Medical Services Plan & Medical Coverage

Overview

The ministry assists eligible recipients and their families to access Ministry of Health premium-assisted medical coverage through the Medical Services Plan (MSP).

This medical coverage is provided to recipients of income assistance, hardship assistance, disability assistance, and Refugee Claimants who meet the MSP residency criteria and in the case of Refugee Claimants, a valid work permit.

Policy

Effective:  February 17, 2009

The ministry assists eligible recipients and their families to access Ministry of Health premium-assisted medical coverage through the Medical Services Plan (MSP).

Recipients of income assistance, hardship assistance, disability assistance and eligible Medical Services Only (MSO) recipients are eligible to receive premium assistance through the Medical Services Plan (MSP).  Refugee Claimants in receipt of assistance may also be eligible for premium assistance if they meet residency requirements and have a valid Work Permit.

[For more information on MSO, see Related Links – Medical Services Only.]

The MSP coverage available to eligible ministry recipients is identical to the coverage offered to the general public. The ministry’s role is limited to applying to the Ministry of Health (MoH) on behalf of the recipient and the recipient’s dependants. At the time of enrolment in MSP,  recipients should be encouraged to register for the Fair PharmaCare program as soon as they receive their Personal Health Number.

The ministry has no authority to meet the costs of medical services not covered by MSP, unless clearly specified in the Employment and Assistance Act or Regulation or the Employment and Assistance for Persons with Disabilities Act or Regulation.

When a case is closed, Medical Services Plan coverage continues for six months as premium assistance.  However, prescription coverage through PharmaCare ends immediately. If the recipient  has registered for Fair PharmaCare, the recipient  may still be eligible for coverage based on their income.  Coverage for dental and optical supplements cease at the end of the month of case closure.

[For information on PharmaCare, see Related Links – PharmaCare.]

 

Ministry of Health (MOH) Criteria for MSP Coverage

Effective:  February 29, 2008

Recipients must meet all of the following MoH criteria to be eligible for Medical Services Plan (MSP) coverage:

  • have the legal right to reside in Canada
  • make their home in BC
  • have resided for three continuous months in BC (for example, if the arrival date is mid-June, the eligibility date is September 1)
  • be physically present in BC for six months per calendar year

If the recipient does not meet the MSP residency requirements outlined above, MSP coverage will be post-dated for three months. New residents from other parts of Canada should maintain coverage with their former medical plan during the three-month waiting period.

[For information on PharmaCare, see Related Links – PharmaCare.]

 

Ministry of Social Development and Poverty Reduction Health Supplements

Effective:  December 1, 2003

In addition to medical services covered by Medical Services Plan (MSP), the ministry may provide specified health supplements to eligible recipients based on their client categories.

[For information on health supplements, see Related Links – Health Supplement Summary.]

Procedures

Effective:  December 1, 2003

Medical Services Plan (MSP) coverage remains in effect when an individual is temporarily out of the province.  However, this does not include PharmaCare assistance or ambulance coverage obtained out of the province. 
Recipients should contact MSP directly for clarification on what will be covered in their specific circumstances when leaving the province.  [see Contacts]

Effective:  February 25, 2013

To initiate Medical Services Plan (MSP) coverage for a recipient, follow these steps:

  1. Have the recipient sign the MSP Client Release on page 5 of the Application for Income/Disability Assistance – Part 2 (HR0080) [see Forms and Letters].
  2. Apply for coverage to be effective in the month the recipient becomes eligible for assistance.
  3. If the recipient does not meet the MSP residency requirements (three continuous months in BC), post-date the coverage to when the recipient is eligible (this is done in the coverage effective field by entering the month and year in which the recipient will meet three continuous months in BC).
  4. MSP coverage type is “B” (basic) for all recipients (this field cannot be changed).
  5. CareCard to Office should remain as “N” (no).
  6. If the applicant/dependant has lived in BC continuously since birth enter “Y” (yes) and then go to number 10 for the remaining steps on how to initiate coverage. If “N” (no) is answered then complete the next steps.
  7. Enter the province or country where the applicant/dependant most recently came from.
  8. Enter “Y” or “N” depending on if the applicant/dependant intends to reside continuously in BC.
  9. If the recipient had health coverage in a previous province and the number is known, enter the number.
  10. Enter “A” (applicant) beside the recipient’s name and “D” (dependant) beside any dependant names on the file.
  11. If the Personal Health Number (PHN) is known enter the PHN and press enter, then print the Confirmation of Application for Medical Benefits form and give this form to the recipient.
  12. If the PHN is not known leave the PHN blank. If there is an exact match (a search is done on the MSP database) then the PHN will automatically populate in the PHN field. Print the Confirmation of Application for Medical Benefits form and give this form to the recipient.
  13. If the PHN is not known and the system finds more than one match then the ‘MSP Person Select By SIN’ or ‘MSP Person Select By Name’ screen will display:
  • Compare the full name, sex, and birth date shown at the top of the screen with the information in the box below, which is a direct link to the MSP database. Also check the recipient’s identification to ensure the Ministry of Social Development and Poverty Reduction has their documented name entered correctly as MSP only registers people using their documented name, not nicknames or aliases. If an exact match is listed then select the exact match. If in need of assistance when selecting a match contact the Registries Admin Service Desk [see Contacts].
  • If an exact match is not listed there is also the option to select “Cannot Determine or Person Not Shown; request a new PHN.”  Before selecting this option contact the Registries Admin Service Desk [see Contacts] for assistance in finding the PHN as a duplicate PHN may be created by selecting this option. The Registries Admin Service Desk will advise of which PHN to use.
  • Print the Confirmation of Application for Medical Benefits form and give this form to the recipient.
  1. For recipients who previously met eligibility requirements but coverage was not applied for, MSP can only be backdated for up to one year or to the open date of the case. Note full details.
  2. All MSP applications are processed electronically except for persons who are
    non-Canadians (including children born in Canada to non-Canadians).  Print and forward to MSP the application, accompanied by either of the following for each non-Canadian on the MSP application:
  • Confirmation of Permanent Residence (IMM5292) and Permanent Resident Card or prior to June 28, 2002:  Record of Landing (IMM1000)
  • if deemed a Convention refugee, a copy of the letter (notice of decision) from the Convention Refugee Determination Division of Citizenship and Immigration Canada
  • if the  recipient is a Refugee Claimant, and has lived in BC for 3 consecutive months, a copy of a valid Work Permit and confirmation of Refugee Claim (IMM1442).
  • Note: All applicable steps from 2 to 15 are completed on the MSP Application Add (MSP A)
  1. The recipient must complete the MSP application process by doing one of the following:
  • attending an ICBC driver licensing office to apply for the BC Services Card
  • contacting Health Insurance BC by email or phone to apply for the BC Services Card, if the recipient does not have two pieces of identification or is unable to attend an ICBC driver licensing office

                [see Contacts]

Effective:  February 29, 2008

Ministry staff can add dependants through the Medical Services Plan (MSP) Information Update.

  • Adding a newborn to an existing case: Most newborns are now given PHNs as soon as they are born; therefore a PHN should already exist on the database.
  • When adding MSP coverage for a newborn the MSP Person Select By Name screen will likely display requiring a selection to be made from the list of possible matches. The “name” used to assign a PHN for the newborn at the hospital may be different from the newborn’s given name and surname on the live birth registration which is the name that is entered on the case.

Therefore when selecting a match be aware of the following:

  • The newborn’s surname will likely appear as the surname the mother was registered under in the hospital.
  • The newborn’s first name will likely show as “Baby Girl” or “Baby Boy” for single birth; and “Baby Girl A,” “Baby Boy B,” “Baby Boy C,” etc., for multiple births.

If you cannot find the newborn’s PHN call the Registries Admin Service Desk [see Contacts] to get the correct PHN.

When dependants are deleted from a case or a case closes, MSP will automatically be cancelled through a system-generated message to MSP.

Following the initial application, the recipient must report any changes to names, sex, or birthdates to MSP.  [see Contacts]