On This Page You Will Find:
- What is Excessive Demand?
- How Excessive Demand is Assessed
- Understanding the Excessive Demand Threshold
- Social and Health Services Considered
- Exemptions and Public Policy
- How to Respond to a Procedural Fairness Letter
- Final Decision Process and Next Steps
- Legal Options if Deemed Medically Inadmissible
- Frequently Asked Questions (FAQ)
What is Excessive Demand?
Excessive demand refers to the impact an immigration applicant may have on Canada’s health and social services. If an applicant’s anticipated costs exceed the government-set threshold or if their need for services increases waiting times for Canadians, they may be deemed medically inadmissible. Medical inadmissibility due to excessive demand applies to most economic and family class immigrants. Refugees and protected persons are exempt from this assessment.
Medical Inadmissibility in Canada
Medical inadmissibility applies to individuals whose health conditions may:
- Pose a danger to public health or public safety
- Cause excessive demand on health and social services
Excessive demand cases usually involve chronic illnesses, disabilities, or conditions requiring long-term care, medication, or specialized treatment. Common conditions that may trigger a medical inadmissibility ruling include:
- Kidney disease requiring dialysis
- Certain types of cancer requiring prolonged treatment
- Severe disabilities requiring institutional care
- Neurological disorders with high care needs
- Conditions requiring expensive medications or long-term medical supervision
IRCC officers assess each case based on a medical examination and reports provided by a panel physician. If a condition is identified as potentially leading to excessive demand, the applicant may receive a Procedural Fairness Letter (PFL) to respond and provide additional evidence.
How Excessive Demand is Assessed
Immigration, Refugees, and Citizenship Canada (IRCC) evaluates an applicant’s medical history and projected needs for health and social services. A medical officer assesses whether the applicant will exceed the cost limit or strain service availability.
The medical officer considers:
- The applicant’s medical condition
- The anticipated treatment, medication, and support services required
- Cost estimates for health and social services
- Impact on waiting times for Canadians and permanent residents
If excessive demand is determined, the application is sent to the Humanitarian Migration and Integrity Division at the IRCC Niagara Falls office (HMID-NF) for further review.
Understanding the Excessive Demand Threshold
The excessive demand threshold is the cost limit IRCC uses to determine medical inadmissibility. This amount is updated annually based on the average per capita health and social services cost in Canada. Here are recent thresholds:
- 2025: CAD $27,162 per year
- 2024: CAD $26,220 per year
- 2023: CAD $25,689 per year
- 2022: CAD $24,057 per year
- Before 2022: CAD $8,019 per year
If an applicant’s projected costs exceed these limits over five years, they may be denied entry.
Social and Health Services Considered
Health Services
- Medical care and treatment
- Pharmaceutical coverage
- Diagnostic services
- Hospitalization
- Government-funded medical devices
Social Services
- Home care
- Residential and specialized care
- Social and vocational rehabilitation
- Personal support services (assistance with daily activities)
Exclusions: Some services are not factored into excessive demand calculations, including:
- Special education services
- Non-professional personal support services (e.g., housekeeping, meal preparation)
- Behavioral therapy and speech therapy
Exemptions and Public Policy
Some applicants are exempt from excessive demand provisions. IRCC has a public policy allowing applicants to remain eligible if their estimated costs fall below a set limit ($24,057 per year as of 2022).
Applicants who meet humanitarian and compassionate grounds may also receive exemptions. Sponsored spouses and dependent children are typically not assessed for excessive demand.
How to Respond to a Procedural Fairness Letter
If IRCC believes you may exceed the excessive demand threshold, they will issue a Procedural Fairness Letter (PFL). This letter gives you a chance to respond before a final decision is made. Your response may include:
- Medical Opinion: Additional assessments from a Canadian or recognized medical professional
- Cost Mitigation Plan: A documented plan outlining how you will cover health/social services without relying on government funds
- Legal Representation: Consultation with an immigration lawyer for an official response
A strong response demonstrating how costs will be privately covered or mitigated can improve your chances of approval.
Final Decision Process and Next Steps
Once you respond to the procedural fairness letter, IRCC reviews your submission and decides whether to approve or refuse your application. If refused, you may:
- Request Reconsideration: Provide additional documents or new evidence.
- Appeal the Decision: Depending on the immigration category, you may appeal.
- Apply for an Exemption: Request an exemption under humanitarian and compassionate grounds.
Legal Options if Deemed Medically Inadmissible
If you receive a refusal due to excessive demand, you may consider the following legal options:
- Judicial Review: You can apply for a judicial review of the decision in Federal Court.
- Humanitarian and Compassionate Application: If applicable, you can submit an application emphasizing hardship and mitigation strategies.
- Alternative Immigration Pathways: Some provincial nominee programs and employer-driven pathways may allow for an exemption.
Consulting an immigration lawyer can help determine the best course of action.
Frequently Asked Questions (FAQ)
What happens if my medical costs exceed the excessive demand threshold?
If your expected costs surpass the threshold, IRCC may find you medically inadmissible. You may respond with a mitigation plan or request an exemption.
Are all applicants subject to excessive demand rules?
No, refugees, protected persons, and certain sponsored family members are exempt from excessive demand rules.
Can I provide private health insurance to overcome excessive demand concerns?
Private insurance does not guarantee acceptance, but showing the ability to cover medical costs privately can strengthen your case.
Does excessive demand apply to children with disabilities?
Children needing special education services alone are not subject to excessive demand rulings. However, medical conditions requiring additional health or social services may trigger inadmissibility concerns.
Can I challenge an excessive demand decision?
Yes, you can submit additional medical evidence, request reconsideration, or appeal the decision with legal assistance.
Overcoming Concerns
Understanding excessive demand is crucial for a successful Canadian immigration application. If you receive a procedural fairness letter, responding effectively can help you overcome medical inadmissibility concerns. Consider consulting an immigration lawyer to improve your case.
