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.

James and I with our very own care cards!

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.

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About MarmitetoMaple

I'm originally from the UK and have been working and living the dream in Vancouver, BC, since January 2011. I am a firm believer in travel, good cheese, volunteering and community engagement.

21 responses to “MSP, Care Cards, and Healthcare in BC”

  1. dontjudgeaduckbyitscover says :

    I don’t suppose you know how much chiropractic treatment costs as a rough guide, do you? This duck has old bones!

  2. marmitetomaple says :

    Hi Duck, thanks for the comment! Chiropractic care typically costs around $45 per treatment in Downtown Vancouver, though you should expect to pay up to $70 for your initial consultation. I hope that helps!

  3. dontjudgeaduckbyitscover says :

    Right, I had better get saving then! Not long until we arrive now and my joints will need some TLC! Thanks for the useful info, great post.

  4. Dan B says :

    Very informative! Can’t believe it took 4 hours to clean your teeth! Jesus… I’ve forgone getting my teeth cleaned as I didn’t want to pay the money, but I might just have to get it done now, incase I also have years of plaque build up on them!

    I’ve got to say my own opinion is that the health system here is slightly flawed. If you can’t afford insurance (on top of MSP), you’re basically never going to get the preventative treatment that you need because that would cost you even more money. In the long term it just makes it worse for the patient as their health has to deteriorate to the point where they need emergency treatment, at which point long term damage may have already been done.

    If I didn’t have the savings to pay for my own dental work, the whole thing could have literally ruined my entire life. It’s a scary thought.

    • marmitetomaple says :

      Tell me about it – 4 hours over three appointments. It was incredibly painful too. Apparently I was a borderline gum disease case, despite those 6 month check ups in the UK!

      I very much agree about the preventive care being essential to avoid the long term damage. I would love to see basic dental included with MSP, it’s such a critical part of healthcare and can be one of the most expensive problems to fix.

      Congratulations on having the savings to fork out for your own dental work, I know for sure that would not have been an option for me so I am very very grateful for insurance!

  5. darek says :

    hey ive lived in bc for about 4 years now and i haven’t applied for a care card. how does it work if i apply for one now? ive been making over $30,000 for the last 2 years. would they charge me for the previous 2 years?

    • marmitetomaple says :

      Hi Darek, thanks for the comment! I think the answer depends what kind of visa you’ve been on. I applied after being in BC for 18 months on a working holiday visa (and also making over $30,000) and wasn’t charged. My excuse would have been that I’d only just decided to stay in Canada for the long term as a resident, but I wasn’t even asked anything. I would imagine it’s similar if you’re on a Temporary Work Permit, but if you already have PR then they might be more likely to charge you. Let me know what happens if you do decide to apply for one now!

    • RGM says :

      Hi Darek, I’m wondering if you ever applied. I have a PR card but haven’t applied for the care card yet. I’ve been a PR for almost 4 years but not working.
      I’m wondering if you were charged retroactively.
      Thanks!

      • MarmitetoMaple says :

        Hi Darek, thanks for the comment! Yes I did apply after I’d been here for about 18 months (while I was still on a working holiday visa). I wasn’t charged retroactively, and I haven’t heard of this happening (even though it says that it could). Fingers crossed you won’t be either if you’re thinking of applying!

  6. cork2canada says :

    Hi, thanks so much for all the info on this topic. I’m moving over next month. What travel insurance did you get before you moved there? I’ve been looking up a few and they are very expensive.

    • marmitetomaple says :

      Hi there, thanks for the comment, and good luck for the big move! I went with ACE Travel Insurance, just over 200 pounds for a year. This meets all the criteria that BUNAC set for their insurance providers and also includes casual snow sports. I wrote a post back in 2010 on travel insurance here which you might find useful!

  7. charle says :

    very informative. thanks. i have some few questions. Myself and my wife are immigrants and made a short landing in vancouver last June 2012. Currently we are in dubai and are planning to move permanently in vancouver this coming November. We have not applied for an MSP. My wife is two months pregnant and her expected due date will be on April 2013. What will be the best thing to do so that her maternity and medical expenses will be covered by MSP? I have heard that giving birth in canada is quite expensive.

  8. chris says :

    Hello , recently my wife and I were out on a nature hike and she slipped on a wet log and twisted possibly sprained her ankle . Now she is a US citizen living here with me on a visitor permit till her permanent resident goes thru , I have already qualified for the spouse sponsorship . She doesnt have travel insurance so how much will it cost for doc visit with xrays and anything needed for her ? Thank You
    Chris

    • marmitetomaple says :

      Hi Chris, thanks for the comment and sorry to hear about your wife’s accident. I’ve been lucky enough not to be in that situation myself so I’m afraid I don’t know the answer. However, as a walk innfee to see a doctor will be $80-150 I would estimate the total cost to be well in the hundreds depending what she needs. The best thing to do is bite the bullet and head to a walk-in centre and find out. Best of luck!

  9. Curing Toenail fungus says :

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  10. Kento says :

    Hey there,
    I came across your website while trying to apply for MSP, and I have a question regarding this topic! I wonder if you could help me answer it.

    I have not applied for MSP after almost 3 years of being in BC (I moved from Japan to BC on a student visa). It says on the application that I may be charged retroactively for the premium, but I wonder if this was the case for you when you applied for MSP after 18 months of your move.

    • MarmitetoMaple says :

      Hey Kento, thanks for the comment.

      I’d read that too, but when I applied I was not charged retroactively at all. I was all ready to argue my case based on not knowing whether I was actually going to stay long-term, but I didn’t need to. I know a lot of people who applied or MSP after being in Canada for more than a year or two and haven’t been charged so hopefully it won’t happen to you!

      Best of luck with the application if you go for it,

      Lizzie

  11. Tom says :

    Hi Lizzie,
    I was actually randomly researching BC MSP on google and there was a link back to this site! I wanted to warn people, I was told by BC Revenue Services that it’s a real catch 22 if you move to BC unemployed. If you are a new immigrant you are required to register for MSP but you are not eligible for the $0 cost that comes with unemployment, which is reserved for people who have been living in Canada for at least one year. So, if you move to BC and are looking for a job or waiting for your job to start (as in my case), even if you have no income, you are required to enroll in MSP and you are expected to pay upwards of about $70/month now.

    You’d think this would be considered unconstitutional, to force new immigrants to pay such a high price for health insurance before they are employed, but apparently according to Revenue Services, it is legal.

  12. MarmitetoMaple says :

    Hi Tom,

    Thank you so much for the update, I really appreciate you sharing this! I also think it’s crazy that you’re not able to qualify for the $0 cost, which I think also extends to having to be a permanent resident too (my friends on working holiday visas who earn below the threshold also don’t qualify). As my post mentions, I didn’t register when I moved here even though I was legally required to and I wasn’t charged retroactively (nor have I heard of that being enforced) but it is worth noting that it is technically a requirement. Way to welcome new immigrants to Canada!

    Another catch that I found last year after I moved jobs is that if you’re on a working holiday visa, you are only eligible for MSP if you are employed. When I switched jobs I didn’t tell MSP so they thought I wasn’t working and cancelled my coverage – it took two months to reinstate!

    Makes me miss the NHS…..!

    Lizzie

  13. Shenita Gorka says :

    It’s really a great and useful piece of information. I’m satisfied that you shared this useful information with us.Please stay us up to date like this. Thank you for sharing.

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