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I am a mid-30's software developer wanting to emigrate from the US into Canada -- probably Ontario (having enjoyed a vacation to Toronto a few years ago). I speak and write English fluently, but as my only language. I have about $80k USD in retirement accounts and $25k USD in liquid accounts, as well as owning a home and car, with no other debts. I have no children, and have a bachelors degree in CS.

A difficulty is that I require a medication which is expensive (at least in the US), and there is no generic. I am only able to obtain a 2 week supply at a time, and may very likely die without it. The price via a Canadian pharmacy website is giving me $171/dose pricing (dosage is daily).

This leads to numerous uncertainties with how immigration would work:

  • Does having a known medical need like this count as a mark against me?
  • Is obtaining medical insurance as a resident alien plausible given a pre-existing condition?
  • Am I going about this the right way? If not, what step am I missing?
  • What is the actual order of operations for me?
  • Is there ever a critical point where I do not have medical coverage through either the US or Canada, even if I have to purchase supplementary insurance myself?

My ultimate goal is to be able to work, earn an income, pay taxes, and live a life. In the US, I am very beholden to a particular employer, because health-care is inexorably tied to the employer. Knowing that I need this health care will sometimes cause them to treat me poorly at work, as quitting is much harder for me.

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For the first two questions,

  1. AFAIK yes, but it might be able to mitigated. "Excessive demand on health or social services" is one of the ground for inadmissibility. But note that many Canadian public healthcare plans don't ordinarily cover prescription drugs and you would still be expected to support yourself in Canada without relying significantly on social systems, so you would most likely need supplementary insurance (through employer or otherwise).

If the only thing that you depends on is outpatient prescription medication (not excessively regular medical consultations etc.), you may be invited to submit a mitigation plan.

The mitigation plan might allow you to access public prescription coverage (e.g. from Trillium program in Ontario) at a later date.

For the calculation of the cost for this purpose, look in provincial drug Formularies, which may have a lower negotiated cost, e.g. https://www.formulary.health.gov.on.ca/formulary/.

More information:

  1. It is possible. There are so called "guaranteed issue" supplementary health insurances, sometimes also available through employers.

But these usually require you have provincial coverages first, which you might not have in some provinces due to waiting period (you get enrolled only after three months in Ontario for example). So you might have some problems there. Your nationality in most cases does not matter as long as you are a Canadian resident (PR or on work permit).

More importantly though, it will be (much) harder to find an insurance with annual maximum > 50k for prescription drugs (if the cited cost is correct).

Your employer (and/or ex-employer) would be your best bet.

Perceivably you might be able to get a short term continued coverage in the US. If you live near the border, you can go to the US every two weeks.

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All of the above is assuming you qualify for one of the immigration or work programs of Canada. On that I think it would need a lot more personal information that it might not necessarily fit here.

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