Eligibility and Enrollment

All residents of B.C. must enroll with MSP

Under the Medicare Protection Act, enrollment with MSP is mandatory for all eligible residents and their dependents.

»  Who is Eligible?
»  How to Enroll with MSP
»  When does Coverage Begin?
»  Coverage During the Waiting Period
»  Changes that Affect Your Coverage
»  Adding and Removing Dependents
»  Absence from B.C.
»  Cancelling Your Coverage
»  First Nations and Inuit Residents

Who is Eligible?

An individual must be a resident of B.C. in order to qualify for medical coverage under MSP. A resident is a person who meets all of the following conditions:

• must be a citizen of Canada or be lawfully admitted to Canada for permanent residence;
• must make his or her home in B.C.;
• must be physically present in B.C. at least 6 months in a calendar year; and
• dependents of MSP beneficiaries are eligible for coverage if they are residents of B.C.

Certain other individuals, such as some holders of study and/or work permits issued under the federal Immigration and Refugee Protection Act are deemed to be residents, but tourists or visitors to B.C. do not qualify. If you are uncertain about your eligibility status, contact MSP for assistance.

Dependent - includes a spouse and children who are B.C. residents.

Spouse - means a resident who is either married to or is living and cohabiting in a marriage-like relationship with the applicant and may be of the same gender as the applicant. (Note: in the case of divorce, the former spouse is no longer eligible for coverage as a dependent and must apply for separate coverage.)

Child - means a resident who is the legal ward or child of the applicant, is supported by the applicant, is neither married nor living and cohabiting in a marriage-like relationship, and is either age 18 or younger or age 19 to 24 and attending school or university full-time.

How to Enroll with MSP

If you are applying for a self-administered MSP account, complete an Application for Enrollment form (see MSP Forms for ways to obtain a form) and send it to MSP. Copies of documents to support the name and Canadian citizenship or immigration status of the persons listed on your application may be required.

If MSP coverage is available through your employer, union or pension plan, contact that office for information and a group application form. Any existing self-administered account will be cancelled by MSP when your group application is processed.

If your employer, union or pension plan stops providing coverage under a group account, a self-administered account will automatically be set up for you and you will be billed directly for premiums from that date.

Persons who have or may be eligible for MSP benefits through Health Canada (Canadian status aboriginals) or the Ministry of Employment and Income Assistance should contact those agencies.

When does Coverage Begin?

New residents or persons re-establishing residence in B.C. are eligible for coverage after completing a waiting period that normally consists of the balance of the month of arrival plus two months. For example, if an eligible person arrives during the month of July, coverage is available October 1. If absences from Canada exceed a total of 30 days during the waiting period, eligibility for coverage may be affected.

You should apply for MSP coverage immediately after arriving in B.C., rather than at the end of the waiting period, to allow time for your application to be processed.

When a family moves to B.C. from another part of Canada and the husband and wife arrive separately, the waiting period for family coverage begins on the later date of arrival. If, however, a spouse will reside in B.C. for 12 or more months before the rest of the family moves here, that spouse needs apply for MSP coverage before the end of the 12 month period (coverage provided by the former home province cannot exceed 12 months). Once they arrive in B.C., the other family members can be added to the account - see Adding and Removing Dependents below. The rest of the family remains eligible for coverage in the other province for the balance of the month of departure plus two months, and will be required to complete the waiting period once arriving in B.C.

Coverage During the Waiting Period

New residents from other parts of Canada should maintain coverage with their former medical plan during the waiting period. New or returning residents arriving from outside Canada should contact a private insurance company for coverage during this period.

Changes that Affect Your Coverage

Address Change

You should report an address change to MSP immediately - if possible, use one of MSP's online Address Change Forms. (Also see Permanent Move from B.C.)

Name Change

When you change your name and the name on your CareCard is now incorrect, you need to apply to have a new CareCard issued to you with your correct legal name. MSP will need your personal health number and a copy of a legal document indicating your correct name, such as a marriage or change of name certificate. When MSP issues a new CareCard because a person's name has changed, a fee is not charged.

• If your premiums are paid through an employer, union or pension group plan, you need to complete a Group Change Form and submit it to your group plan administrator, along with the copy of the legal document showing your name change. (If you cannot access the electronic form, please obtain one from your group plan administrator.)
• If you pay your premiums directly, you need to complete a CareCard Replacement Form and send it to MSP with the copy of the legal document showing your name change. (If you cannot download the electronic form, it is available through MSP's Forms-by-Fax service, by visiting a Government Agent/B.C. Access Centre or by contacting MSP.)

Marriage

When you marry (or begin living in a marriage-like relationship - see the definition of spouse under Who is Eligible?), you should combine separate MSP accounts into one family account - see Adding a Spouse below. If one or both spouses are changing their names, follow the instructions for Name Change.

Divorce

Upon divorce, the former spouse of an account holder is no longer eligible for coverage under the same account. See Removing Dependents below.

Adding and Removing Dependents

If you are unsure who can be covered under your account, see Who is Eligible?

Adding a Newborn Child

The B.C. hospital where the baby is born will provide the mother with a Baby Enrollment Form (if you did not get this form, you can obtain one from the MSP Forms page). The completed form should be submitted as soon as possible to either your group plan administrator if you are covered under an employer, pension or union plan, or directly to MSP if you are covered under a self-administered account.

Adding a Spouse or Children

• If you pay premiums directly through a self-administered account and the person you are adding is not already enrolled with MSP, you can obtain an Addition of Family Member form from this web site, through the Forms-by-Fax service or at a Government Agent/B.C. Access Centre. If the person is currently enrolled with MSP under a separate account, contact MSP with details, including the person's name, personal health number, and relationship to you.
• If you are enrolled under a group plan administered by an employer, union or pension office, you need to complete a Group Change Form (if you cannot print this electronic form, please obtain one from your group plan administrator). Submit the completed form to your group plan administrator.

Removing Dependents

• If you have a self-administered account, visit a Government Agent/B.C. Access Centre in your area or contact MSP directly - there is no form to complete. MSP needs to know the person's name, personal health number and the reason for your request. If the request is because of separation, divorce or a child leaving home, please provide the person's new address and, if applicable, the date he or she left the province.
• If you are enrolled under a group plan administered by an employer, union or pension office, you need to complete a Group Change Form (if you cannot download this form, please obtain one from your group plan administrator). Submit the completed form to your group plan administrator.

• marry or live together in a marriage-like relationship,
• start full-time employment,
• or turn 19 years of age.

Absence from British Columbia

For information on your eligibility for MSP coverage and benefit entitlements while you are temporarily away from B.C., see Leaving B.C.

Cancelling Your Coverage

If you will no longer be a resident of B.C., you must notify MSP of the date of your departure and your new address; otherwise, premium billing may continue. If possible, use one of MSP's online Address Change Forms. Also see Permanent Move from B.C. (Note: failure to pay premiums does not constitute notification to cancel your coverage.)

It is possible for adults (but not minor children) to formally opt out of or cancel their MSP coverage. B.C. residents who cancel their coverage are disqualified from and unable to access all provincial health care programs. For details, see Information About Opting Out of Ministry of Health Services Programs (PDF 19Kb). To obtain an Election to Opt Out form, contact MSP. If your financial situation may qualify you for help with the payment of premiums, see Premium Assistance.

First Nations and Inuit Residents

Basic Medical Coverage

MSP is the provincial government program that provides basic medical benefits. For example, MSP pays for medically required services of physicians and surgeons. All residents of B.C. are required to enroll with MSP - only those (adults) who formally opt out of all provincial health care programs are exempt. Generally, Status Native and Inuit residents enroll through Health Canada's First Nations and Inuit Health Branch.

If you require an application or need to add a family member (spouse or child with status) to your coverage, contact your Band office, an Indian Health Centre or Health Canada's First Nations and Inuit Health Branch (see contact information below).

If you have a non-status family member who needs to obtain coverage, contact MSP directly.

Each person who is enrolled with MSP is issued a CareCard with a unique Personal Health Number that you present when health care services are required.

If you are already covered by MSP, forms are available on this web site to advise our office of an address change within B.C., to request a new CareCard, or to advise us that you or a family member have left B.C. permanently (see Permanent Move from B.C.).

Non-insured Health Benefits and Items

Non-insured health benefits for Status Natives and Inuits are provided by the federal government, under Health Canada's First Nations and Inuit Health Branch. These non-insured benefits and items include dental care, prescriptions, glasses, medical supplies, etc. Any questions should be directed to:

First Nations and Inuit Health Branch
Health Canada
540 757 West Hastings Street
Vancouver, B.C.  V6C 3E6

Vancouver and Lower Mainland: 604 666-0737
Other areas of B.C. (toll free): 1 800 317-7878

Visit their web site at www.hc-sc.gc.ca/fnihb/index.htm