A38 Medical Inadmissibility: What It Means
Inadmissibility on health grounds: danger to public health, danger to public safety, or excessive demand on health or social services.
What A38 means
A38 refers to section 38 of the Act. A foreign national may be inadmissible on health grounds if their condition is a danger to public health, a danger to public safety, or might reasonably be expected to cause excessive demand on health or social services.
Excessive-demand findings in particular have specific thresholds and a procedural fairness process.
Why officers cite A38
- A condition assessed as a danger to public health
- A condition assessed as a danger to public safety
- Anticipated costs exceeding the excessive-demand threshold
What it does not mean
- Excessive demand does not apply to all immigration categories — some are exempt
- It does not always mean refusal — a fairness response can change the outcome
General options after a A38 refusal
Respond to the fairness letter. For excessive-demand cases, a procedural fairness letter allows you to respond, sometimes with a mitigation plan showing costs will not exceed the threshold.
Check category exemptions. Certain categories, such as some family-class and protected-person cases, are exempt from the excessive-demand ground.
This page explains what a refusal code means and is for general information only. It is not legal advice, and it does not recommend a course of action for your specific case. Refusal decisions are discretionary and fact-specific. For advice tailored to your situation, consult a CICC-licensed immigration consultant or lawyer.
Common questions
What is the excessive demand threshold?
It is a cost figure set by IRCC and updated periodically. If anticipated health or social-service costs are expected to exceed it, an excessive-demand concern can arise — but a fairness response and mitigation plan may address it.
Are any applicants exempt from the excessive demand ground?
Yes. Certain categories, including some family-class sponsorships and protected persons, are exempt from the excessive-demand assessment.
Upload your letter and receive a clear, code-specific analysis of what the officer flagged and your realistic next steps.
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