Applying for Express Entry with a Pre-Existing Medical Condition: What You Need to Know in 2025

Immigrating to Canada through Express Entry is a dream for thousands of skilled workers every year. However, one of the most common concerns many applicants face is: “Will my medical condition stop me from getting Canadian permanent residence?”

This is an important question because Canada places a strong emphasis on the health and safety of its residents. Immigration, Refugees and Citizenship Canada (IRCC) has strict rules to ensure that new immigrants do not pose risks to public health or create an unsustainable demand on Canadian healthcare and social services.

In this blog, we will explain the latest medical requirements for Express Entry in 2025, what types of conditions can create challenges, and most importantly—what you can do to strengthen your application if you have a pre-existing health condition.

New Rule: Upfront Medical Exams for Express Entry

As of August 21, 2025, all Express Entry candidates are now required to submit an upfront Immigration Medical Exam (IME) when they apply for permanent residence.

Previously, IRCC used to request medicals after you submitted your application. But with this change, your medical eligibility will now be assessed right at the beginning of the process.

This means if you have a pre-existing condition, you must be prepared with clear medical reports, treatment history, and documentation before submitting your Express Entry application.

Grounds for Medical Inadmissibility

Not every health issue will cause problems. IRCC reviews cases individually. However, there are three main grounds under which an application can be refused for medical reasons:

1. Excessive Demand on Health or Social Services

If your condition is likely to require treatment, medication, or social services that would exceed a certain cost threshold, your application may be flagged.

👉 For 2025, the threshold is CAD $27,162 per year or CAD $135,810 over five years.

Conditions such as advanced kidney disease, uncontrolled diabetes, or complex mental health issues requiring long-term support may be considered “excessive demand.”

What you can do:

• Show evidence of stable management of your condition.
• Provide a mitigation plan (explained below).
• Demonstrate ability to cover expenses through private insurance or personal funds.

2. Danger to Public Health

If your condition is contagious and poses a risk to others—such as untreated tuberculosis or certain infectious diseases—IRCC may find you inadmissible.

What you can do:

• Provide medical reports showing treatment, vaccination, or successful management.

Submit recent test results proving non-infectious status.

3. Danger to Public Safety

This applies to medical conditions that may cause unpredictable or dangerous behavior, such as uncontrolled seizures or violent psychiatric disorders.

What you can do:

• Submit reports from doctors or psychiatrists confirming stability.

Provide evidence of ongoing treatment and medication adherence.

What is a Mitigation Plan?

One of the most powerful tools applicants can use is a mitigation plan.

A mitigation plan is a written statement explaining how you will manage your condition in Canada without placing an excessive burden on public healthcare. It typically includes:

• Medical evidence of how your condition is stable or improving.
• Treatment plan (e.g. medications, therapies, doctor visits).
• Proof of financial resources or private insurance to cover costs.
• A declaration showing your commitment to fund your own care.

While Canada’s healthcare system is public, IRCC accepts mitigation plans to demonstrate that an applicant has realistic strategies to minimize cost to taxpayers.

The Procedural Fairness Letter (PFL)

If IRCC suspects you may be medically inadmissible, they will issue a Procedural Fairness Letter (PFL).

This letter gives you 90 days to respond with additional medical evidence, test results, or a mitigation plan. In some cases, you can request an extension.

It’s important not to panic if you receive a PFL. Many applicants are still approved after providing strong documentation and a clear mitigation plan.

Tips to Strengthen Your Express Entry Application with a Medical Condition

1. Be Transparent – Disclose your condition honestly. Trying to hide it will only create problems later.
2. Get Updated Medical Reports – Provide detailed and recent records from your specialists.
3. Show Treatment Stability – Demonstrate that your condition is controlled with medication or therapy.
4. Prepare Your Mitigation Plan Early – Don’t wait for IRCC to ask. Being proactive shows responsibility.
5. Consider Private Insurance – This can reassure IRCC that your treatment costs won’t fall entirely on the public system.
6. Consult an Immigration Lawyer or Consultant – Especially if your condition is serious or costly, professional guidance can make a big difference.

Final Thoughts

Having a pre-existing medical condition does not automatically mean your Express Entry application will be refused. IRCC assesses applications on a case-by-case basis, focusing on whether your condition poses risks to public health, safety, or creates an excessive financial demand.

With upfront medical exams now mandatory in 2025, it’s more important than ever to prepare comprehensive medical documentation and, if necessary, a strong mitigation plan.

By being proactive, transparent, and well-prepared, many applicants with medical conditions have successfully achieved their dream of becoming Canadian permanent residents.