a country · CanadaCanada

One of the two largest source markets in the world, and the one whose patients leave for a date rather than a discount. Provincial insurance covers medically necessary hospital and physician care at home; it does not cover the wait, and it barely follows a patient across the border. Canadians appear as inbound patients in Mexico, Costa Rica, the Caribbean and the United States, and Canadian surgeons appear in this site's data mostly as the comparison.

The wait has a published measure. The Canadian Institute for Health Information reports the share of patients treated inside a national benchmark of 182 days — 26 weeks from the date a patient was ready to be treated — and for 2024 it recorded 68% of hip replacements and 61% of knee replacements done inside it, alongside 69% of cataract surgeries within their 112-day benchmark, 94% of radiation therapy within 28 days and 83% of hip fracture repairs within 48 hours. That report was published on 12 June 2025. CIHI's joint replacement indicator, updated in June 2026 on the April-to-September window, put hip and knee replacements combined at 65% inside the six-month target.

Read the complement instead and the market appears: in 2024 close to four knee patients in ten were still waiting more than six months after being ready for surgery, in a country where the surgery itself carries no bill.

What the state pays when they go is set by statute. The Canada Health Act, R.S.C. 1985, c. C-6, makes portability a criterion of a provincial plan: for insured services provided outside Canada, section 11(1)(b) requires payment "on the basis of the amount that would have been paid by the province for similar services rendered in the province". Inference — that clause is the whole economics of leaving. A province reimburses at its own domestic rate, which for an operation bought privately in Florida or Tijuana is a fraction of the invoice, and the patient carries the difference. Portability pays for an emergency abroad; it does not fund an elective trip.

Trade practice — Canadian outflow also runs inside the country's own borders in a way this site cannot chart: to private surgical clinics in provinces that permit them, and to Quebec's parallel arrangements. The traffic that leaves the country is the visible end of a larger domestic argument about who may sell an operation to a Canadian.

A Canadian patient referred for an elective joint replacement enters a provincial queue measured from the decision to treat. Where the wait is long, the routes out are three: pay privately in the United States, usually in cash and usually within a day's drive; buy a package abroad, most often in Mexico, Costa Rica or the Caribbean; or wait. None of the three is reimbursed as a matter of course, and prior authorisation for out-of-country care is a provincial process with its own criteria. Dentistry sits outside the public plans altogether, which is why Canadians are one of the three origins Mexican surgeons name most often.

As of the June 2026 CIHI update, 65% of hip and knee replacements in the April-to-September window were done inside the 182-day target. This record carries no count of Canadians treated abroad: the estimates in circulation come from think-tank surveys of physicians rather than from a register, and they are left to their own publishers rather than repeated here.