCP) rates, which are the rates paid to Newfoundland and Labrador physicians. When the amount billed exceeds the amount payable, payment of the difference is the patient’s responsibility.

Insured medical services obtained outside of Canada which are not available in Newfoundland and Labrador ‒ but are available in another province ‒ are payable at the rates established by the medical care plan in that province. When the amount billed exceeds the amount payable, payment of the difference is the patient’s responsibility.

However, if a patient is planning to have insured medical treatment which is not available in all of Canada, and they wish to claim reimbursement of the related medical costs through the MCP, the patient must ask their physician to request prior approval from MCP before obtaining such treatment in another country. In doing so, they will be made aware in advance of the rate at which their medical bills will be reimbursed.

If the patient is granted prior approval based on the unavailability of the services in Canada, the Medical Care Plan will provide coverage for medically necessary physician services. Payment will be in the currency of the country where the services are received provided the rates are deemed to be fair and reasonable as determined by the Newfoundland and Labrador Department of Health and Community Services. Prior approval is mandatory to receive payment at rates higher than those published in the MCP or other provincial physician fee schedules. If a patient opts to travel outside the country for medical service/treatment and prior approval has not been granted, the fees for services rendered will be the responsibility of the patient. To learn more ‒ click here

Nova Scotia

Nova Scotians who are referred by their health care provider for a medically necessary insured service outside Nova Scotia may be eligible for financial assistance. However, not all medical services are covered by Medical Services Insurance (MSI), and a patient cannot self-refer.

It is the patient’s physician’s responsibility to ensure that a referral is completed by an appropriate physician specialist in order to obtain pre-approval from MSI first. All referrals are reviewed by the MSI Medical Consultant on behalf of the Department of Health and Wellness under the Health Services Insurance Act.

The out-of-province treatment must be done in an accredited medical facility that is approved by MSI. If the patient wishes to be considered for financial assistance from MSI, they must not receive, or make payment or financial arrangement, for any medical service outside Nova Scotia until they have received pre-approval by MSI. Without pre-approval, the patient will be responsible for all costs of care, travel, and accommodation. The patient will also be responsible for any costs not covered by MSI.

All pre-approved medically necessary services that are provided on an in-patient or out-patient basis will be insured at 100%. Upon approval, the patient will also be advised by the Department of Health and Wellness, in writing, if they are eligible for financial assistance with travel and accommodation, and how to submit claims for reimbursement. To learn more ‒ click here

New Brunswick

For out-of-country services, New Brunswick Medicare only covers:

• Emergency hospital services;
• Emergency physician services at New Brunswick rates; and
• Services for which a patient has received prior approval.

An “emergency” is related to a specific incident that occurs while outside Canada where a delay in the provision of treatment would threaten life, such as (but not limited to) fractures, sutures, strokes and cardiac arrests. Emergency services do not include services related to a pre-existing condition which requires ongoing monitoring, or follow-up visits resulting from an out-of-country emergency.

However, New Brunswick Medicare covers out-of-country services not available in Canada on a prior approval basis only. This involves having a written request submitted to New Brunswick Medicare by a New Brunswick specialist who identifies a specific, medically necessary and scientifically acceptable service unavailable in New Brunswick or elsewhere in Canada.

Furthermore, as per the New Brunswick Medicare website, “Residents may choose to seek non-emergency out-of-country services, however, those who receive such services will assume responsibility for the total cost.” To learn more ‒ click here

Prince Edward Island

Medical services for an emergency or sudden illness within Canada are covered for Island residents with a valid PEI Health Card. However, pre-approval by Health PEI is required for a non-emergency medical or hospital service, either in Canada or abroad.

A PEI physician or nurse practitioner will request approval for a patient’s out-of-province health service. Typically, the service will be approved only if the treatment is not available in the province. If treatment options within Canada have been exhausted and are not available, an out-of-country request can be submitted and assessed for approval. If approval is granted, all charges for insured services may be covered.

This website does not endorse any health care providers. 

Patients are encouraged to research any facility – public or private – before deciding to use their services.

However, SecondStreet.org, the organization that published this website, has spoken with many patients who have had positive experiences with various health providers in Canada and abroad. We hope these interviews can assist you with your research:

Cambie Surgery Centre | Vancouver, BC – Ken Clifford (received shoulder surgery)

Mercy Medical Center | Baltimore, MD – Allison Ducluzeau (received cancer-related surgery)

Surgical Solutions Network | Calgary, AB – Sharon Kilkenny (received hip replacement)

NordOrthopaedics | Kaunas, Lithuania – Max Johnson (received knee surgery)

ONZ Spine | Germany – Jackie Herrera (received spinal neck surgery)

BajaMed Group | Mexico – Tracy Skinner (received back surgery)

Enande | Germany – John Massing (received back surgery)

BajaMed Group | Mexico – Christina Sanford (received back surgery)

If you have received or are planning to receive health care services abroad, there are a number of ways to you may be able to make claims and deductions on your federal taxes. It is important to note, while SecondStreet.org has some helpful tips below, our think tank is not certified to provide tax or accounting advice. If you are considering deducting health care expenses on your taxes, SecondStreet.org strongly recommends seeking professional advice from an accountant.

FEDERAL TAX CREDIT

On lines 33099 and 33199 on your federal tax return, a patient may claim “eligible” medical expenses on their tax return providing that they were paid for during the tax year, and were not  claimed for the tax year prior to the expense occurring. The Canada Revenue Agency’s website states that, “you can claim all amounts paid, even if they were not paid in Canada.” The website also indicates “Medical Services outside of Canada” is an eligible expense, and defined as, “if you travel outside Canada to get medical services, you can claim the amounts you paid to a medical practitioner and a public or licensed private hospital. A “licensed private hospital” is a hospital licensed by the jurisdiction that it operates in.” These expenses can also be claimed without the requirement of obtaining a prescription, certification in writing, or a Form T2201. The website also states that eligible procedures for tax credits include cancer treatment, dental services, hospital services, kidney machines, laser eye surgery, medical services by medical practitioners, moving expenses, prescription drugs and medications, rehabilitative therapy, and treatment centres.

However, it should be noted that only medical expenses in excess of the lesser of $2,635 for 2023 (and $2,759 for 2024), or 3% of line 23600 on the tax form (net income) can be claimed for this federal tax credit. While the medical expenses tax credit will depend on the claimant’s income and the cost of the medical expenses incurred, the tax credit will typically only be a few hundred dollars, which will provide minimal financial relief when medical expenses themselves can be thousands of dollars. 

WHAT CAN I CLAIM FOR TRAVEL EXPENSES?

A patient seeking health care abroad reached out to SecondStreet.org through PatientOptions.ca seeking more information about what claims could be made for travel expenses abroad. 

After speaking to an accountant, we can provide the below information:

According to the CRA, you can claim travel expenses if you meet the following conditions:
– Substantially equivalent medical services were not available near your home.
– You took a reasonably direct travel route.
– It was reasonable, under the circumstances, for you to travel to that location for medical services.
 
Additionally, you can claim the travel expenses of an attendant if a medical practitioner certifies in writing that you were unable to travel alone to receive medical services.

To claim accommodation, meals, parking, and transportation expenses, you must travel more than 80 km (one way). If you travel between 40 km and 80 km (one way), you can only claim the cost of public transportation. Travel less than 40 km (one way) is not eligible for travel expense claims.

Please note that the CRA will request receipts with proof of payment to support the medical expenses claimed on your tax return. You will also need a letter from your doctor stating that the required medical services were not available near your home and recommending that you travel to receive the procedure.

Once again, while this information is intended to provide insight into the types of claims which can be made, we strongly recommend speaking to a professional accountant before making any claims or deductions related to health expenses abroad.   

Hope Air
Hope Air provides support for travel expenses incurred by patients who require surgical and/or ongoing treatment away from home. The charity provides free airline travel, free hotel/lodge accommodation, free meal vouchers and free ground transportation. Patients must be in financial need to qualify. However, the program will only fund travel expenses that are not covered by provincial health care plans.

Canadian Red Cross

The Canadian Red Cross has a small loan program whereby individuals may donate equipment to help those in need. This includes equipment such as wheelchairs, walkers/crutches, and other durable medical equipment. However, the program does not provide direct funding for those who have incurred medical expenses.

March of Dimes Canada

The Northern Medical Clinics Program at March of Dimes Canada has funded medical specialists to travel to northern communities in Canada and provide medical services for individuals who cannot afford to travel to receive medical care. This has saved patients from incurring travel expenses, but the program does not provide financial grants for patients wishing to travel to receive timely medical care.

GoFundMe

GoFundMe has proven to be an effective fundraising tool for Canadians in receiving support for incurred medical expenses. The website lists multiple examples whereby Canadians received funding to assist with medical expenses, including $61,000 raised to help “Todd” recover from a double knee surgery. 

Veterans Affairs Canada

For veterans of the Canadian Armed Forces, health related travel expenses can be reimbursed by Veterans Affairs Canada. Health-related travel expenses include transportation, parking, meals, lodging, and out-of-province travel. Veterans can claim the costs online, but treatment benefits to be reimbursed must be approved by Veterans Affairs Canada and be submitted within 18 months of the medical appointment.

GiveSendGo

GiveSendGo is a Christian-based fundraising website that was founded in 2015 and operates in over 80 countries. It uses a very similar model to GoFundMe where Canadians can fundraise for medical expenses.

Whether you receive surgery in Canada or abroad, complications are a potential risk.

With this in mind, you would be well-advised to look into the track record of any surgeon or health provider you’re considering before receiving surgery. 

One might think that the risk of complications would be higher if you travel abroad for treatment, but that’s not always the case. Canada has struggled with avoidable surgical complications in the past.

According to a 2019 news release from the Canadian Institute for Health Information (CIHI), “…rates of avoidable complications after surgery, such as lung clots after hip or knee surgery, are 90% higher [in Canada] than the OECD average.”

CIHI’s website currently notes: “[Canada has] made some progress in areas like hospital mortality and hospital-acquired infections, but Canada is in the bottom quarter of OECD countries for other patient safety measures, such as rates of obstetrical trauma and some surgical complications.” 

That’s not to say patients never receive quality treatment in Canada – certainly, many do – but it’s possible that a foreign provider comes with a lower risk. 

If you are considering a private provider in Canada or abroad, you’ll want inquire as to what happens in the event that complications arise – does your insurance cover it? Does the facilities’ insurance cover it? If so, how much? Etc.

Finally, the federal government has an important note on their website about traveling abroad for treatment:

“Flying soon after surgery may also increase your risk of complications, including:

• blood clots in the legs

• blood clots in the lungs

• air becoming trapped in a blood vessel post operation”
  
  

You’ll want to discuss this possibility with your family doctor in Canada and any foreign provider.

Surgery comes with risks – whether you receive the procedure in Canada or abroad.

With that in mind, patients would be wise to investigate what happens if your surgery abroad runs into complications. For example, if you’re receiving knee surgery abroad and need to be rushed to an emergency room, does your surgical provider have coverage for that kind of situation? What happens if you require a longer recovery period and need to reschedule your flights?

Some companies will provide insurance specifically for medical tourism situations:

Medi-Quote Insurance Brokers: This company notes it provides medical tourism insurance coverage for everything from trip cancellation to emergency medical coverage.

To visit their website – click here

VUMI Canada

VUMI Canada offers Canadians the option to purchase private medical insurance, and in the event of a medical emergency, connect them with doctors and hospitals abroad that can provide timely and efficient medical services, including surgeries and medications. Plan prices depend on age, location and other factors, but in Canada, the typical coverage plan seems to be around $2,000 per year for a male under 55.

Cigna Healthcare

Cigna serves more than 180 million people worldwide and provides insurance plans for individuals to access 1.5 million hospitals and health care professionals. They offer plans for global professionals, families, retirees and students.

IM Global

While not an international health network like VUMI Canada, IM Global offers international health insurance to provide medical coverage for individuals and their families who are living or working outside of their home country for one year or more. IM Global describes this coverage as ideal for those who are expats, have dual citizenship, or work abroad frequently. Their coverage is “designed to provide long-term, worldwide medical cover that allows you to receive and continue treatment wherever you choose.”

MyCare

MyCare offers Canadian policyholders health insurance which allows patients and their families to access timely first or second medical opinions, and if required, additional diagnostics, on-site care or treatment at North American health care facilities. They also provide a policy called “Surgical Waitlist Insurance” which can be utilized when a patient faces a long wait time when requiring a medical procedure or surgery. The policy is not cheap, costing approximately $500,000 for the lifetime of the policy holder. However, patients have the assurance of coverage for up to two surgeries per year, which includes diagnostic procedures like MRIs, CT scans, and PET/CT scans. All services are provided by independent Canadian surgical facilities, and policies include medical file compilation and review, and pre- and post-surgical consultations.

While telemedicine is a valuable option for many patients who are seeking immediate and non-emergency health care, some provinces impose limitations on patients seeking care from out-of-province doctors.

For example, in Quebec, the Collège des Médecins du Québec (CMQ) takes the position that an out-of-province physician must obtain a license that is valid in Quebec to provide virtual care to patients residing in Quebec. Furthermore, there is an added requirement that the physician pass a French language exam. 

This means that when using a telemedicine provider, a Quebec patient will be unlikely to speak with a doctor based in Alberta or Ontario (who is also registered in Quebec and speaks French), and will therefore have limited practitioner choice and availability.

Similar provisions also apply throughout other provinces. In Alberta, the College of Physicians and Surgeons of Alberta (CPSA) states that an out-of-province physician providing virtual care to patients located in Alberta must be registered with the CPSA in their Telemedicine Register. However, an out-of-province physician who does not hold a valid and active permit with the CPSA may provide virtual care to a patient located in Alberta in the following circumstances:

• If the care sought is not readily available in Alberta (eg: specialty care not readily available in Alberta); 
• To provide follow-up care or continuity of care for which an established physician-patient relationship exists; or
• If the virtual care encounter is for emergency assessment or treatment of the patient where there are no other care options available.

In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) states that physicians providing virtual care to Ontario patients must hold a valid and active certificate of registration with the CPSO. This applies unless the provision of virtual care from a physician licensed elsewhere is in the patient’s best interest, for example, where the care sought is:

• Not readily available in Ontario (eg: specialty care not available in Ontario); 
• Provided within an existing physician-patient relationship and intended to bridge a gap in care (eg: a physician who is the health care provider to a patient who has recently moved to Ontario and does not yet have a replacement health care provider); or 
• For urgent or emergency assessment or treatment of a patient.
  
  

In contrast to the requirements of the other Colleges (mentioned above), the College of Physicians and Surgeons of British Columbia (CPSBC) does not require local licensing in order for a physician to provide telemedicine services to a patient located in the province. The CPSBC only requires that foreign physicians hold a license in the jurisdiction in which they are located in order to provide telemedicine services to B.C. patients. This means that while physicians licensed in the U.S. would be unable to provide telemedicine services in British Columbia, physicians from other provinces throughout Canada would be able to provide services to patients, thereby increasing practitioner choice and availability for B.C. residents.