Returning to Canada for Health Insurance

[lawman3966]

Being a dual citizen of Canada and the U.S., and living in the U.S., the current health insurance situation in the U.S. has led me to consider returning to Canada in order to participate in one of the provincial health plans (likely British Columbia's).

Returning to Canada for a permanent stay presents various complications to the returning migrant's investments and taxes. However, a comment in another thread got me thinking about returning to Canada for a limited period, for example, until I'm of Medicare age in the U.S. (I'm currently 57).

I'm posting to find out whether anyone who is similarly situated (either a dual citizen, or a U.S. citizen who's lived in Canada) on the board has investigated this option, and knows how to pull off such a move while minimizing the disruption to investments and taxes.

(I have nearly every type of account: taxable mutual fund account; Traditional IRA, Roth IRA, three different 401Ks, a TSP account, and a couple of taxable checking accounts).

[Dash man]

I'm not an expert in your situation, but US citizens are required to pay US income taxes wherever they've lived in the world. There are deductions for foreign taxes paid, but Uncle Sam still wants his share. I suggest you find a tax advisor to guide you through this.

[Meadbh]

I do think it would be a good idea to consult with an accountant specializing in cross-border taxation, in the province you wish to live in.

These sites might be helpful.

Returning to Canada - A Resource Guide for Canadian Expatriates Moving Back to Canada

TaxTips.ca - Canadian residents and non-residents - Who pays tax in Canada, and on what income?

CRA Magazine

T1135 - Foreign Income Verification Statement

Medical Services Plan of B.C. - Province of British Columbia

[frank]

why does the canadian health care system look so much better than the one we have available? price, access to health care, quality of health care? just curious why you would want to do what you suggest.

[Nemo2]

Quote:

Originally Posted by frank why does the canadian health care system look so much better than the one we have available? price, access to health care, quality of health care? just curious why you would want to do what you suggest.

In Ontario, and perhaps in other provinces, the doctors are unhappy:

https://coalitionofontariodoctors.ca/stopbill41/

[savory]

When the Lost Canadian program became law, I applied and received my Canadian citizenship. I mainly did it for the same reason you are considering moving to Canada; take advantage of the Canadian health care program.

My research was mainly targeted at qualifying for health care. What I remember is the provinces have various time frames for residential requirements. If timing is an issue, you may want to research those requirements by provonce.

Otherwise, I think the advice of researching tax issues would be a good idea. There are tax rules in place but getting advice is a good idea in my opinion. I do remember that the USA is one of the few or perhaps only country that taxes based on citizenship. This means you will owe some USA taxes up to the point of the tax treaty agreement with Canada.

Good luck and if you are willing to share your research, I would be interested in learning more.

[Alan]

Quote:

Originally Posted by Meadbh I do think it would be a good idea to consult with an accountant specializing in cross-border taxation, in the province you wish to live in. These sites might be helpful. Returning to Canada - A Resource Guide for Canadian Expatriates Moving Back to Canada TaxTips.ca - Canadian residents and non-residents - Who pays tax in Canada, and on what income? CRA Magazine T1135 - Foreign Income Verification Statement Medical Services Plan of B.C. - Province of British Columbia

Good links and good advice, particularly about consulting with a specialist in cross border taxation.

The USA does have a Tax Treaty with the USA and any US Citizens living in Canada have to file and pay taxes in both countries, with tax credits applied as necessary.

https://www.irs.gov/businesses/inter...eaty-documents

[Hyperborea]

Be aware that many countries have an exit or expatriation tax of some kind - US and Canada included. If you become a resident of Canada now and then leave later you will have to do an exit tax return that will potentially require you to go through a "deemed disposition" of various assets and pay tax on the deemed capital gains.

Leaving Canada (emigrants)

[Sunset]

Quote:

Originally Posted by frank why does the canadian health care system look so much better than the one we have available? price, access to health care, quality of health care? just curious why you would want to do what you suggest.

Nearly free, and a better quality system according to various comparisons of industrialized countries.

However, you wait longer for non-urgent tests and procedures. Drugs are typically not included, but are lower priced, and you can always have a cheap drug plan.

[6miths]

Quote:

Originally Posted by Nemo2 In Ontario, and perhaps in other provinces, the doctors are unhappy: https://coalitionofontariodoctors.ca/stopbill41/

Gee I'm a doctor in Ontario and I'm not unhappy... quite the contrary in fact, I am very happy. There are always things to complain about and lobby for. Who doesn't want to work fewer hours for more money or feel that they have better representation or have more control of their life or a gold-plated government pension plan. When I sit around with my colleagues and talk turkey, there is seldom a one that doesn't think that Canada has one of the best healthcare systems in the world and that it is far superior to the system in the US - even for doctors in recent years. The US system doesn't serve the countries population well and is bloated with countless middlemen collecting their golden crumbs and driving costs to unsustainable levels. (Mods can cut out the last sentence or two if they are found to be offensive).

Waiting times are usually about 90 days but have been reduced in some provinces in recent years. While waiting one can get private insurance and even if uninsured costs would look like a bargain.

[Meadbh]

Quote:

Originally Posted by Sunset Nearly free, and a better quality system according to various comparisons of industrialized countries. However, you wait longer for non-urgent tests and procedures. Drugs are typically not included, but are lower priced, and you can always have a cheap drug plan.

Nothing is free. Our healthcare system is paid for in taxes (including the aforementioned departure taxes if the OP wants to return to the US to benefit from US 'Medicare). That said, as a single payer system, the per capita costs are very much lower than in the US.

https://en.m.wikipedia.org/wiki/List...ure_per_capita

Waiting times for elective procedures are the main problem with our system. Urgent issues are prioritized (see Nemo2's recent experience with herpes zoster ophthalmicus).

Lack of insurance coverage is not an issue and is not a barrier to receiving care, as it is in the US. Also, the patient never has to chase insurers, fight bills, or worry about the personal financial burden of treatment. That's got to count for something.

[savory]

Quote:

Originally Posted by 6miths Gee I'm a doctor in Ontario and I'm not unhappy... quite the contrary in fact, I am very happy. There are always things to complain about and lobby for. Who doesn't want to work fewer hours for more money or feel that they have better representation or have more control of their life or a gold-plated government pension plan. When I sit around with my colleagues and talk turkey, there is seldom a one that doesn't think that Canada has one of the best healthcare systems in the world and that it is far superior to the system in the US - even for doctors in recent years. The US system doesn't serve the countries population well and is bloated with countless middlemen collecting their golden crumbs and driving costs to unsustainable levels. (Mods can cut out the last sentence or two if they are found to be offensive). Waiting times are usually about 90 days but have been reduced in some provinces in recent years. While waiting one can get private insurance and even if uninsured costs would look like a bargain.

Thanks for taking the time to write. If I elect to take advantage of my Canadian citizenship, your comments will be helpful to my decision.

[ShokWaveRider]

My family will have to go too if we cannot afford health insurance. We will have to see. We are also dual nationals.

[kcowan]

I live in Mexico for 6 months, Canada for 5 months and Europe for a month. Mexico is pretty good, Canada is excellent if you have a PCP and can get timely referrals. I get most of my stuff done in Canada but have no problem getting necessary procedures done in Mexico. Costs are not an issue except for dental which is much cheaper in Mexico.

One problem for USians is that you have to pay taxes in both countries and Canada is better for long time residents who are retired. As a short timer you miss out on 2 pensions worth $12k to $16k, while you get might get SS and Medicare. Most USians in Mexico return to the US for major procedures whereas Canadians have the choice but at extra costs.

[Nemo2]

Quote:

Originally Posted by 6miths Gee I'm a doctor in Ontario and I'm not unhappy... quite the contrary in fact, I am very happy.

Perhaps it's only the doctors that see me that are unhappy, (maybe that's why they schedule my appointments for days they're closed?), but there's a petition for patients to sign in the waiting rooms of the last couple/three physicians I've visited.

But, being an 'onlooker', I bow to your experience.

[Sunset]

Quote:

Originally Posted by Nemo2 Perhaps it's only the doctors that see me that are unhappy, (maybe that's why they schedule my appointments for days they're closed?), but there's a petition for patients to sign in the waiting rooms of the last couple/three physicians I've visited. But, being an 'onlooker', I bow to your experience.

Obviously anybody that finds they can close up shop on some day, must be making enough, or they would be open.

Those petitions are like tip jars springing up all over the place, just another attempt to get more money from someone.

[Nemo2]

Quote:

Originally Posted by Sunset Obviously anybody that finds they can close up shop on some day, must be making enough, or they would be open.

Guess I should have written 'kidding' in parenthesis.

[6miths]

Quote:

Originally Posted by Sunset Obviously anybody that finds they can close up shop on some day, must be making enough, or they would be open. Those petitions are like tip jars springing up all over the place, just another attempt to get more money from someone.

And yet this observation rings of truth. MDs in Canada are generally quite well off and quite comfortable. Not CEO comfortable but doing very well. What do you suppose would happen if any particular group quit complaining about their slice of the pie?

[photoguy]

Quote:

Originally Posted by lawman3966 I'm posting to find out whether anyone who is similarly situated (either a dual citizen, or a U.S. citizen who's lived in Canada) on the board has investigated this option, and knows how to pull off such a move while minimizing the disruption to investments and taxes.

I'd like to know this too. My initial uninformed thoughts would be that I keep pretty much all my investments in the US and just transfer money for living directly (wire transfer or norbert's gambit). I'd file three tax returns (joint in US, individual x2 in canada) and hope that the treaty more or less evens things out. But I haven't filed a canadian tax return in 20 years...

Here's are some links that I've found that may be helpful:

IRS publication on for US Citizens residing abroad
https://www.irs.gov/uac/about-publication-54

IRS Publication on US - Canada Tax Treaty (mostly from perspective of Canadians in US)
https://www.irs.gov/uac/about-publication-597

Treatment of US retirement plans in Canada:
https://www.sunnet.sunlife.com/files...1k_to_RRSP.pdf
(seems like tax deferred nature is mostly maintained including roth)

How Canadian residents are taxed on US social security
How Canadian Residents Receiving US Social Security Are Taxed - Gedeon Law and CPA
(taxed at 85% in canada, no US tax)

Bank of Montreal brochure for US citizens in Canada
https://www.bmo.com/pdf/nesbitt/USCi...20BMO%20NB.pdf

BMO brochure on interest, dividends and cap gains in Canada
https://nesbittburns.bmo.com/getimag...ntent_id=64461
(My god the canadian dividend system is complex)

[lawman3966]

Quote:

Originally Posted by photoguy I'd like to know this too. My initial uninformed thoughts would be that I keep pretty much all my investments in the US and just transfer money for living directly (wire transfer or norbert's gambit). I'd file three tax returns (joint in US, individual x2 in canada) and hope that the treaty more or less evens things out. But I haven't filed a canadian tax return in 20 years... Here's are some links that I've found that may be helpful: * * SNIPPED * *

Thanks for the links. It's apparent that there's a lot of homework to do on this point before making the move. Your comment about where you'd keep your investments addresses one of the most important issues for bi-nationals. However, my understanding is that Canada has rules regarding where its residents' investments can be kept. I was led to believe that Canada tends to require that non-retirement assets be moved to Canada within some time period after migrating back to Canada.

One problem I've read about in the past is the combination of Canadian investment rules (regarding locating investments in Canada) and unfavorable IRS treatment of Canadian-registered investments (in comparison with comparable U.S. investments) tends to impose significant cost and record-keeping requirements on U.S. citizens living in Canada (whether they are dual US-CAN citizens or U.S. citizens and Canadian residents).

Some posters on a Canadian-centered site I visited once suggested that dual citizens were best advised to renounce their U.S. citizenship after a few years in Canada to avoid the taxation and reporting burdens imposed on dual citizens living in Canada. I'm hoping to avoid resorting to that extreme a measure.

Thanks again for the input. Looks like there's a lot of reading to do.