Transitional Health Services

Effective: September 1, 2015

Through Transitional Health Services (THS), the ministry provides continued access to certain health supplements for one year to families with children who leave income assistance (IA) for employment.

To be eligible for THS coverage, a person must be part of a family unit that: 

• ceased to be eligible for income assistance as a result of employment income, and

• includes, on the date of that ineligibility, either:

  • a dependent child, or
  • a person who provides care for a supported child

In the regulation, an adult recipient who meets the above THS eligibility criteria is referred to as a main continued person. 

A dependent child is eligible for THS as long as they were a dependent child in the family unit on the day the family unit became eligible for THS and they remain a dependent child.  In the regulation, they are referred to as a dependent continued person. 

The family unit is eligible for THS for 12 months.  THS coverage starts the 1^st of the calendar month following the date on which the family unit ceases to be eligible for IA. This date is referred to in the regulation as the continuation date.

For example: A family unit received a cheque for August IA but based on reported employment income is not eligible for the September IA cheque.  The start date of the 12 months of THS coverage will be September 1^st.   

Where a family unit has a combination of income that results in the family unit ceasing to be eligible for income assistance, the family unit is still eligible for THS for up to 12 months, as long as a portion of their income is from employment.

For example: A family unit received income from two sources: spousal support and employment.  The total income received is over income assistance rates.  As the family unit reported employment income, they would qualify for THS coverage.

All adults and dependent children on the THS case on the continuation date receive THS coverage for 12 months.  THS coverage cannot be given to new family members who were not recipients or dependent children in the family unit at the time the family unit become eligible for THS. Therefore, new dependants (adults or children) must not be added to an existing THS case. A dependant who leaves a family unit, is removed from the THS case and subsequently returns to the family unit during the 12 months of THS coverage may be added back on the THS case. THS recipients (and any dependent children) will retain THS coverage even if family unit separates during the 12 month coverage period.

While providing care for a supported child is part of the eligibility criteria for THS, the supported child is not provided with THS coverage as they are not part of the family unit for the purposes of providing IA.  They would have health supplements covered under other programs (i.e. Ministry of Children and Family Development’s health supports). 

As assistance can only be provided to residents of BC, a recipient ceases to be eligible for THS coverage if they take up residence outside British Columbia. [See Related Links – Residency].

Hardship Assistance for employment are not eligible for THS.

Effective: January 1, 2020

Under the Transitional Health Services (THS) coverage, individuals maintain access to almost all of the health supplements they had while their family unit was in receipt of income assistance. 

While in receipt of income assistance, adults with employment obligations have access to a limited number of health supplements.  All dependent children and adults in family units with a qualifying person (i.e.: PPMB or in special care) have access to additional health supplements. 

The health supplements that can be accessed under THS coverage is dependent on each individual’s eligibility for health supplements at the time their family unit transitioned from income assistance to THS. 

[For more information, see Related Links – Health Supplement Summary] 

THS family units maintain access to the following health supplements at the same level they had while in receipt of income assistance:
 

• Medical Services Plan (MSP) coverage
• no deductible PharmaCare coverage
• optical (basic eyewear and repairs)
• eye examinations (if not already covered by Medical Services Plan)
• medical supplies
• extended medical therapies
• medical transportation
• medical equipment and devices
• basic dental services (children and only those adults in a family unit that includes a PPMB)
• denture supplement
• emergency dental services
• crown and bridgework (restricted to PPMB adults only)
• tube feed supplement (if the person is in receipt of the tube feed supplement at the time their family unit transitions to THS)
• infant formula supplement (restricted to children only)
• alternative hearing assistance supplement (children and only those adults in a family unit that includes a PPMB)

Individuals must also meet the eligibility criteria of the specific supplement [see Related Links].

Coverage Examples

Dental:

THS Expected to Work (ETW) family unit:

• adults maintain access to emergency dental only
• children maintain access to basic dental coverage of $2000/2 years

THS PPMB family unit:

• adults maintain access to basic dental coverage of $1000/2 years
• children have basic dental coverage of $2000/2 years

Medical equipment and devices:

THS Expected to Work (ETW) family unit:

• adults do not have access
• children maintain access to medical equipment

THS PPMB family unit:

• both adults and children maintain access to medical equipment

Effective: September 1, 2015

THS cases are not eligible for any of the following health supplements:
 

• orthodontics
• diet supplements
• short term nutritional supplements
• monthly nutritional supplements
• tube feed supplement (if the person is not in receipt of the tube feed supplement at the time their family unit transitions to THS)
• natal supplements
• alcohol and drug supplement

Effective: January 1, 2020

Recipients of Transitional Health Services (THS) whose financial circumstances have changed and are requesting income assistance or hardship assistance may apply for assistance as follows:

• If they have not received income assistance in any of the preceding six months, complete an application by using the Eligibility Review process and signing an HR0080R.
• If they have received income assistance in any of the preceding six months, and their case is open, the ministry has discretion to use either the streamlined reapplication process or where needed the Eligibility Review process and signing an HR0080R. 

[For more information, see Related Link – BCEA Streamlined Application (Returning within Six Months)]

[For more information, see Related Link – Eligibility Review]

Effective: September 1, 2015

To maintain a THS eligible family unit’s access to health supplements (for example, Medical Services Plan, PharmaCare, dental, and optical), the case must remain open as a THS case. THS cases will retain eligibility for up to 12 months. At the end of the 12 month period the THS case will no longer be eligible and the case will be closed.

The system will initiate THS coverage based on the results of the monthly reporting process and the family unit’s composition.

To initiate a family unit’s THS coverage, follow these steps:
 

1. Record the income amount and source on the system.
2. Profile documentation to the client’s case.

If income is in excess of income assistance rate for two consecutive months, the system will complete the following steps through a batch job:
 

1. Cheque production will be turned off.
2. The Assisted Eligibility tool will assess if case is eligible for THS based on type of income declared and family composition.
3. If eligibility criteria are met, the system will automatically update the case to THS.
4. The system generated THS Notification letter HR3618 will be sent [see Forms and Letters].
5. The THS case will auto-close after the 12 calendar months of THS coverage has expired.  Close code THS-close will be used.

Note:  The system will include the 2 consecutive months of no IA cheque as part of the calculation of the 12 month THS coverage period.

Effective: April 1, 2017

To assess eligibility for a health supplement for persons with THS coverage, follow these steps:

EAO	1.	Verify continued eligibility for THS coverage by ensuring case is open and person is still active on case.  Update the case if necessary. Take the opportunity to verify and update the address.
	2.	If the person has an open THS case, they must still meet the eligibility criteria for the specific health supplement that has been requested. Review Policy section for more information on “Eligible THS Health Supplements.”
	3.	Once initial eligibility criteria has been confirmed, follow the procedures outlined under the specific health supplement requested:   Related Links – Medical Services Plan and Medical Coverage Related Links – Dental and Orthodontic Services (only dental may be considered for persons with THS coverage) Related Links – Optical Services Related Links – Medical Equipment – Hearing Aids Related Links – Medical Equipment and Devices Related Links – Medical Equipment – Orthoses Related Links – Medical Supplies Related Links – Medical Transportation Related Links – PharmaCare Related Links – Extended Medical Therapies Related Links – Infant Formula Supplement Related Links – Tube Feed Supplement Related Links – Alternative Hearing Assistance Supplement

Answer  Each former IA recipient is eligible as a main continued person and therefore will retain their THS coverage for the remainder of the 12 month period. Each dependent child that had been receiving THS also keeps their THS coverage as a dependent continued person as long as they remain a dependant of one of the main continued persons.

Answer   No.  THS coverage is only provided to persons who were part of the family unit on the date the family unit ceased to be eligible for income assistance.  Supported children are not considered part of the family unit.