America -> Canada (my experience as a dual citizen with chronic illness)
Hello AmerExit community!
Recently in Canada, some changes have been made regarding claiming citizenship by descent and I wanted to share my experience of moving from America to Canada (Quebec) in 2020. This will be solely my personal experience and does not comment on if I agree with the systems in place nor does it mean I believe this will be the case for everyone who takes a similar route to me. This is also not to say one country will always be a better option for each person. Each country has its own issues and neither is a utopia, and while my experience moving has been exceedingly positive that does not erase the issues others have had.
Some important context to know before reading is below:
1: I live with severe autoimmune disease and need to take biologics. One of my main motivations for my move was I had a poor quality of life in the states due to this. I spent all my time fighting a cycle of gaining and losing access to the meds that keep me healthy and alive.
2: My parents are both Canadian citizens that immigrated to America. Because of this, my citizenship was very straightforward and easy to apply for. This is something I’m immensely grateful for and really lucked out on. So while I can’t answer a lot of immigration questions, I can at least compare what living in both countries is like.
3: For specifics, I moved from Chicago to Montreal. I had lived in the United States for 24 years at the time of my move and had never lived in another country prior. I now have lived in Canada for about 6 years.
4: Each province can be quite different so I really do want to stress this is my experience with Quebec, specifically Montreal. I only have RAMQ which is the standard public medical care, no private insurance.
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Motivations: In early 2019, I had a family emergency happen that essentially forced my mom to relocate back to Canada with no notice. I’m very close with my mom, and decided to move as quickly as I could so she would not be alone. On top of this, I had a full intestinal perforation from previously undiagnosed Crohn’s disease a few months before that made me need to start strong medications urgently and keep access to them to have any quality of life. I started the application to receive documentation of my citizenship immediately and included a note from my doctors asking for my case to be expedited so I could access RAMQ asap. There are a few situations that allow you to expedite your citizenship certificate, and if you know you are 100% a citizen I recommend checking to see if you meet any of them.
Wait Times: Getting the information for my application took around a week to compile and the embassy received it one additional week after that. I honestly don’t remember why but for some reason I HAD to send my application in through the mail and could not do it online. After sending it off, I applied and paid for an expedited US passport which took around 2 weeks to receive. I was able to cross into Canada as a citizen with just the certificate, but this was during COVID so they had to call my family and verify my information. After arriving, I made an appointment with a RAMQ office to set up health insurance and they as able to receive my card within a month. From there, it took another few months to get specialists but since then I have no issues waiting for appointments. Things move very fast if you are on top of it.
It is important to note Canada has a VERY high wait time for general practitioners, and you will most likely wait years to have one. However: There is a great system in place called 811 that you call and in my experience living in Montreal, I have always been able to see a doctor the same day I call for minor emergencies.
Key Differences in Medical: If I’m being honest, moving to Canada was the best decision I could have ever made for my health. There are MASSIVE differences in my quality of life after moving that I’m so thankful for.
In America, I spent hours every week fighting insurance and stressing over how I was going to be able to get the medications I needed. These meds cost sometimes over 10k out of pocket, so paying for them was not an option. Some people find ways to qualify for low cost payments or have private insurance, but I did not and consistently my coverage was revoked and then reinstated in a vicious cycle. I had problems with Medicaid constantly getting my reported income wrong (or I would go over the allowed amount by a few dollars) which causes your coverage to disappear. This caused me to develop antibodies to multiple treatments and ultimately caused more scarring and permanent damage to be done to me. My doctors in the states were pretty awful in the suburbs, but in the city (especially at universities) they were excellent. In Chicago, I remember waiting 6-8 hours to see an ER doctor if I could even afford to go see one. During my intestinal perforation episode, I took a bus to the ER because I could not afford an ambulance. On average, I would spend about 350+ a month on medications NOT INCLUDING my biologics.
In Canada, I have never once had issues getting my medications. There is a program here that requires pharmaceutical companies to supply biologics for free until some insurance will cover them. Even if no insurance ever does, you still receive them for free if you have been prescribed it. My doctor will write me a prescription and I will start my medication the same week , it’s crazy how simple it is compared to the hoops you need to jump through in the states. I personally think the quality of doctors is better here in Canada, I see doctors affiliated with a university hospital and absolutely adore them. The ER wait times here are the exact same as the states, but the key difference is on RAMQ you don’t pay a cent. My appointments, most medications, lab work, etc, is all free here. Some people do pay a small fee for lab work, but most disabled people are exempt from this. Ambulances here are not free, but cost around 200 or less in the cities which is WAY better than the states. Overall, I spend less than 50 a month on my medical care and it’s incredibly easy for me to manage.
Key differences in living: Not surprisingly, the rent here is WAY cheaper than Chicago. It has been slowly going up in price over the years, but I still manage to pay 2k CAD (1.4k USD) rent total for a large 2 story home in a very popular spot in Montreal only a block from a metro. In a major American city I can image this would be closer to 5.5k CAD (4k USD) if not more. Food in Canada IS expensive, if I were to calculate how much I spend per month I think my grocery bill is slightly higher here than it is in the US. I would not say it’s a massive difference, but it is something to be aware of.
Something that really shocked me moving here is how much less stressed everyone seems. Canada has excellent systems in place for unemployment where the government will give you enough money to live on if you lose your job. You also can’t just fire someone for no reason and there’s seniority benefits, which is pretty great. Maternity leave exists here too and is paid for up to 15 weeks, but I believe this can turn into parental leave for up to 76 weeks maximum. I don’t see anywhere near as many young people working 2-3 jobs just to afford basic rent and people have a lot more free time here. Things are not nearly as catastrophic, and honestly life here is very calm and safe.
People in both countries tend to be mostly very kind, you get your bad apples but I think that goes for anywhere. Other than stress levels, the only other big difference I can think of is religion is WAY less a part of life here. In Montreal, it’s uncommon to meet people who are Christian and even in the suburbs most people tend to be agnostic/atheist. There’s definitely churches/mosques/etc and groups of people that are religious, but it’s not the majority of the population like it tends to be in a lot of America.
Notes on Quebec: If you do wish to settle in Quebec, I highly recommend coming with at least basic French skills. While you can get by with just English temporarily, if you are looking to work here and really want to be a part of the community French is integral. Finding work with no French skills is VERY difficult and will make your life very hard. The government offers free French classes to most people (in a lot of cases you are even given a weekly pay for taking them) but you need to apply very early because the wait time can be up to a year. I’m unsure if you can apply before moving into the province, but I strongly recommend applying the second you step foot into Quebec. I am taking full time francisation lessons and really enjoy them! I love Montreal and think it’s a beautiful city, and I don’t plan on moving into the near future.
Other things to know: Canada is WAY smaller than the states. New York City has a population of 8.58million while ALL OF QUEBEC has about 9 million. While a lot of people think Canada is essentially “mini America”, this is very untrue. Canada has so many major differences once you truly settle in and deserves a lot more respect than to just be compared to its southern counterpart. It’s a very unique country and if you immerse yourself, so many cool things to learn and experience. If you enjoy nature, Canada has the most breathtaking areas usually only an hour north of most cities. It’s truly gorgeous here!!
That being said, I do go through periods of missing where I grew up and the first year here was very hard for me to adjust to. I still sometimes think of the parts of America I loved and feel an ache in my chest to be able to revisit them one day, but ultimately I do not regret my choice to move here.
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In summary: TLDR is that my move to Canada greatly improved my quality of life and access to medical care here is much better in my opinion. The only difference to me is care is actually easier to access in Canada if anything and I’m not hemorrhaging money to do it. If anyone has questions on anything please ask away and I’ll do my best to answer!