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Health Insurance BC: Summary of Benefits

Important: changes to the MSP premium rate calculations are now effective as of January 1, 2017, as per the 2016 budget. Click here for more.

The following is a brief summary of Health Insurance BC (the name of the B.C. provincial healthcare plan) coverage and benefits.

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Health Insurance BC administers the provincial health insurance plan which consists of:

  • Medical Services Plan (MSP): Enrolment in MSP is mandatory for all BC residents and their dependents. Premiums are billed one month in advance. MSP provides medical and health benefits, with premiums determined by family size and income.
     
  • Pharmacare: covers prescription drugs and various medical supplies. 
     
  • Fair Pharmacare: most common Pharmacare plan. Provides assistance for prescription costs; deductibles are primarily based on income.

Medical Services Plan

Provides payment for the following health and medical benefits:

  • Medically required services of physicians and surgeons.
  • Dental or oral surgery if medically required (must be done in a hospital).
  • Routine eye examinations for patients under 19 or older than 64 years old.
  • Midwife services.
  • Eye exams that are required medically.
  • Diagnostic services (including x-rays and/or laboratory services) when ordered by a registered physician or supplementary healthcare worker.
  • Surgical podiatry services (if a podiatrist is opted out of the plan there may then be charges not covered by MSP).
  • Supplementary health benefits (e.g. paramedicals such as chiropractors, acupuncture, massage therapy, naturopathy, etc.) MAY be covered IF you are receiving some form of premium assistance. See the BC Supplementary Benefits web page for more information.

For those families who need assistance with premiums, Health Insurance BC offers programs such as:

  • Regular Premium Assistance Program: based on annual family income and allowable MSP deductions. Run by MSP.
  • Temporary Premium Assistance Program: short term assistance based on unexpected financial hardship. Run by the Ministry of Finance.

The Medical Service Plan (MSP) does not offer coverage for:

  • Any services that are not considered medically necessary.
  • Routine dental services (e.g. cleanings, fillings, extractions and exams).
  • Restorative dental services.
  • Physical examinations if not medically necessary (e.g. tests for driving a vehicle, life insurance, immigration, etc.).
  • Cosmetic surgeries.
  • Routine eye examinations for patients aged 19-64.
  • Ambulance services (although in-province ambulance transportation is subsidized, thereby decreasing cost to BC residents).
  • Eye glasses, contact lenses, hearing aids and other durable medical equipment.
  • Counsellors and psychologists.
  • Pharmaceutical drugs (unless you qualify for assistance, see below).
  • Paramedicals such as chiropractors, massage therapists, etc. (unless you are receiving premium assistance).

BC Pharmacare

BC Pharmacare offers one of the most comprehensive drug programs in Canada (most of these plans require active enrolment in MSP).

If you do not qualify for any of the programs below then you do not qualify for prescription drug coverage.

These drug plans are:

  • Fair Pharmacare: the largest plan which is subsidized and based on family net income. Depending on your income status, a deductible is determined; once that amount has been met Pharmacare assists with paying eligible drug costs. Lowest income families are not required to pay a deductible and get immediate assistance.
  • Plan B: coverage for permanent residents of licensed residential care facilities.
  • Plan C: for recipients of the BC Income Assistance plan.
  • Plan D: for people who are registered with a provincial Cystic Fibrosis Clinic and in need of digestive enzymes.
  • Plan F: for children in the At Home Program of the Ministry of Children and Family Development who would otherwise be reliant on institutional care.
  • Plan G: for individuals of any age who need financial aid with their psychiatric medications.
  • Plan P: BC Palliative Care Drug Program. For residents who wish to have palliative care in their home.
  • BC Smoking Cessation Program: nicotine replacement therapy plan for residents who want to quit smoking. For full details on what is covered go here.
  • BC Center for Excellence in HIV/AIDS: a government resource that monitors and disseminates HIV research and treatment.

New Premium Calculations

The following summarizes the changes to the premium calculations for the Medical Services Plan (MSP). For the full rate tables go here.

  • There are no premiums required for minors and dependent post-secondary students.
  • Premiums are based off of the number of adults on MSP.
  • A qualified spouse on MSP cannot also qualify as a post-secondary student.
  • Full premium assistance available to those whose net income is $24,000 or less per year.
  • Partial premium assistance is available to those whose net income less than $42,000 per year.

- for full coverage details visit the Health Insurance BC web site -

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Last updated February 2017