The Big Picture
Each province and territory manages its own health care insurance plan. Its government also plans and finances health care services.
These plans follow five main principles under the Canada Health Act. The five principles deal with what services are covered, who receives coverage, keeping coverage during situations such as moving or travel, access to care, and how the insurance plan is run.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Each province and territory develops and administers its own health care insurance plan.
- The Canada Health Act (1984) sets five principles for provincial and territorial health insurance plans.
- The five principles are comprehensiveness, universality, portability, accessibility, and public administration.
- Provincial and territorial governments plan health services, decide where facilities are located, and decide how many health care providers are needed.
- Provincial and territorial health insurance plans pay hospital and physician costs.
- Under portability, coverage from the previous province or territory continues for up to 3 months during a move.
Jump to:
Course Notes: Key Ideas You Need to Know
What Provinces and Territories Are Responsible For
Each province and territory develops and administers its own health care insurance plan.
Provincial and territorial governments also finance and plan health care services. Their responsibilities include decisions about:
- where hospitals and long-term care facilities are located
- how hospitals and long-term care facilities are organized
- how many physicians, nurses, and other service providers are needed
- how much money to spend on health care services
Provincial and territorial health insurance plans pay hospital and physician costs.
Medicare and the Canada Health Act
Medicare is Canada’s national health care insurance system. It publicly funds the full cost of medically necessary health services for permanent residents.
The Canada Health Act (1984) identifies the types of health care services that are insured. It also sets five principles that provinces and territories must meet to qualify for federal health care funding.
The five principles are:
- Comprehensiveness
- Universality
- Portability
- Accessibility
- Public administration
1. Comprehensiveness
Comprehensiveness means medically necessary health services must be insured.
In a hospital, coverage includes necessary:
- drugs
- supplies
- diagnostic tests
A range of necessary services provided outside a hospital are also covered. The principle also includes hospitalization and access to physicians and surgical dentists.
2. Universality
Universality means every permanent resident of a province or territory is entitled to insured health care services on similar terms and conditions.
The basic idea is equal entitlement to the insured level of health care services.
3. Portability
Portability means health care coverage continues in situations such as unemployment, job changes, moving, and travel.
Coverage continues when a person:
- becomes unemployed
- changes jobs
- moves between provinces or territories
- travels within Canada
- travels outside Canada
A person who moves has responsibilities too. The person must inform the province or territory and register with the new province or territory.
Number to remember: During the move between jurisdictions, the previous province or territory provides coverage for up to 3 months.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition gives the general portability rule that previous coverage continues for up to 3 months during a move.
In Nova Scotia, the provincial plan is the Nova Scotia Health Insurance Program. For Canadian citizens or permanent residents moving permanently from another province or territory, Nova Scotia Health Card coverage usually starts on the first day of the third month after the person becomes a Nova Scotia resident. The person needs to contact the previous province or territory to make sure coverage continues until Nova Scotia coverage begins.
Why this matters in Nova Scotia: The Canada-wide portability principle stays the same, but Nova Scotia gives a specific start date for its own coverage when someone moves here.
Official source: Healthcare coverage if you move to Nova Scotia: Health Card
Last checked: August 26, 2026
4. Accessibility
Accessibility means people receive medically necessary insured services regardless of:
- income
- age
- health status
- gender
- geographical location
Additional charges for publicly insured services are not permitted.
5. Public Administration
Public administration means the health insurance plan must be run by a public organization on a nonprofit basis .
The organization must be accountable to:
- the citizens
- the provincial or territorial government
Exam Clue Words
- Must: Provincial and territorial plans must meet the five Canada Health Act principles to qualify for federal health care funding.
- Every: Universality applies to every permanent resident of a province or territory who is entitled to insured services.
- Regardless of: Accessibility means income, age, health status, gender, or geographical location does not remove access to medically necessary insured services.
- Up to 3 months: During a move, the previous jurisdiction provides health coverage during the transition for up to 3 months.
- Must be run: Public administration requires the insurance plan to operate through a public organization on a nonprofit basis.
Fast Review
Use these points for a quick last-minute check:
- Provinces and territories develop and administer their own health care insurance plans.
- They finance and plan health care services.
- The Canada Health Act (1984) sets five Medicare principles.
- Comprehensiveness deals with coverage of medically necessary services.
- Universality deals with entitlement to insured services for permanent residents.
- Portability keeps coverage in place during changes such as unemployment, job changes, travel, or moving.
- During a move, coverage from the previous jurisdiction continues for up to 3 months while the person registers with the new one.
- Accessibility deals with access to medically necessary insured services regardless of income, age, health status, gender, or geographical location.
- Public administration requires a public, nonprofit organization to run the insurance plan.
- Provincial and territorial governments decide where hospitals and long-term care facilities are located and organized, how many service providers are needed, and how much to spend on health services.
Final Pep Talk
The five Medicare principles look similar at first, so focus on the one main idea behind each term. Review the names, their meanings, and the 3-month portability detail until you separate them quickly.