British Columbia residents don’t have to rely solely on private insurance or pay out of pocket for their medical expenses. The territory offers a government-funded public health care plan to all residents to help pay for medically required services and treatments. 

Health Insurance BC runs the Medical Services Plan or MSP on behalf of the British Columbia Ministry of Health. Though MSP coverage pays for many health care services, the insurance program doesn’t cover all treatments, services, or necessary medical supplies. To reduce out-of-pocket expenses, supplementing the provincial insurance with employer-based group benefits is a worthwhile option.

British Columbia Health Care Insurance Coverage

Every eligible resident of British Columbia must enroll themselves and their dependents in MSP.  To be eligible, an applicant must meet specific criteria:

• Be a Canadian citizen
• Live in B.C. for at least six months in a calendar year
• Be a minor child of a B.C. resident
• Be a dependent post-secondary student between the ages of 18 and 25
• Be a First Nations’ resident 
• Have a study or work permit valid for six months or more

MSP plan members may be responsible for paying monthly premiums. Family size and income determine the premium amount.  Each month, residents receive invoices for the next month’s premium, which they can pay via pre-authorized debit charges or credit cards. 

Currently, the premium rate for British Columbia health insurance is half its pre-January 1, 2018 amount. Families with an adjusted income of $26,000 or less will not have to pay a premium.

Medical Services

After receiving approval to pay for medical care through MSP, the plan member and their dependents can make use of several benefits. The plan covers:

• Medically necessary medical services by request of physicians and surgeons
• Essential diagnostic tests or services like x-rays by physicians, midwife, or registered physician
• Maternity services, including doctors and midwife services
• Eye examinations for people younger than 19 and older than 64
• Medically necessary eye examinations for people between the ages of 19 and 64 
• Surgical podiatry
• Medically necessary dental or oral surgery in a hospital setting

British Columbia health care insurance may cover some paramedical services like naturopathy, massage therapy, and osteopathy. 

B.C. Pharmacare

BC Pharmacare covers prescription drug coverage for MSP. To receive assistance paying for prescriptions and medical supplies through B.C. Pharmacare, applicants must have an active enrollment in the provincial health insurance plan.

B.C. Pharmacare is an inclusive drug program that consists of several parts, improving the likelihood of qualifying for prescription medication assistance. 

• Fair Pharmacare: As the most extensive prescription drug plan, Fair Pharmacare bases eligibility on family income. Low-income families will not have to pay a deductible but will receive immediate assistance.
• Plan B: This option is for permanent residents and provides coverage for approved medications and supplies.
• Plan C: This is prescription coverage for B.C. residents who receive income assistance through the Ministry of Social Development and Poverty Reduction.
• Plan D: This plan is for residents who require medication and products for cystic fibrosis.
• Plan F: This plan is for highly handicapped children.
• Plan G: Low-income residents can receive psychiatric medications through this plan. 

British Columbia Health Insurance Coverage Restrictions

Despite MSP’s inclusiveness with its prescription drug programs and medical services, the provincial health care plan does have exclusions, such as: 

• Services, treatments, and procedures that are not medically necessary, such as cosmetic surgery
• Physical examinations that are unrelated to health services, such as physicals for life insurance
• Routine and restorative dental care, such as tooth extractions and fillings
• Ambulance transport
• Routine vision care
• Medical equipment, such as contact lenses, eyeglasses, and hearing aids
• Psychologists and counsellors

Paramedical services are not typically part of MSP insurance coverage. However, the plan may pay for the expenses if the plan member receives premium assistance.

Supplementing BC Provincial Health Care Plan

The B.C. provincial health care plan is usually sufficient for relatively healthy individuals who don’t require much medical attention. However, disabled persons, people with dependents, and people dealing with sudden illnesses and injuries may find themselves responsible for medical bills. 

Group benefits are an excellent way to supplement the mandatory B.C. insurance plan. Plans are customizable to fit your business’s needs and your employees. You can include various insurance products to help workers pay for expenses MSP will not cover. 

Extended Health Care

Adding an extended health care plan to a group benefits package is one of the best ways to pay for services and treatments government plans overlook or decline to pay. It effectively supplements provincial health plans by providing the following benefits:

• Hospital coverage
• Prescription drug coverage
• Vision care
• Out-of-province emergency services
• Accidental dental coverage
• Private nursing services

Reduce Out-of-Pocket Medical Expenses Through Extended Benefits

Searching for the best group benefits plan quotes can be time-consuming and sometimes ineffective. At Group Enroll, we simplify the process. We partner with an exclusive selection of the best insurance providers in Canada to help our clients find the most affordable insurance products via hassle-free quote comparison services.

Our knowledgeable representatives can help you find custom benefits to ensure that your employees have the best coverage available at affordable rates. Fill out our quick quote form today to begin comparing the most recent quotes from top insurance companies, or contact our team to learn more about group insurance products.