Is private surgery legal in Canada? Yes, but the answer depends on one thing most people never hear about: the province that insures you. This page explains that rule in plain words. It also sets out what each province says in its own reporting, and what the rule means if you live in Ontario.
We are a coordination service, so we deal with this question every day. If you want the wider picture first, start with our overview of private surgery in Canada. Then come back here for the legal part.
Is private surgery legal in Canada? The one rule
Here is the rule in one sentence. You generally cannot pay privately, inside your own province, for a service that your own province insures. But you can travel to another province and pay there.
So the rule follows the patient, not the surgeon. A knee replacement that Ontario insures is not for sale to an Ontario resident inside Ontario. However, that same Ontario resident can go to Montreal and pay for it there.
The reverse also holds. A patient from Alberta, British Columbia or Nova Scotia can come to Ontario and pay for surgery that their own plan would cover at home. That is why ACCESS works with centres in two provinces.
This is not a trick. It is how the system reads. Each province writes its rules about the people its own plan insures, and you remain free to travel within your own country.
Why private surgery rules differ by province
Two layers of law sit behind the rule. The first is federal, and the second is provincial.
The Canada Health Act sets conditions for provinces
The Canada Health Act does not speak to patients directly. Instead, section 4 says its purpose is to set criteria and conditions that provinces must meet to receive their full federal cash contribution.
Two of those conditions matter here. Section 18 says a province cannot allow extra-billing on insured services. Section 19 says a province cannot allow user charges. If a province lets those charges happen, Ottawa deducts money from its transfer. Health Canada's overview of the Act explains the same structure.
The Act also has a portability criterion in section 11. It means your home plan still covers insured services while you are temporarily away in another province. That covers public care, though, and not private fees.
Provincial law does the actual work
Because the federal Act binds provinces, each province writes its own law to stay within it. Those laws limit what doctors and clinics may charge the people that the province insures.
That is the key point. A provincial law protects its own residents from charges inside its own system. So it does not reach a patient who lives somewhere else. In short, the restriction lives with your health card.
Province by province: what each one says
Every row below comes from the Canada Health Act Annual Report 2024 to 2025. In that report, each province and territory describes its own rules in its own words. We have summarised them and kept their own statute names. Where a province says nothing on a point, we say nothing either.
Atlantic Canada and Quebec
| Province | What its own chapter says |
|---|---|
| Newfoundland and Labrador. | Section 7 of the Medical Care and Hospital Insurance Act bars a practitioner from charging a beneficiary more than the plan pays. That holds even if the practitioner has opted out. |
| Prince Edward Island. | A doctor outside the plan cannot bill it. Under the Health Services Payment Act, that doctor must tell patients so. |
| Nova Scotia. | The province says its plans allow no user charges or extra charges. |
| New Brunswick. | Regulation 84-20 does not permit user fees for insured services. The province also refused 23 requests to pay back privately bought care in 2024 to 2025. |
| Quebec. | The Health Insurance Act bars user fees. It also bars incidental fees for insured persons, except where regulation allows them. But Quebec also lets doctors practise fully outside the plan as non-participating professionals. |
Quebec matters most for Ontario patients. Its own chapter says non-participating professionals practise outside the plan, and the Régie pays neither them nor their patients. So those surgeons set their own fees, and the patient pays them directly.
Ontario and the West
| Province | What its own chapter says |
|---|---|
| Ontario. | The Commitment to the Future of Medicare Act bars doctors from taking payment for an insured service to an insured person, except from OHIP. It also bans paying for faster access. |
| Manitoba. | Since 1 January 1999, a surgical facilities regulation stops private surgical facilities from charging extra for insured services. |
| Saskatchewan. | Section 18 (1.1) of the Saskatchewan Medical Care Insurance Act bars charging a beneficiary more than the prescribed payment. |
| Alberta. | Section 9(1) of the Alberta Health Care Insurance Act bars extra-billing by doctors in the plan. A doctor who leaves the plan cannot bill it, and the patient cannot claim the cost back. |
| British Columbia. | Section 17 of the Medicare Protection Act bars enrolled practitioners from charging for benefits. Section 45 bans private insurance for publicly funded benefits. |
British Columbia has also tested its law in court. The province reports that the Supreme Court of Canada refused to hear the Cambie Surgeries appeal on 6 April 2023. That left the challenged provisions of the Medicare Protection Act in force.
The territories
| Territory | What its own chapter says |
|---|---|
| Yukon. | There are no user fees and no extra-billing for services its plan covers. |
| Northwest Territories. | Section 14 of the Medical Care Act bars extra-billing, unless the doctor has opted out and collects their own fees. |
| Nunavut. | Section 14 of the Medical Care Act bars extra-billing, unless the doctor has chosen to collect fees outside the plan. |
Notice the pattern. Every one of these rules speaks about the province's own plan, its own insured people and its own doctors. None of them, as reported, says a resident may not travel elsewhere and pay.
Is private surgery legal in Ontario?
Ontario residents face the tightest version of the rule, because Ontario law bars private payment for insured services at home. So an Ontario patient who wants private surgery goes to Montreal. Private surgery is legal in Canada for an Ontario resident, just not inside Ontario. ACCESS coordinates care there at Westmount Square Surgical Centre and CMC Montreal.
Ontario's own page on OHIP coverage outside Ontario is honest about the money side. It lists the services OHIP will not pay for in another province. That list includes fees charged by private hospitals or facilities. So you pay those yourself, and OHIP does not pay you back.
The same page also answers a common worry. A short trip for surgery does not end your OHIP coverage. Ontario only asks you to confirm your coverage if you will be away for more than 7 out of 12 months.
Finally, you do not give up your choice of surgeon. Ontario surgeons on the ACCESS roster also operate at the Montreal centres. So an Ontario patient can still see an Ontario surgeon, just in Quebec.
Private surgery if you live outside Ontario
If you live outside Ontario, you have two options. You can come to Panacea Clinic in Waterdown, Ontario, or you can go to Montreal. The choice usually comes down to the procedure, the surgeon and the trip.
Either way, the principle holds, and private surgery is legal in Canada for you wherever the province you travel to allows it. Your own province's rules apply to care inside your own province. So every procedure we coordinate is open to every patient in Canada. You can read about each centre on our facilities page, and the orthopedic procedures page covers hip and knee replacement, ACL reconstruction and rotator cuff repair.
Do you lose your place on the public waitlist?
We looked for a clear written answer to this, and we could not find one. None of the provincial chapters we read says that paying privately elsewhere removes you from a public list.
But we will not guess for you. Waitlists sit with hospitals, surgeons and health authorities, and the practice can vary. So ask two people before you decide. First, ask the office of the public surgeon whose list you are on. Then ask your provincial health ministry.
Also bear in mind the medicine. Surgery is not always the answer, even when the wait is long. A good surgeon will tell you when a less invasive option makes more sense.
How does private surgery work in Canada with ACCESS
ACCESS coordinates care. We do not sell surgery. The surgeon operates, the facility provides the operating room, and we arrange everything around them.
That means the consultation, imaging, the surgery date, travel, accommodation and follow up. You get one coordinator and one all-inclusive quote. Our fee is a separate coordination fee, and we disclose it up front. Money for the surgeon and the facility passes through to them.
Our how it works page sets out each step. And if you are thinking about the cost side, our guide to the medical expense tax credit for private surgery explains what you may be able to claim.
Is private surgery legal in Canada: common questions
Can you pay for private surgery in Canada?
Yes. But in most cases you pay in a province other than the one that insures you. Inside your own province, its law usually bars paying privately for a service the plan covers.
Is private healthcare in Canada legal?
Private healthcare in Canada exists, and much of it is legal. Clinics can charge for services the public plan does not cover. For insured services, each province limits what its own residents can pay for at home.
Can an Ontario resident pay for surgery in Quebec?
Yes. Ontario's rules bar private payment for insured services inside Ontario. Quebec lets surgeons practise outside its public plan and bill patients directly. So an Ontario patient can pay for surgery at a private centre in Montreal.
Will my province pay me back for private surgery elsewhere?
Usually not. Ontario says OHIP does not cover fees from private hospitals or facilities in other provinces. And New Brunswick reports that it turned down every request it reviewed to repay privately bought care in 2024 to 2025.
Does the Canada Health Act ban private surgery?
No. The Act sets conditions that provinces must meet to receive full federal funding. It penalises provinces that allow extra-billing or user charges on insured services. The rules that patients actually meet come from provincial law.
Is paying privately in another province a way of jumping the queue?
No. You are not paying for a better place in a public line. Instead, you step outside that line and buy care elsewhere, where the rules allow it. Ontario's ban on paying for faster access applies inside Ontario's own system.
About this article and its sources
This page is general information, not legal advice. The rules can change, and your situation may raise questions we cannot answer here. So if you need certainty, speak to a lawyer or your provincial health ministry.
We last reviewed this page on 4 November 2026, and we check every source at least twice a year. If you spot an error, tell us and we will fix it. And if you want a straight answer about your own case, talk to a coordinator.