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Health Insurance BC: Summary of Benefits

Important: as of January 1, 2018, premium rates are reduced to 50% of their previous amounts. In addition, families with a net adjusted income of $26K or less will not have to pay any premiums.

The following is a brief summary of Health Insurance BC (the name of the B.C. provincial healthcare plan) coverage and benefits.

Health Insurance BC administers the provincial health insurance plan which consists of:

  • Medical Services Plan (MSP): Enrolment in MSP is mandatory for all BC residents and their dependents. Premiums are billed one month in advance. MSP provides medical and health benefits, with premiums determined by family size and income. If you are new to B.C. make sure you apply for MSP immediately upon arrival.
  • Pharmacare: covers prescription drugs and various medical supplies.
  • Fair Pharmacare: most common Pharmacare plan. Provides assistance for prescription costs; deductibles are primarily based on income.

Medical Services Plan
Residents pay a monthly premium (based on family size and income) which pays for part of their healthcare costs.

MSI offers coverage for the following health and medical benefits:

  1. Medically required services of physicians and surgeons.
  2. Dental or oral surgery if medically required (must be done in a hospital).
  3. Routine eye examinations for patients under 19 or older than 64 years old. Eye exams for residents 19-64 only covered if deemed medically necessary.
  4. Maternity care (midwife and doctor services).
  5. Eye exams that are required medically and are performed by either an ophthalmologist or optometrist.
  6. Diagnostic services (including x-rays and/or laboratory services) when ordered by a registered physician or
  7. supplementary healthcare worker such as a midwife, podiatrist or surgeon.
  8. Surgical podiatry services (if a podiatrist is opted out of the plan there may then be charges not covered by MSP).
  9. Supplementary health benefits (e.g. paramedicals such as chiropractors, acupuncture, massage therapy, naturopathy, physical therapy etc.) MAY be covered IF you are receiving some form of premium assistance. See the BC Supplementary Benefits web page for more information.
    The Medical Service Plan (MSP) does not offer coverage for:

Any services that are not considered medically necessary (e.g. cosmetic surgery).
Routine and restorative dental services (e.g. cleanings, fillings, extractions and exams).
Physical examinations if not medically necessary (e.g. tests for driving a vehicle, life insurance, immigration, etc.).

Routine eye examinations for patients aged 19-64.
Ambulance services (although in-province ambulance transportation is subsidized, thereby decreasing cost to BC residents). For ambulance fees click here.
Eye glasses, contact lenses, hearing aids and other medical equipment.
Counsellors and psychologists.
Pharmaceutical drugs (unless you qualify for assistance via one of the Drug Programs, see below).
Paramedicals such as chiropractors, physical therapy, acupuncture, massage therapists, naturopathy, etc. (unless you are receiving premium assistance).
BC Pharmacare
BC Pharmacare offers some of the most comprehensive drug programs in Canada (most of these plans require active enrolment in MSP).

If you do not qualify for any of the programs below then you do not qualify for prescription drug coverage.

These drug plans are as follows:

Fair Pharmacare: the largest plan which is subsidized and based on family net income. Depending on your income status, a deductible is determined; once that amount has been met Pharmacare assists with paying eligible drug costs. Lowest income families are not required to pay a deductible and get immediate assistance.
Plan B: Permanent Residents of Licensed Residential Care Facilities. Covers the cost of eligible prescription drugs and certain medical supplies for permanent residents of licensed residential care facilities.
Plan C: Recipients of B.C. Income Assistance. Full coverage of eligible prescription costs for residents who are receiving income assistance via the Ministry of Social Development and Poverty Reduction.
Plan D: Cystic Fibrosis. Coverage of digestive enzymes and other products in the Cystic Fibrosis Formulary.
Plan F: Children in the At Home Program. Community-based care for severely handicapped children who would otherwise have to get institutional care.
Plan G: Psychiatric Medications. Coverage for some psychiatric medications for low-income residents.
Plan P: BC Palliative Care Drug Program. Coverage for medications, medical supplies and other equipment used for palliative care in the resident’s home.
Plan W: First Nations Health Benefits. Coverage for prescription drugs, medical supplies, etc. Funded by the First Nations Health Authority.
BC Smoking Cessation Program. Nicotine replacement therapy plan for residents who want to quit smoking. For full details on what is covered go here.
BC Center for Excellence in HIV/AIDS: a government resource that tries to improve the health of British Columbians with HIV via the development, monitoring and dissemination of HIV-related research and treatment programs.
MSP Monthly Premiums
BC residents pay monthly premiums that pay for a portion of their healthcare costs. These premiums are based on family size and income.

Invoices are sent out for the next month’s premiums, and payment can be made via credit card, pre-authorized debit or by going to your financial institution.

For the full rate tables go here.

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