Canada Increases Excessive Demand Cost Threshold on Health Services in 2026

In a major immigration policy update, Immigration, Refugees and Citizenship Canada (IRCC) has officially increased the excessive demand cost threshold in 2026, a change that directly affects how medical inadmissibility is assessed across Canada’s immigration system.

This update is highly significant for applicants applying for temporary residence, permanent residence, or undergoing an immigration medical exam, as the excessive demand cost threshold is one of the most common and least understood reasons for medical refusal.

With Canada raising the excessive demand threshold on health services, thousands of applicants who were previously close to refusal margins may now fall within acceptable limits.

What Is Medical Inadmissibility in Canada?

Under Canadian immigration law, anyone applying to visit, study, work, or immigrate must be medically admissible.

According to the Immigration and Refugee Protection Act (IRPA), an applicant can be found medically inadmissible if their condition is likely to:

1. Pose a danger to public health
2. Pose a danger to public safety
3. Causes excessive demand on health or social services

Among these, excessive demand medical inadmissibility is the most common issue affecting economic immigrants and non-exempt family applicants.

What Changed in 2026: New Excessive Demand Cost Threshold

IRCC has confirmed the new excessive demand cost threshold for 2026, which is now higher than in previous years.

Excessive Demand Cost Threshold Comparison

This represents:

1. An increase of $1,716 per year
2. An increase of $8,580 over five years
3. Approximately 6.3% higher than 2025

This increase directly impacts how medical inadmissibility due to excessive demand is calculated during an immigration medical exam.

Why the Excessive Demand Cost Threshold Matters

The excessive demand cost threshold is not a fee paid by applicants. Instead, it is a benchmark IRCC uses to estimate whether the publicly funded cost of treating a medical condition will exceed acceptable limits.

There are two ways an applicant can be refused due to excessive demand:

1. Cost-based refusal:

Projected health or social service costs exceed the threshold

2. Wait-time refusal:

Required services would worsen wait times for Canadians

Even if costs are below the threshold, applicants may still face refusal if service demand is deemed too high.

Who Can Be Affected by Medical Inadmissibility?

Medical inadmissibility can affect a wide range of applicants, including:

1. Temporary residents (students, workers, visitors)
2. Permanent residence applicants under Express Entry and PNPs
3. Business immigration applicants
4. Accompanying family members

Importantly, one family member’s medical inadmissibility can impact the entire application, depending on the category.

What Counts as “Excessive Demand” Under Canadian Rules

IRCC applies a strict 5-year cost assessment based on projected publicly funded services.

Services Considered in Excessive Demand Assessments

The focus is on publicly funded services, not privately paid care.

What IRCC Reviews During the Immigration Medical Exam

When assessing medical inadmissibility, IRCC medical officers evaluate:

1. Diagnosis and prognosis
2. Expected treatment plan
3. Type and frequency of services required
4. Projected public cost over five years

Officers are not allowed to consider:

1. Applicant’s income or wealth
2. Willingness to pay privately (in most cases)
3. Personal intent not to use services

This ensures the excessive demand threshold is applied uniformly.

Worked Example Using the 2026 Threshold

This shows how the 2026 excessive demand cost threshold can be decisive for applicants near the margin.

Who Is Exempt from Excessive Demand Rules?

Certain applicants are exempt from refusal based on excessive demand, including:

1. Refugees and protected persons
2. Sponsored spouses and common-law partners
3. Sponsored dependent children

However, even exempt applicants must still meet public health and safety requirements.

Procedural Fairness Letters: What Applicants Should Know

If IRCC believes an applicant may exceed the excessive demand cost threshold, they may issue a procedural fairness letter.

Applicants usually have 90 days to respond with:

1. Updated medical reports
2. Revised treatment plans
3. Corrected cost estimates

This letter is not a refusal, but a critical opportunity to respond.

Mitigation Plans: When Are They Allowed?

Mitigation plans are permitted only in specific situations and cannot replace public healthcare.

What a Valid Mitigation Plan Must Include

Applicants cannot opt out of public healthcare services except in very limited cases.

Common Misunderstandings About Medical Inadmissibility

1. Being able to work does not prevent refusal
2. Private insurance does not cancel excessive demand rules
3. Promises alone are not accepted as evidence

Understanding these realities is critical for applicants undergoing an immigration medical exam.

Conclusion: What the 2026 Increase Really Means

The increase in Canada’s excessive demand cost threshold in 2026 provides welcome relief for many applicants, but does not eliminate risk. It raises the bar modestly, offering greater flexibility, especially for borderline cases, while keeping the integrity of Canada’s public healthcare system intact.

Applicants must still prepare carefully, understand how medical inadmissibility works, and respond promptly if concerns are raised.

How Visa Solutions 4u Can Help

Navigating medical inadmissibility, excessive demand rules, and immigration medical exams can be overwhelming. Visa Solutions 4u supports applicants by:

1. Explaining excessive demand thresholds clearly
2. Reviewing medical and cost documentation
3. Assisting with procedural fairness responses
4. Guiding mitigation plan preparation

With professional support from Visa Solutions 4u, applicants can reduce risk and approach Canada’s medical admissibility process with confidence.