The costs of a standard hospital stay alone in Nova Scotia ran at approximately $5,910 in 2017, but the Nova Scotia MSI program saves many of the 900 thousand Canadians in Nova Scotia billions of dollars annually.
A common misconception of Canadian health care from across the borders is that Canadian health care is free. It is, to an extent, but it only takes one diagnosis to occur in a New York minute that catapults any Nova Scotia resident into a financial hit.
You can avoid that by arming yourself with this comprehensive guide explaining exactly what Nova Scotia MSI is, what you are covered for and prepare yourself for what you aren't.
What is Nova Scotia MSI?
Much of your health care needs in Nova Scotia will be federally funded by the program known as Nova Scotia MSI which stands for the Medical Services Insurance program.
If you are new to Nova Scotia, you are wondering how the provincial and federal health care system works. Nova Scotia MSI is the name of the provincial service that provides federally funded health care.
So MSI is both provincial and federal.
The service covers health care for eligible residents of the province at the basic level. Everything from doctor's visits and tests is covered, some pharmaceuticals are covered, certain dental services are covered, and vision appointments are as well.
What Isn't Covered by MSI?
What MSI doesn't cover are the extras in health care – glasses, some extensive dental work, orthotics, and upgraded hospital stays.
MSI doesn't cover a lot of those extras but covers slightly more than what some other provinces are getting.
For example, Nova Scotia covers some basic dental services for children under 14. Other provinces such as Ontario do not have this coverage.
MSI is available only to residents of Nova Scotia that meet eligibility requirements. Visitors are not covered and will have to use their own insurance or other provincial health care for medical and dental services.
You will be confirmed for MSI eligibility if you receive a card in the mail after applying for it. This card must be kept with you at all times.
What Does the Law Say About My Coverage?
The legislation behind MSI is the Canada Health Act and the Canada Health Transfer.
The Canada Health Act is the federal legislation that mandates funding for Nova Scotia MSIS. This Act is the Act that ensures all Canadians have access to health care with little to no costs.
The Canada Health Transfer, on the other hand, is the Act that funds the health care system of Canada. In order for provinces to receive funding for health care, they must meet certain conditions that the country mandates must be in place for health care funding.
The program mandates that you are legally covered for basic health care coverage such as doctor's appointments, vision appointments, and some testing. It covers extraneous health care needs in some instances, such as extreme dental surgery for adults.
What Are the Basic Benefits of MSI?
MSI covers basic health care such as doctor's office visits, emergency room visits, standard hospital stays, and some dental care.
Dental care is now available for children under the age of 14 for standard services. Some additional preventive services for dental care includes fluoride treatment and some coverage for molar sealants.
Physiotherapy is also covered by MSI if it occurs in a hospital setting and is deemed medically necessary.
Vision is also covered by MSI to some extent, and coverage includes one optometrist visit every two years. Glasses and contact lenses are not covered by MSI.
Hearing aids are not covered. If you call 911, you will have to pay for the ambulance that arrives which will cost approximately $142 in Nova Scotia.
But MSI does cover some hospital-related costs when they are medically required.
Does MSI Have Hospital Coverage?
When you are sick, MSI will cover basic hospital expenses, including nursing services and standard accommodation in a hospital stay.
If you have purchased additional health care insurance or have it through your work, you may be covered for upgrades in hospital care through those providers.
That might, for example, be the difference between a wardroom and a private room in a hospital stay.
If you don't get it through work, there is a list of health care insurance companies in Canada that you can learn about and pick the provider that will be the best for you and your family.
That would not be provided by MSI and your insurance information can be provided to the hospital when you are admitted to ensure your hospital stay is aligned with what you are covered for.
When a diagnostic test is deemed medically necessary, it will also be covered by MSI. This includes tests like X-rays, MRIs, and endoscopies.
What Is MSI Dental Coverage?
MSI dental coverage is very basic and covers the most standard of testing for children under the age of 14. Any child over that would not be covered and would be an out of pocket expense for the parent or guardian.
If however you need oral surgery and it is performed in a hospital, that is covered by Nova Scotia MSI.
That coverage is provided by Green Shield insurance company, through Nova Scotia MSI.
There are some exceptions to the dental coverage in MSI. Some coverage exists for unique and extreme dental conditions such as cleft palate or dental issues arising after a cranial reconstruction.
If a patient is a student of the School for the Blind or is mentally challenged, they may also be covered for dental under MSI.
You may have additional insurance through work or through your own purchase that may help you cover those costs. Find out what you need to know about dental insurance in Canada if you are considering it.
Does MSI Cover Prescriptions?
Generally speaking, prescriptions are only covered for individuals over the age of 65, but there are many instances or programs where MSI will cover prescription medication.
Medication given during a hospital stay is covered by MSI. But prescriptions you take home with you are not.
The province of Nova Scotia, however, does offer some prescription assistance programs such as Family PharmaCare, Senior's PharmaCare, and Drug Assistance for Cancer Patients in financial need.
There are many other programs such as the Community Services Program, Palliative Care Drug Program, and the Nova Scotia Diabetes Assistance Program offered to many Nova Scotians that have regular extraneous medical expenses above MSI coverage.
Does MSI Cover Out-of-Province Health Care?
If you are a Nova Scotia resident traveling out of the province, the country does provide some health care funding to you if needed. But you aren't covered for much and need to know about out of province claims before you go.
If you randomly visit a doctor for an appointment somewhere other than Nova Scotia, you will have to pay for it. Emergency room visits will be covered by Nova Scotia MSI to the point of $525 per day.
An accident or a sudden illness is also covered by MSI.
A Nova Scotia resident is not covered when out of the country, however,r there have been some recent changes to that.
A Nova Scotia resident may be referred for treatment outside of the country, and that may be paid for by Canada. But a written approval must come from the Department of Health and Wellness.
Otherwise, when out of the country most Canadians aren't covered by MSI.
One exception to that is to Canadians who receive advance approval for out-of-province and out-of-country health care needs.
Some Nova Scotia residents like to visit warmer areas, such as Florida, for up to six months of the year. With advance approval, their medical needs are covered in Florida at MSI's basic coverage.
That amount of time was recently extended to seven months.
Nova Scotia vacationers can also take more medicine of their own across the border than they could in years past.
Before departure, Nova Scotia residents must simply inform MSI of their vacation, and the details of it, by email or by phone.
Empower Yourself With Information
While the cost of hospital stays and overall health care in Nova Scotia is slightly lower than the national average in the rest of Canada, health care costs are continuing to rise.
Nova Scotia MSI doesn't cover everything, and some diagnoses come with consistent costs that could impact the entire family on a regular basis.
You need to know what MSI covers and what it doesn't. One diagnosis could have you scrambling with stress facing months ahead of uncertain costs.
Empowering yourself with this information will empower you to see solutions that will give you peace of mind when it comes to the medical needs of you and your entire family. Peace of mind comes through insurance in the health care world.
You never want to be at the emergency room with a migraine or head trauma and be worried about being left in a wardroom of nonstop noise. Empower yourself with peace of mind when you know how to choose the best plan for your family.