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MSP Coverage: Is It Enough Or Should You Purchase Additional Health Insurance?

on 23 Oct, 2018

Over 400,000 British Columbians sustain injuries every year. Of these, falls cause the most in terms of hospitalizations.

There’s also the estimated one million people in B.C. who suffer from a mental illness every year. These health issues are in fact, the top reason for hospitalizations in the province.

These figures only give us a tiny insight into B.C.’s health status. But, they should be enough to make you think about your own health. Especially the adequacy of your health insurance coverage.

That pointed out, you’re likely saying your MSP coverage is there to back you up. You believe it’ll kick in in case you develop these or any other serious health problems.

How much of this belief is true and founded though? That’s what we’ll help you uncover in this post. Keep reading to determine if it’s best you get more coverage!

The Lowdown on MSP Coverage

MSP, or Medical Services Plan, is B.C.’s version of public health insurance. Eligible Canadians and permanent residents can obtain this coverage. To be more specific, the law requires them to enroll with the program.

At its core, MSP pays for the cost of needed medical services. These are the “medically necessary” services you get from physicians, dentists, and surgeons. If your doctor requires you to take eye exams, MSP covers those too.

The plan may also cover some diagnostic services, such as x-rays. In certain situations, even some types of orthodontic services.

Apart from medical benefits, MSP also provides coverage for some supplementary benefits. We’ll cover all these in more detail below.

Although MSP is public insurance, that doesn’t mean it’s free. Granted, this coverage can help bring down your healthcare costs. But, the fact remains that you still need to pay premiums every month.

The Medical Benefits MSP Provides

So, what does MSP cover in terms of medical benefits? The list is quite long, but we’ve summarized them for you.

Medical Needs as Required by an MSP-Enrolled Doctor

It covers medical needs deemed a requirement by an MSP-enrolled physician. In other words, the doctor who says you need the service should be part of MSP providers. If your physician isn’t, then your plan won’t cover the costs if you pushed through with the service.

Dental and Oral Surgeries that Require a Hospital Setting

If you’re facing a dental emergency requiring surgery in a hospital, MSP will cover the costs for you. The keyword, here again, is “medically-required”. If you need dental fillings, root canals, or crowns, you’d have to shell out money from your own pocket.

If you have dental insurance, it may cover you for these non-emergency treatments.

Also, as mentioned above, some orthodontic services may fall under MSP dental coverage. But this only applies to conditions relating to severe congenital facial abnormalities.

Eye Examinations

If you’re having vision problems, your MSP may cover you for eye exams. That’s if the test is medically-required. You also need an ophthalmologist or optometrist to conduct the test.

Other Medical Benefits Under MSP

If your registered physician orders you to get an x-ray, MSP may cover its cost. To get covered, you need to acquire the x-ray from an approved diagnostic facility.

You may also need these diagnostic services as ordered by your dental or oral surgeon. If they’re MSP-registered, then you can use your coverage to get the service for free.

The Supplementary MSP Benefits

One in five Canadians suffers from chronic pain. Low back pain is one of the most common forms, affecting as much as 85% of employees.

Enter BC MSP coverage offering supplemental benefits like chiropractic and physical therapy. Acupuncture, massage therapy, naturopathy, and non-surgical podiatry services are also offered.

Now, to pain sufferers, that’s some pretty good news, right?

These supplemental benefits aren’t an automatic coverage addition to MSP though. There are eligibility factors you first need to meet.

For instance, you need to be an MSP Premium Assistance or Income Assistance, recipient. Or, your MSP enrolment should indicate you’re a Mental Health Client. You may also be eligible if you hold an At Home Program-enrolled MSP.

These are only a few of the requirements for you to enjoy the MSP supplemental benefits. If not, then expect to pay out-of-pocket expenses to receive these treatments.

The Longer List of Services MSP Doesn’t Cover

MSP won’t cover anything that’s not considered medically-required. That means cosmetic procedures are out of the picture.

Almost all other dental services (except for those mentioned above) aren’t also covered. The same goes true for routine eye exams for MSP holders aged 19 to 64.

It also doesn’t help pay for the costs of health appliances like hearing aids and eyeglasses. Neither does it cover the costs of purchasing prescription drugs. FYI, medications cost each Canadian a whopping $1,086 per year.

Services like physical examinations and CT scans are coverage exclusions too. In fact, any preventive service without medical effectiveness proof are also excluded.

Services provided by psychologists and counselors also don’t make the cut. That’s not good news to the 12% of B.C.’s population suffering from anxiety disorders. Or the 21.3% in total who have either depression or anxiety (or even both).

The takeaway? As helpful as MSP is, relying only on it can prove quite expensive when emergencies arise. Especially when MSP doesn’t cover those emergencies or health care needs.

That’s why now may be the time for you to consider supplementing with private health insurance.

Supplementing Your MSP with Personal Health Insurance

Based on our explanation of MSP above, you can already see how it leaves many gaps in your health care needs. What’s more, almost all those exclusions are quite common in B.C. residents. If you rely on MSP alone, your out-of-pocket expenses are sure to skyrocket.

Enter personal (private) health insurance products. As many as two-thirds of Canadians own these products. Which makes complete sense, what with the state of public health insurance.

Private health insurance bridges the gap left by MSP. That means they provide coverage for prescription drugs, dental, and eye health services. Some private policies also offer coverage for home health and even rehabilitative care.

In a nutshell, these policies can help bring your risks down of facing high medical bills. They can also pay for preventive care that MSP doesn’t cover.

What’s more, some supplemental health insurance plans also offer out-of-Canada coverage. Although MSP offers some form of coverage outside B.C., it may not be enough. This is especially true for British Columbians who often travel outside the province.

Your Options Outside of MSP

You have quite a lot of options when it comes to private health insurance. There’s the Green Shield Health Insurance Zone Fundamental for starters.

One of the biggest advantages to this product is that you don’t need medical underwriting. That means you don’t have to undergo a health check to get the coverage. So long as you’re younger than 75, you’re a Canadian resident, and you have MSP, you can qualify.

This said, you can still get covered even if you have a pre-existing condition. If you’re one of the 1.4 million B.C. residents with diabetes, this plan could be a good option.

This product also covers some of the cost of prescription drugs as well as vision and dental care. You also get some coverage for extended health services. These include services from PTs and alternative doctors.

To top it all off, part of the cost of receiving mental health care services is also covered. There’s also some coverage for diagnostic and home support services.

These are only some of the gaps in MSP that the Zone Fundamental aims to bridge. Keep in mind that there are plenty of other insurance plans also worth looking at. The Manulife FlexCare ComboPlus Starter Plan is one such product.

Should You Buy Personal Health Insurance?

The answer to this depends on your personal and family’s needs. If you believe your MSP coverage isn’t sufficient, consider private health insurance. That way, you can get your loved ones insured as well.

Also, make sure that you’re maximizing your employer-sponsored health insurance. It’s likely you’re already receiving some form of health coverage from them. If it’s still not enough, then getting personal health insurance may be a good choice.

Another good reason to supplement your MSP is if you’re about to lose your existing coverage. This can happen if you’re about to leave your current employer. Quitting your job means saying goodbye to your employer-sponsored insurance.

Don’t Forget to Compare Your Private Health Insurance Options

Have you determined that your MSP coverage isn’t enough? If so, then you may want to start shopping around now for supplemental insurance.

Don’t forget to compare as many offers as possible. A comparison is the only way to secure the best personal health insurance for your needs.

The good news is, we’ve done a lot of the research for you. Check out our guides on private health insurance to further help you during your search!

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