8/3/2019 Msp Brochure Bc
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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.
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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.
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