Opting Out of MSP
Many supplementary benefits practitioners are opted-out of the Medical Services Plan (MSP). This means they are allowed to charge patients more for a service than is set out in the applicable Payment Schedule.
Guidelines for Hard and Soft Opt Out Status
In accordance with the Medicare Protection Act – Part 3 – Practitioners Section 14(2) – you must notify the MSP in writing that you have elected to opt out. The actual effective date will be determined by MSP and will be 30 to 45 days from the receipt of the request. MSP will attempt to accommodate requests for specific effective dates within that timeline.
If you are applying for an MSP Billing Number using the Practitioner Registration Form (HLTH2848 – CX307), you should check the OPT OUT (BILL THE PATIENT) box on the form. If you check the OPT IN (BILL THE MEDICAL SERVICES PLAN), you are agreeing to accept the MSP fee as payment in full for the service. If you checked the wrong box, contact HIBC to correct the error.
There are two main types of “opting out”, generally referred to as "hard opt out" and "soft opt out" status.
"Hard Opt Out" - the practitioner chooses to collect payment in full directly from the patient, including the MSP fee. MSP then reimburses the patient directly for insured services.
"Soft Opt Out" - the practitioner elects to opt out but continues to be reimbursed by MSP (on behalf of the patient) for the MSP portion of the fee. The patient pays the practitioner any additional charges.
You will need to provide the following information in your letter requesting opt out status:
- Opted Out status that you require – Hard Opt Out or Soft Opt Out
- If you will be billing electronically (Teleplan) or through online submission
- Indicate if you want direct bank deposit (DBD) - (for Soft Opt Out only)
- Your MSP Practitioner and Payee number
- Current address
- Signature of Practitioner(s)
Please mail or fax to:
Health Insurance BC (HIBC)
Practitioner and Patient Services
PO Box 9480
Victoria, B.C. V8W 9E7
Fax: (250) 405-3592
- Practitioner’s request to opt out will be processed by HIBC within 30 to 45 days from receipt of request
- Practitioner will receive an opt-out date notification package by mail
- Opted out practitioners who bill electronically (Teleplan) should contact their software vendor regarding changes in their software and changes in format for submitting opted out MSP claims.