Beginning August 21, 2025, Immigration, Refugees, and Citizenship Canada (IRCC) has made it mandatory for all Express Entry applicants to undergo an upfront Immigration Medical Exam (IME) as part of their permanent residence (PR) application—unless they qualify for specific exemptions. Maple News reports that this policy aims to ensure public health and better manage Canada’s healthcare resources.
Applicants may be exempt from the IME requirement if they already live in Canada, completed a prior IME within the last five years, and have been previously assessed as posing a low or no risk to public health and safety. These exemptions help streamline the process for individuals with recent medical evaluations already on file.
A common concern among applicants is whether a pre-existing medical condition could impact their eligibility. IRCC evaluates medical conditions based on two key criteria: risk to public health/safety and potential excessive demand on Canada’s health or social services. If a candidate’s condition is expected to significantly increase wait times or cost more than a set financial threshold, the application could be at risk of refusal.
For 2025, the excessive demand threshold is set at CAD $135,810 over five years, or $27,162 per year. This benchmark helps IRCC assess whether the medical cost burden of an applicant falls within acceptable limits. It’s important to note, however, that not all medical conditions lead to rejection. In many cases, individuals may be accepted with conditions that require follow-up, including medical surveillance for illnesses like tuberculosis.
Medical inadmissibility is a nuanced area in Canadian immigration. While being found medically inadmissible can complicate an application, individuals have the right to respond to preliminary findings and may, in many cases, provide additional documentation or a mitigation plan outlining how they intend to manage their condition without burdening the public system.
Express Entry candidates are strongly encouraged to consult with an immigration advisor or legal expert, particularly if they have health conditions that may pose challenges during the PR application process. Adequate preparation and a clear understanding of Canada’s medical admissibility criteria can significantly improve an applicant’s chance of success.
This change underscores IRCC’s continued focus on health-related policies as part of the immigration screening process. As the Express Entry system evolves, staying informed about new requirements—like the IME mandate—will be vital for prospective immigrants to navigate the path to Canadian permanent residency effectively.