How Canadians Use Health Spending Accounts To Access Medical Treatment Sooner

Garrett Agencies Team

November 17, 2025

5 min read

Canada’s health care system is under pressure. Wait times for specialist consults, imaging, and elective surgeries have stretched into months and, for many procedures, years. For business owners and self employed Canadians, long delays often translate into lost productivity, prolonged pain, and unnecessary economic strain.

This is one reason more Canadians are exploring treatment options outside the country. A Health Spending Account changes the equation because it allows these costs to be claimed as legitimate medical expenses within your corporation. The result is faster access to care, lower after tax costs, and real flexibility when the public system cannot provide timely treatment.

This article explains how it works, when cross border medical travel becomes an eligible expense, and how an HSA can be a strategic tool for both personal health and business continuity.

Why Delayed Treatment Has Become a Serious Business Issue

Canadian wait times have grown long enough that they now affect commercial activity. When the owner, key manager, or a skilled employee is out of commission for months because of a preventable delay, the entire operation suffers.

Recent national polling shows a rising number of Canadians are open to traveling abroad for treatment simply to avoid long queues. People are not frustrated with the quality of Canadian care. The problem is access. For elective procedures, orthopedic surgeries, advanced imaging, and certain specialist driven treatments, the wait can exceed six months to two years.

For entrepreneurs who cannot afford lengthy downtime, this creates a difficult choice. Stay on the wait list and manage chronic pain or pursue treatment elsewhere at full cost. This is where a Health Spending Account becomes a powerful tool.

How an HSA Helps Fund Medical Treatment Outside Canada

A Health Spending Account is a CRA approved plan that allows your incorporated business to pay for eligible medical expenses with pre tax corporate dollars. For self employed individuals with arm’s length employees, it works the same way. For expenses incurred abroad, the key rule is simple:

If the service would qualify as a medical expense in Canada, it generally qualifies under an HSA even when performed outside the country.

This includes:

Orthopedic procedures such as knee and hip surgery
Specialist consults
Diagnostic imaging
Dental procedures
Physiotherapy and rehabilitation
Many types of elective surgery that have long domestic wait lists

If a treatment is available in Canada but not available to you on a timely basis, receiving it elsewhere often becomes both medically reasonable and HSA eligible.

CRA Medical Travel Rules You Need To Know

The CRA allows medical travel expenses to be claimed when the required service is not available locally. These rules also apply when claiming through an HSA. The key thresholds are:

Travel of at least 40 km one way

Transportation costs can be claimed.

Travel of at least 80 km one way

Transportation, meals, accommodations, and parking may be claimed if travel was required to access the medical service.

A companion’s travel is also eligible when medically necessary.

Documentation required

A receipt or letter from the practitioner confirming the service and date of treatment is mandatory. Without it, the claim will not be accepted.

This framework creates real advantages for Canadians who pursue treatment outside the country. When distances exceed 80 km, an HSA can reimburse:

Commercial airfare
Accommodation near the treatment center
Meals at reasonable amounts
Parking
Ground transportation
The actual medical procedure or consult

For high cost procedures, this can result in significant corporate tax savings for business owners.

Example Scenario

A business owner has been told the wait for an orthopedic procedure will be close to a year. The condition is painful and affects day to day functioning, making it harder to run the business. The same procedure is available outside Canada within two to four weeks.

Using an HSA, the business can reimburse:

The surgery cost billed by the foreign provider
The flight
Hotel accommodations
Meals during the stay
Ground transportation
Parking
Eligible companion costs if required

This converts a large personal expense into a fully deductible corporate medical benefit. For many owners, the tax savings alone cover a substantial portion of the overall cost.

Planning Tip: Split Large Procedures Over Two Fiscal Years

For high cost surgeries, the reimbursement does not need to occur in a single fiscal period. Many HSA providers allow the expense to be processed so the business claims part of the cost in one year and the remainder in the next. This strategy smooths cash flow and keeps the deduction manageable.

Garrett Agencies helps clients plan this correctly and ensures that the HSA is structured in a way that aligns with CRA guidelines.

Why This Matters for Small Teams and Arm’s Length Employees

The benefit is not only for business owners. Employees with an HSA can use it to cover:

Dental copayments
Vision expenses beyond their plan maximum
Chiropractic and physiotherapy top up amounts
Out of pocket costs for paramedical services
Travel related medical costs when treatment is required outside their community

This gives employees meaningful financial support at a time when many households are stretched thin.

Is Cross Border Care Right for You

Not every situation justifies travelling abroad. But when long delays affect your ability to work or live comfortably, having the option matters. An HSA gives you the freedom to access treatment where and when you need it, without relying entirely on the public system’s schedule.

For many clients, it becomes a way to restore control over their health, reduce downtime, and protect their business from extended interruptions.