Overcoming Medical Inadmissibility in Canada Express Entry

How to Manage Medical Inadmissibility When Applying for Express Entry to Canada

Applying for permanent residence in Canada through the Express Entry system is an exciting step toward building a future in one of the world’s most welcoming countries. But for applicants with pre-existing medical conditions, there can be hurdles—namely, the possibility of being found medically inadmissible. The good news? You’re not out of options. With the right information and preparation, many applicants can overcome this challenge.

As of August 21, 2025, Immigration, Refugees and Citizenship Canada (IRCC) now requires all new Express Entry applicants to complete an upfront Immigration Medical Exam (IME). This means you must submit your medical results at the same time as your permanent residence application—not afterward, as was previously the norm.

In this post, we’ll walk you through the three main reasons IRCC might find someone medically inadmissible, and more importantly, what you can do about it.

Key Highlights

• Medical inadmissibility can stem from excessive demand on public services, public health risks, or public safety concerns.
• As of August 21, 2025, Express Entry applicants must include an upfront Immigration Medical Exam (IME).
• Conditions like diabetes, schizophrenia, or hepatitis B may trigger closer review—but do not automatically lead to refusal.
• You can submit supporting documentation to show your condition is under control and not a burden on public resources.
• If IRCC is concerned, they will issue a Procedural Fairness Letter, giving you 90 days to respond.
• A mitigation plan, if invited, can help you prove you’re financially and medically prepared to manage your condition in Canada.

1. Excessive Demand on Health or Social Services

This is the most common reason Express Entry applicants may be considered medically inadmissible. IRCC assesses whether your health condition might create an excessive burden on Canada’s publicly funded health or social services.

In 2025, the cost threshold is set at $27,162 per year or $135,810 over five years. If it’s believed that your care needs will exceed this, IRCC may flag your application.

Conditions That Could Trigger Review

Examples of medical conditions that may lead to a review for excessive demand include:

• Chronic illnesses like diabetes, kidney disease, or heart conditions
• Mental health issues such as bipolar disorder or schizophrenia
• Developmental conditions like autism or Down syndrome
• Mobility impairments or neurological disorders (e.g., cerebral palsy)
• Infectious illnesses requiring long-term care, such as hepatitis B or C

It’s worth noting that just having one of these conditions doesn’t automatically mean your application will be refused. IRCC looks at the specifics of your case, including how well your condition is managed and your treatment plan.

How to Respond

If you’re worried about excessive demand, consider including documents such as:

• Private health insurance that covers your treatment costs
• Recent medical test results and a letter from your specialist showing a good prognosis
• Evidence of effective treatment that controls your condition

These documents help build a case that you won’t place undue pressure on Canada’s public systems.

2. Danger to Public Health

Another reason IRCC might deny an Express Entry application is if they believe your health condition poses a risk to public health in Canada. This generally applies to contagious or infectious diseases.

What IRCC Considers

• IME results and lab tests
• Specialist assessments (if applicable)
• Whether you currently have or have been exposed to infectious diseases
• How your condition might impact others

How to Show You’re Not a Risk

To address this concern, you might include:

• Medical reports showing your illness isn’t contagious or is being properly treated
• Lab results demonstrating controlled or cured medical conditions
• Proof of treatment compliance

Just because you’ve had or been exposed to a disease doesn’t mean your application will be denied. IRCC evaluates each case individually.

3. Danger to Public Safety

Finally, IRCC may find you inadmissible if they believe your condition could pose a threat to public safety. This usually involves unpredictable behaviour or risk of sudden incapacity.

IRCC Will Look At:

• Risk of seizures, blackouts, or other sudden impairments
• Mental health conditions linked to violent or erratic behaviour

How to Respond

If you’re managing a condition that could raise these concerns, you can strengthen your application by submitting:

• Specialist or psychiatric assessments confirming you’re stable
• Proof that your condition is under control (e.g., prescriptions, therapy reports)
• Evidence of a non-violent history while managing your condition

The key here is to demonstrate stability, compliance, and low risk to others.

Steps to Address Medical Inadmissibility

What to Do If You Receive a Procedural Fairness Letter

If your application raises medical concerns, IRCC will usually send a Procedural Fairness Letter. This gives you an opportunity to respond and provide additional documentation. The letter will outline:

• The officer’s concerns about your medical condition
• Requests for more information or test results
• A 90-day deadline to respond

You can request more time if needed, but it’s best to act quickly. Include items like:

• Updated medical records or new treatment plans
• Support letters from physicians
• Proof of financial or private support for ongoing care

Submitting a Mitigation Plan

If IRCC sees excessive demand as the main issue, they may invite you to submit a mitigation plan. This is your chance to show that you can manage your health needs without putting strain on public services.

Your plan might include:

• Proof of private insurance for medications and treatments
• Financial documents showing you can afford your care
• Doctor’s letters confirming your treatment plan
• A signed Declaration of Ability and Willingness form

Just a heads-up—you can’t fully opt out of Canada’s public health care system. But showing that your outpatient needs (like medications) will be privately funded helps reassure IRCC.

Final Thoughts

Medical inadmissibility doesn’t have to be the end of the road. If you’re proactive, organized, and transparent, you can make a strong case for your ability to thrive in Canada without burdening its public systems.

Need help determining your eligibility or navigating a potential roadblock?

Check your eligibility for all Express Entry streams and find out your points using our Manitoba PNP points calculator.

Thinking about applying but unsure if a health condition might hold you back? Don’t worry—you’re not alone. Many Canadians started where you are now and successfully made it through the process.

Contact us today to learn more about how we can help you build your future in Canada.