Forms for B.C. Residents

The forms listed here will help you to enrol, manage and cancel your self-administered MSP account. For faster, easier submission, several forms can be completed and submitted online through a secure connection, as indicated. Most forms are also available in PDF format to be filled out, printed and mailed to Health Insurance BC.

Forms are also available from Service BC Centres located throughout the province, or by contacting MSP. In addition, forms can be sent to you through MSP’s Forms-by-Fax service, available 24 hours a day 7 days a week at (250) 356-0998.

MSP Forms

First Nations MSP Forms

 

MSP Enrolment

Form # Form Name and Information
102

Apply for MSP coverage under a self-administered plan.

 

Account Maintenance

Form # Form Name and Information
203

Report changes, including the addition or deletion of a family member, to your self-administered MSP account.
NOTE: This does not include the addition of a newborn.

7062
6759

Change the address on your MSP plan when you are moving from one residence within B.C. to another residence within B.C.

115

Apply for MSP coverage for your baby under your existing MSP account if the Registration of Live Birth form cannot be used to enrol your baby.

Continue coverage for a person 19 to 24 years of age under their parent/legal guardian's MSP account while they are attending an educational institution.

 

Premium Assistance

Form # Form Name and Information
119

Apply for regular premium assistance.

107

Apply for temporary premium assistance.

 

Account Cancellation

Form # Form Name and Information
7063

Cancel your coverage when you are moving outside B.C.

 

Authorization

Form # Form Name and Information
2942

Authorize the release of your medical records to specific individuals.

 

Reimbursement

Form # Form Name and Information
2944

Request a reimbursement for MSP-billable services that you received in B.C. and paid for up-front.

 

Waiving the MSP Coverage Wait Period

Form # Form Name and Information
293
293A

 

Out-of-Country

Form # Form Name and Information
2814

Submit a claim for eligible expenses for medical treatment in another country.

2806

Allow your private medical travel insurance company to claim the provincial reimbursement for eligible medical treatments in another country.

2807

Allow MSP to send your private records to a medical travel insurance company.

 

First Nations

Form # Form Name and Information
178

Apply for MSP coverage if you are a registered Status Indian who is assisted by the First Nations Health Authority. The application must be authorized by the First Nations Health Authority.

308

Report changes, including addition or deletion of a family member, if you are a registered Status Indian who is enrolled under the group plan administered by the First Nations Health Authority. The Change Request form must be authorized by the First Nations Health Authority office.
NOTE: This does not include the addition of a newborn.