MSP, Care Cards, and Healthcare in BC
I’ve been wanting to write this post for quite some time, but have also been putting it off. Comparing different healthcare systems around the world can result in opinions being offered and political statements being made, especially when the two countries being compared have very different payment structures involved. This article is intended to be an introduction to the healthcare options offered to Brits living in Canada on working holiday visas, and is based on my own experience. Etc. etc.
What’s this MSP malarkey?
MSP stands for Medical Services Plan (of B.C.), and is insurance that provides coverage for basic medical procedures and services. This includes doctor’s appointments, x-rays, basic surgery, maternity care and medically essential podiatry and dentistry. More importantly, this does not include non-essential examinations, prescriptions, cosmetic surgery or dental work, routine eye exams, massage therapy, acupuncture or chiropractic services. All BC residents must enrol with MSP, and means tested premiums are payable based on annual household income.
So you have to pay for healthcare in Canada?
The short answer, is yes. The long answer, is it depends. The chart below shows the monthly premium rates based on net income. The most an individual will currently pay is $64 per month, with those earning under $22,000 receiving 100% assistance, or free healthcare. Many employers have group plans and will pay a percentage of an individual’s monthly premium. My employer offers a group plan and I receive a discount of 50%, so I pay $32 per month. Different provinces have different arrangements too, as anyone from Ontario (where basic healthcare is free) will tell you.
What is a care card?
A care card is proof that you have MSP coverage, and has your name and personalized number on it. Everyone who applies for MSP is sent a care card in the mail, and you take this to the doctor whenever you have an appointment. Don’t lose it.
Am I eligible for MSP coverage?
The killer question. The answer is, any Canadian resident who has been living in BC for at least 3 months. Brits (or others) on a working holiday visa are eligible for MSP, though there is some extra criteria. In addition to having lived in BC for three months, you must have a work permit for (and intend to reside in BC for) at least six months and you must be working at least 18 hours a week. This is the important part, as you need a confirmation letter detailing your hours from your employer to apply. This is great news for anyone intending to stay for the long term (particularly if you are prone to doctors visits)! Even better, the mandatory enrolment rule doesn’t apply to residents on a working holiday visa as you’re not considered a resident if you’re only here short term, so you get to decide if you want to apply or not.
What if I don’t have MSP?
If you’re not eligible to apply for MSP, or you choose not to, your medical coverage will be limited to what’s included in the travel insurance that you purchased in order to qualify for the IEC visa. This is not a lot. It will cost at least $100 to see a doctor in a walk in clinic, plus the cost of any drugs you’re prescribed. There are free clinics around, though they are few and far between and tend to focus on sexual health. There is no standard prescription charge like in the UK, and prices vary between pharmacies (Note for all my female readers: you have to pay for contraceptive pills here, at approximately $20 per month. I know). Any large costs, for example emergency surgery, you’ll be able to claim back from your medical insurance. Unfortunately the excess is usually around $100, which means that you won’t be getting back those walk-in clinic charges. It took me almost 18 months to apply for MSP because I was putting off the monthly premium, and in that time I was lucky in that didn’t need to see a doctor at all. My boyfriend on the other hand had to pay a $100 walk in fee and $45 for prescribed ear drops. If you think it’s likely that you’ll need to see a doctor, MSP is definitely worth the monthly premium.
What about the dental work?
As MSP only covers basic medical services, medical insurance is available as an optional purchase for anyone wishing to buy extra coverage. This could be through a company like Pacific Blue Cross (at approximately $300 a year for the most basic coverage), or through your employer if they offer an extended services plan as part of your benefits package. This is common place for the majority of ‘professional’ jobs, and is usually little or no charge to the employee. I pay a very small amount each month (less than $10) and my coverage includes 100% of dental work (up to $2,500 a year) 80% of prescription drugs (up to $500 a year), 100% of hospital or medical services when ordered by a doctor (up to $25,000) and 100% of paramedical services including acupuncture, physiotherapy and massage therapy (up to $500 each per year). My boyfriend is also covered free of charge. There is a lot of small print, and not every service is covered; I can claim $150 of optical services every two years, whereas my eye exams/contact lenses actually cost closer to $800 every two years. Extended healthcare plans available through employers are usually only offered to permanent staff, so if you’re on a temporary contract you might need to look at private insurance.
If I’m paying this much money, the standard of care had better be good.
My thoughts exactly, but rest assured it is. My experience of Canadian medical services is limited, but I’ve spent more time at the dentist in the past 6 months than I did in 23 years in the UK. My first appointment was a little over a year after seeing my NHS dentist in the UK, and I was feeling very guilty about missing my regular check ups. My initial visit to the surgery included a full round of x-rays, examinations and introductions to at least four dental staff. As the dental hygienist was showing me my x-rays, she laughed and said ‘so I guess you haven’t been to the dentist in a few years, eh?’. When I informed her that I’d been going every six months until a year ago, she simply replied ‘oh, well they must have a different system in the UK’. Indeed. A different system where having year’s worth of plaque built up on your teeth is a good thing, apparently. After 4.5 hours of cleaning (seriously), two further check-ups and the extraction of three wisdom teeth, I consider myself to be pretty well versed in Canadian dental care. All I can say is that I would hate to have gone through any of these procedures at my very fast yet apparently not very thorough NHS dentist in the UK. This is just my experience, and I really do love the NHS, however I do believe that dental care in particular is much better in Canada.
How do I find a doctor or dentist?
Just as in the UK, some doctors and dentists will be taking new patients and some won’t. The College of Physicians & Surgeons in BC has a searchable listing of doctors taking new patients, and BC Dental has a similar service for dentists. If all else fails, a simple google search for a practitioner near you, followed up by some phone calls, is just as effective. Opticians are just like the UK; there are chain compaies and independent stores, and you can call to make an appointment (I recommend Iris).
If I have MSP, do I still have to purchase UK medical insurance to renew my visa?
Yes, you do. Firstly, because medical/travel insurance for travellers living abroad covers you for all of the very big and very expensive things, including emergency surgery. It also includes repatriation if anything should happen to you, and a whole bunch of travel related benefits for the flight out and back. Secondly, it’s one of the conditions of the IEC visa so nothing else matters.
Anything else I need to know?
This post covers the basics, but if you have any further questions or information that I’ve missed, please do comment below. The Ministry of Health have a very informative website which you can read by clicking here.