8/3/2019 Msp Brochure Bc

http://slidepdf.com/reader/full/msp-brochure-bc 1/2

MEDICAL SERVICES PLAN (MSP)

 The Medical Services Plan pays or medically required services

o physicians and surgeons and or dental or oral surgery when

medically required to be perormed in a hospital. MSP also

provides coverage or other health benets – see Additional

Benets section o brochure or details. MSP is administered

by Health Insurance BC (HIBC). For more inormation, visit

www.hibc.gov.bc.ca.

WHO IS ELIGIBLE?

Residents o British Columbia are eligible and are required to

enrol themselves and their dependents with MSP. Under the

Medicare Protection Act, a resident is dened as a person who

meets all o the ollowing conditions:

  is a citizen o Canada or is lawully admitted to Canada

or permanent residence,

  makes his or her home in B.C., and

  is physically present in B.C. at least six months in a

calendar year (January – December ).

Certain other individuals, such as some holders o study and/

or work permits issued under the ederal Immigration and

Reugee Protection Act are deemed to be residents, but tourists

or visitors to B.C. do not qualiy. Beore applying, please review

the instructions ound on the Application for Enrolment .

Dependents

Dependents must qualiy as residents and include a

beneciary’s:*

1. spouse, either married to, or living and cohabiting in

a marriage-like relationship with the beneciary (and

may be o the same gender), or

2. unmarried child or legal ward, supported by the

beneciary, and

a. under 9, or

b. under 25 and in ull-time attendance at a school or

university.

*A beneciary is a resident enrolled in MSP.

REQUIREMENT TO ENROL

Residents o B.C. are required by law to enrol themselves and

their dependents with MSP. A resident who has ailed to apply

may, on enrolment, owe retroactive premiums.

Benets or active members o the RCMP and Canadian Armed

Forces are a ederal responsibility. Thereore, these members

are ineligible or provincial health care benets and exempt

rom enrolling.

HOW TO ENROL

I coverage is available through your employer, union or pen-

sion plan, contact their ofce or an  Application for Group 

Enrolment  orm. Otherwise, an  Application for Enrolment  

orm can be ound:

  online at www.health.gov.bc.ca/exforms/msp.

html – print and mail to HIBC;

  by phoning HIBC – see General Contact Inormation

section; or

  at a Service BC oce – visit www.servicebc.gov.bc.ca 

or the oce nearest you.

I your application or enrolment is denied and you are dissatised

with the decision made by HIBC regarding enrolment, you can

request a review or an appeal o the decision in writing. Visit

www.health.gov.bc.ca/msp/infoben/faqas.html#notsatis or

detailed inormation.

Documents

I you are a new resident, you are required to provide photocop-

ies (do not send originals) o documents to support the

legal name and Canadian citizenship or immigration status

o all persons listed on your application.

When coverage through an employer, union or pension plan

ends, MSP will automatically set up a sel-administered plan

or you. I you have not heard rom HIBC within 6 days o the

date you let your employer, please contact HIBC (see General

Contact Inormation section).

WHEN DO BENEFITS BEGIN?

New residents or persons re-establishing residence are eligible

or benets ater completion o a waiting period that consists

o the balance o the month o arrival in B.C., plus two months.

Application should be made immediately ater arrival. You must

be in B.C. when applying. I the application is late, the efective

date o benets will be determined by HIBC and may result

in premiums being charged retroactively. I absences rom

Canada exceed a total o days during the waiting period,

eligibility or benets may be afected.

Applicant and Spouse Arrive Separately

When a amily moves to B.C. rom another part o Canada, and

the applicant and spouse arrive separately (within one year), the

waiting period or the amily begins on the later date of arrival .

Benefts During the Waiting Period

Persons moving rom other parts o Canada should arrange or

coverage with their ormer medical plan during the waiting

period. New or returning residents arriving rom outside Canada

should contact a private insurance company or coverageduring this period.

PREMIUMS

Premium rates vary according to amily size. Premiums may be

paid either directly or through payroll or pension deduction.

Assistance with the payment o premiums is available to those

in nancial need. Applicants must, or the last 12 consecutive

months, have been a resident in Canada and been a Canadian cit-

izen or holder o permanent resident status (landed immigrant).

I premiums are not paid, the outstanding amount increases

each month. Premiums that have not been paid during a period

in which a beneciary has been enrolled are a debt owed to

the province and are collectable under law.

Revenue Services o British Columbia issues MSP premium

invoices, processes premium payments and collects overdue

accounts.

A person who is no longer eligible or benefts must notiy

Health Insurance BC o the date o departure rom B.C.,

indicate the reason or cancellation and provide his/her

new address. Failure to pay premiums does not constitutenotifcation to cancel benefts.

CHANG

Certain c

riage or a

your em

oce. I y

Children

when th

  ma

ma

  star

  turn

ent

  In t

elig

or s

CHANG

HIBC muaddress

ting one

exforms/

Accoun

 Account

covered

union or

Address

Change

Move Ou

CARECA

A CareC

is issued

identie

health ca

you or al

an ofen

stolen C

bc.ca toalso be u

8/3/2019 Msp Brochure Bc

http://slidepdf.com/reader/full/msp-brochure-bc 2/2

 To submit claims, visit www.health.gov.bc.ca/exforms/msp.

html or the Out-of-Country Claim orm, which can be printed

and mailed with your original receipts to HIBC at the address

on the orm.

Health services provided outside Canada oten cost more than

the amount paid by the Ministry o Health. Sometimes the

diference is substantial. In addition, some items/services that

may be a benet in B.C. are not covered outside the province.

 The Ministry o Health does not subsidize ees charged or

ambulance service obtained outside British Columbia.

We advise you to buy additional health insurance to supple-

ment your basic coverage beore you leave the province, even i 

you only plan to be away or a day. A private insurance company

or travel agency can advise you about extra coverage to pay

or any diference in ees and can provide benets not covered

by MSP. I you have a pre-existing medical condition, please

mention this when purchasing additional insurance as most

policies will not cover treatment o that condition outside

British Columbia.

LEAVING CANADA TO OBTAIN MEDICAL SE RVICES

I you are leaving Canada to obtain medical services, the B.C.

specialist must write to HIBC (see General Contact Inormation

section) and provide inormation regarding the medical neces-

sity or a reerral outside o Canada. Non-emergency services

that are undertaken without prior approval rom MSP cannot

be considered or payment. Travel costs and accommodation

are the responsibility o the patient. Additional inormation

is available online at www.health.gov.bc.ca/msp/infoben/ 

leavingbc.html .

ABSENCES FROM BRITISH COLUMBIA

Temporary Absences

Residents who spend part o every year outside British Colum-

bia must be physically present in Canada at least six months

in a calendar year (January 1 to December 31) and continue

to maintain their home in British Columbia. However, in some

circumstances residents may be eligible to receive benets or

up to 24 consecutive months while temporarily outside the

province. Approval is limited to once in ve years or absences

exceeding six months in a calendar year.

Studying Outside British Columbia

Residents who leave B.C. temporarily to attend school or

university may be eligible or MSP coverage or the duration

o studies, provided they are in ull-time attendance at a

recognized educational acility.

Beneciaries who have been studying outside B.C. must return

to the province by the end o the month ollowing the month

in which studies are completed. Any student who will not

return to B.C. within that timerame should contact HIBC to

discuss their situation.

Permanent Move rom British Columbia

It is important to contact HIBC beore leaving B.C. or submit

a Permanent Move Outside BC  orm online at www.health.

gov.bc.ca/exforms/msp/7063.html .

Within Canada–Benets are provided or the balance o the

month you leave the province plus two months. I required,benets may be extended or up to three extra months to cover

you while in transit. Upon arrival, you should immediately apply

to the health plan o your new home province or territory.

Outside Canada–Benets are provided or the balance o the

month you leave the province.

Cancelling Benefts

I you will no longer be a resident, you must notiy HIBC o 

your date o departure, indicate the reason or cancellation,

and provide your new address – otherwise, premium billing

may continue. Failure to remit premiums does not constitute

notication to cancel benets.

For more inormation on absences or moving rom B.C., down-

load a copy o the Leaving B.C. pamphlet at www.health.gov.

bc.ca/msp/infoben/pdf/leaving-bc-brochure.pdf  . Alternatively,

contact HIBC or your community Service BC oce.

OTHER HEALTH SERVICES BENEFITS

Prescription Drugs

PharmaCare provides assistance with the purchase o manyprescription drugs and certain other benet items. PharmaCare

does not provide out-o-province benets.

For inormation visit www.health.gov.bc.ca/pharmacare,

contact your local pharmacy, or contact HIBC.

Hospital Benefts

Hospital benets are provided to all residents o B.C. who are

enrolled with MSP. For inormation contact your local health

authority at www.health.gov.bc.ca/socsec .

For patient care quality concerns, please contact 1 866 952-2448.

Ambulance Service

Ambulance Service is not an insured benet; however, the

Province subsidizes ees or beneciaries. Please note that

ees or services required while outside the province are not

subsidized and can range rom several hundred to several

thousand dollars.

For ee inormation visit www.bcas.ca/EN/main/about/fees.

html or contact the BC Ambulance Service:

By Mail:

PO Box 9676 Stn Prov Govt

Victoria BC VW 9P7

By Phone:

Victoria: 25 56-52

 Toll-ree: 665-799

TRAVEL ASSISTANCE PROGRAM (TAP)

  The program provides travel cost discounts or beneciaries

who need to travel outside their communities or physician-

reerred non-emergency specialist medical care. For more

inormation, visit www.health.gov.bc.ca/tapbc or phone

465-49.

PRIVATE

Private in

amount

employe

extende

Private in

not eligi

COLLEC

All perso

Medicar

in B.C. a

benets

and disc

and Prot

provide

collectio

LEGISLA This bro

subject

Medicar

Insuranc

this broc

SERVIC

Service B

the pub

with MS

assistanaccept p

www.ser

directory