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B.C. Provincial Health Insurance Plan

 

On behalf of the B.C. government, Health Insurance BC (HIBC) administers medical coverage through the Medical Services Plan (MSP) and drug coverage through the PharmaCare and Fair PharmaCare programs.

British Columbia residents may stay outside of their province for up to 7 months per calendar year for vacation and up to 24 months, once every 5 years and still retain their B.C. government health insurance plan.

DENTAL

- What is covered: Medical Services Plan (MSP) covers dental and oral surgery, when medically required to be performed in a hospital (excluding restorative services, i.e.: fillings, caps, crowns, root canals, etc.) and orthodontic services related to severe congenital facial abnormalities.

- What is NOT covered: B.C. Health Insurance plan does not provide coverage for dental services, except as outlined benefits listed above (no coverage for routine dental care).

DRUGS

- What is covered: Fair PharmaCare is income-based; the less a family earns, the more help they get. .Fair PharmaCare covers: Eligible prescription drugs; Some medical devices; Eligible dispensing fees and some pharmacy services (such as medication reviews for persons prescribed five medications or more).

- What is NOT covered: B.C. Health Insurance plan does NOT cover prescription drugs (unless you are eligible for PharmaCare).

TRAVEL INSURANCE

- What is covered:  If you are eligible for coverage while temporarily absent from B.C., MSP will help pay for unexpected medical services provided the services are medically required, rendered by a licensed physician, and normally insured by the Medical Services Plan (MSP). Reimbursement for physician services will be made in Canadian funds and payment will not exceed the amount payable had the same services been performed in B.C. Any excess cost is the responsibility of the patient. Although the provincial health insurance does provide some coverage for emergency hospital care when you travel outside Canada, the province limits coverage to a maximum daily payment of $75.00, in Canadian funds. 

- What is NOT covered: B.C. Health insurance does NOT cover hospital expenses after the first $75 per day.

The cost of medical care outside Canada can be much higher than the amounts payable by MSP and extended health care plans. For complete protection, additional medical insurance should be purchased from a private insurance company, even if you only plan to leave the country for a day. Check the exclusions and limitations of your private insurance policy carefully to ensure that the policy meets your personal needs.

VISION

- What is covered: The Medical Services Plan (MSP) provides the following benefits: one annual eye examinations for children aged 0-18 and seniors aged 65+ medically required eye examinations (for example, eye disease, trauma or injury, or health conditions associated with significant risk to the eyes, such as diabetes) provided by an ophthalmologist or optometrist for adults aged 19-64. Optometrists are permitted to charge patients over and above what is payable by the Medical Services Plan for this service, as is the case with all supplementary health services.

- What is NOT covered: B.C. Health does NOT cover eyeglasses, contact lenses, and routine eye examinations for persons 19 to 64 years of age.

PARAMEDICAL

- What is covered: B.C. residents eligible for MSP supplementary benefits will receive up to $23 per visit for a combined annual limit of 10 visits each calendar year for the following services from approved providers: acupuncture; chiropractic; massage therapy; naturopathy; physical therapy; and non-surgical podiatry. Surgical podiatry services are a benefit for all beneficiaries. However, if a podiatrist is opted out, he/she may charge patients more than is insured by MSP.

 - What is NOT covered: MSP does NOT cover services of counsellors or psychologistsacupuncture, chiropractic, massage therapy, naturopathy, physical therapy, and non-surgical podiatry services (except for MSP beneficiaries receiving supplementary benefits).  Note: Many supplementary benefits practitioners are opted-out of the MSP. This means they are allowed to charge patients more for a service than is set out in the Payment Schedule.

HOSPITAL ROOM

- What is covered: B.C. Provincial health insurance plan covers standard ward rooms only.

- What is NOT covered: Private and semi-private hospital rooms are NOT covered by B.C. Health.

PRIVATE DUTY NURSING AND MEDICAL EQUIPMENT

- What is covered: PharmaCare covers approved prosthetic (limb, breast, ocular, nasal, and ear prostheses) and orthotic devices, ostomy supplies, and insulin pumps and supplies (insulin, needles, and syringes) for eligible B.C. residents. Subsidized home support services are available for eligible individuals.

- What is NOT covered: MSP does not provide coverage for hearing aids, and other equipment or appliances.

HEARING AIDS

- What is covered: Hearing aids are NOT covered by the B.C. provincial health insurance plan.

- What is NOT covered: MSP does not provide coverage for hearing aids, and other equipment or appliances.

AMBULANCE

- What is covered: B.C. residents are required to pay an $80 flat fee for ground or air transportations. Eligible residents on premium assistance are not required to pay.

- What is NOT covered: Ambulance fees are NOT covered by the Medical Services Plan of B.C.

Helpful links:

 

 

Visit www.ExtendedHealth.ca or call toll free 1-877-838-0020 to get a quote or apply for Extended Health care insurance.

 

 

 

IMPORTANT NOTE: The information on this web page is for illustration purposes only. Every effort has been made to ensure the accuracy of the information. Coverage details are subject to change. For complete benefits, terms, conditions, limitations, and exclusions, please contact the Ministry of Health for British Columbia.  

 

Last revised in September 2020.