Health fee for international students

Introduced in 2019, the International Student Health Fee (ISHF) is a mandatory monthly fee of $75 charged to all international students studying in British Columbia on a valid study permit for at least six months of the year. This includes K-12 and post-secondary international students. The ISHF ensures that international students both contribute to and benefit from BC’s publicly funded health-care system.

The ISHF is an individual-based fee and applies to each family member enrolled in the Medical Services Plan (MSP) who possesses a valid study permit, regardless of family size, income or secondary immigration status. This fee supports the sustainability of BC’s health-care system, ensuring access to necessary medical services for all residents, including international students.

Under the Medicare Protection Act (the Act), enrolment in MSP is mandatory for all eligible residents of British Columbia. International students who are physically present in BC for at least six months in a calendar year are deemed to be residents under Section 2(a) of the Medical and Health Care Services Regulation (the Regulation) if they possess a valid study permit. The ISHF is authorized by a directive under section 19 of the Financial Administration Act (FAA) that authorizes the Ministry of Health to charge the health fee for international students enrolled in MSP. The directive is guided by the Regulation’s definition of an international student as a person admitted to Canada as a student who possesses a valid study permit issued under the Immigration and Refugee Protection Act for six months or longer and continues to retain such valid authorization and meet the definition of a resident.

International students who possess a valid study permit for a period of six or more months are required to apply for MSP (BC’s health-care coverage) as soon as they arrive in British Columbia. Through this application process, they will be enrolled and then invoiced for the health fee.

Before health-care coverage begins, there is a wait period consisting of the balance of the month in which residency is established, plus two months. International students should carry private insurance until this wait period ends and provincial coverage begins.

To be eligible for medical coverage under MSP, a person must be a resident of British Columbia. The Medicare Protection Act defines a resident as a person who:

Only adult international students who formally opt out of provincial health coverage through MSP are exempt from paying the health fee. [Note: Minors are unable to opt out of provincial health coverage.]

The onus for adults to enroll in MSP or formally opt out of provincial health-care benefits rests with the individual. Opting out is a crucial step that should not be considered without understanding the consequences of doing so. Additional information can be found here.

If the health fee is payable, a monthly invoice is issued by Revenue Services of BC. The invoices are sent to the address on file with MSP.

Learn how to pay your fee.

The health fee is charged to individuals enrolled in MSP under a study permit. Invoices are sent to the address on file with MSP.

It is the individual’s responsibility to provide accurate and up-to-date personal information to Health Insurance BC (HIBC), including the correct address during registration and any subsequent updates. As per Section 7.3 of the Medicare Protection Act, individuals are required to update their address within 10 days of a change, including both the former and new addresses. Address updates can be completed online or by calling 1-800-663-7100

Emergency health-care services will not be denied to anyone, regardless of their enrolment or payment status in MSP. However, private physicians and clinics may require pre-approved payment arrangements before providing non-emergency services.

However, if an international student is not enrolled in MSP or does not have private insurance, they will be responsible for the full cost of any health-care services received. Unpaid health fees are considered a debt to the provincial government and are subject to collection under applicable laws. Revenue Services of BC (RSBC), Ministry of Finance, manages billing and collections for the health fee on behalf of the Province.

Before health-care coverage begins, there is a wait period consisting of the balance of the month in which residency is established, plus two months. International students should carry private insurance until this wait period ends and provincial coverage begins.

The health fee will start on the first day of the month when MSP coverage begins.

If there are questions regarding when an international student’s MSP coverage begins, contact Health Insurance BC.

The health fee will end on the same date that MSP coverage ends:

• If moving within Canada, coverage is provided for the balance of the month in which the student leaves the province plus two consecutive months.

• If moving outside of Canada, coverage is provided for the balance of the month in which the student leaves the province.

Any outstanding amount will remain payable.

No. This is an individual fee which only applies to international students enrolled in MSP who possess a valid study permit issued under the Immigration and Refugee Protection Act for six months or longer and continue to retain such valid authorization and meet the definition of a resident.

For international students bringing family members to BC, only those family members with valid study permits of six months or longer will be subject to the health fee.

Educational institutions do not need to collect the health fee on behalf of the Government of British Columbia. If a school or school district would like to pay the health fee on behalf of their international students, they must be set up as a MSP group plan administrator.

Unless covered under an MSP group plan that has requested to pay the health fee on behalf of their international students, invoices will be sent directly to the individual at the address that is on file with MSP.

The person can submit proof to Health Insurance BC (HIBC) that this is the case. Proof can be in the form of:

• An official letter or email from Immigration, Refugees and Citizenship Canada stating that the person’s study permit has ended on a specific date; or

• a stamp in the person’s passport that is dated and indicates the study permit is no longer valid; or

• a letter or email from the person’s school that provides the date the student completed their studies or withdrew/stopped attending classes, or a dated copy of the person’s final transcript, degree, diploma or certificate. More information on how completion of studies affects the expiry date of a study permit is available here.

NOTE: If the person is issued a new immigration document that may qualify them to continue being enrolled in MSP, a copy of the new immigration document must be provided to HIBC. Otherwise, MSP coverage will be cancelled based on when the person ceased to meet the residency requirements for coverage.

The health fee exists for international students enrolled in MSP who possess a valid study permit of six months or longer. The ISHF is authorized by a Directive under the Financial Administration Act that requires the Ministry of Health to charge the health fee for international students enrolled in MSP. The Directive is guided by the Medical and Health Care Services Regulation’s strict definition of an international student as a person admitted to Canada as a student who possesses a valid study permit issued under the Immigration and Refugee Protection Act for six months or longer and continues to retain such valid authorization and meet the definition of a resident.

As a result of the Directive, all individuals enrolled in MSP with a valid study permit are billed $75 per month, regardless of secondary immigration status. The Ministry of Health has no influence over the type of criteria used by Immigration, Refugees and Citizenship Canada to issue permits.

Individuals who have arrived in BC and enrolled in MSP with a study permit with CUAET notations are exempt from the health fee for the period of March 1, 2022, onwards.

However, subsequent study permits without CUAET notations are subject to the health fee.