While I don't agree with what else Danik has said, the part about provincial health care systems is true. Nothing to do with health card expiry. There is really no open information-sharing between most government agencies/departments. Provincial health only knows a person is out of Canada if the person actually tells them. If IRCC wanted information about a person from a provincial health authority, they would need authorization from that person or they would have to submit a formal request. This really only happens when IRCC is investigating fraud cases.
Have to disagree, when I was out of country for an extended period of time my company advised me my MSP was cxxd because I was out of country too long. A relative who spends many months in Mexico each winter said he knows a number of people down there in the same situation, then tried to use health care benefits coming back after extended period out of the country and were denied. MSP knew they were out of the country and for how long.