Core Medical Coverage for Seniors
The BC Medical Services Plan (MSP) is the provincial health insurance program that covers medically required services for eligible residents. For seniors aged 65 and over, this coverage forms the foundation of their healthcare plan, ensuring access to a wide range of essential services without out-of-pocket costs for the insured portion.
Doctor and Specialist Visits
One of the most fundamental benefits of MSP is the coverage for services provided by physicians and surgeons. This includes a variety of medically necessary services, such as:
- General practitioner (family doctor) visits for check-ups, diagnosis, and treatment of illnesses.
- Consultations with specialists, provided you have a referral from your family doctor.
- Maternity care services, including those provided by midwives.
Hospital and Diagnostic Services
MSP covers most medically required hospital and diagnostic services, which are critical for seniors' ongoing health management. This includes:
- In-hospital stays, surgeries, and the associated anesthesia.
- Diagnostic services ordered by a doctor, midwife, or certain other healthcare providers, such as:
- X-rays and ultrasounds.
- Medically necessary blood and urine tests.
- MRIs and CT scans.
Vision and Oral Care
While MSP does not cover all vision and dental care, it provides targeted benefits important for seniors:
- Eye Exams: Seniors aged 65 and older are entitled to one routine, comprehensive eye examination every year. Medically required eye exams (e.g., for suspected glaucoma or diabetes-related issues) are also covered.
- Dental/Oral Surgery: The plan covers dental or oral surgery when it is medically required and performed in a hospital setting. This does not include routine dental procedures like fillings or cleanings.
Health Services NOT Covered by MSP
It's crucial for seniors to understand what MSP does not cover to avoid unexpected costs. These exclusions highlight the importance of supplementary coverage.
- Prescription Drugs: This is a major exclusion. Prescription medication costs are covered by BC PharmaCare, a separate provincial program.
- Vision Care: While annual eye exams for seniors are covered, MSP does not cover the cost of eyeglasses, contact lenses, or other optical supplies.
- Dental Care: Most dental work, including routine care like cleanings, fillings, and restorative services, is not covered.
- Medical Equipment: Items like hearing aids and other medical appliances are not covered by the basic plan.
- Counselling and Therapy: The services of most counsellors or psychologists are not covered.
- Non-Medically Required Services: Services deemed not medically necessary, such as cosmetic surgery, are not included.
Supplementary Benefits for Paramedical Services
Low-income seniors who are enrolled in MSP may be eligible for Supplementary Benefits, which offer partial payment for certain paramedical services.
Eligibility
To qualify for Supplementary Benefits, you must be a BC resident with a low annual adjusted net income. Eligibility is automatically reassessed annually using income information from the Canada Revenue Agency (CRA).
Covered Paramedical Services
Under Supplementary Benefits, MSP contributes a set amount per visit for the following services, with a combined annual limit of 10 visits per calendar year:
- Acupuncture
- Chiropractic
- Massage therapy
- Naturopathy
- Physical therapy
- Non-surgical podiatry
For each visit, MSP pays a portion of the fee, but the patient is responsible for paying any additional charges from the practitioner, especially if they have opted-out of MSP billing.
Beyond MSP: Leveraging Other Provincial and Federal Programs
To fill the gaps in MSP coverage, seniors in BC have access to several other government programs that can provide significant financial relief.
BC PharmaCare
This program helps BC residents with the costs of eligible prescription drugs, as well as certain medical devices and supplies. The Fair PharmaCare plan, which is income-based, is particularly beneficial for seniors. You must be registered with MSP to be eligible, but enrolment is free.
BC Seniors' Supplement
This is a provincial top-up payment for low-income seniors who receive the federal Guaranteed Income Supplement (GIS). The supplement is paid automatically to eligible seniors; no separate application is required.
Shelter Aid for Elderly Renters (SAFER)
SAFER is a program for low-income seniors (aged 60+) who rent in the private market. It provides monthly cash payments to help make housing more affordable.
BC Bus Pass Program
For a small annual administrative fee, eligible low-income seniors can receive a reduced-cost annual bus pass.
Comparing Key BC Senior Health Programs
| Feature | Core BC MSP | Supplementary Benefits | BC PharmaCare (Fair Plan) | Private Health Insurance |
|---|---|---|---|---|
| Cost | No premiums since 2020 | Income-tested eligibility | Enrolment is free; deductibles/co-pays apply | Monthly premiums apply |
| Primary Function | Covers medically required doctor and hospital services | Partial payment for select paramedical services | Assistance with prescription drug costs | Extends coverage for glasses, dental, etc. |
| Eye Exams | Annual exam covered for seniors 65+ | Not covered | Not covered | Varies by plan |
| Eyeglasses/Contacts | Not covered | Not covered | Not covered | Varies by plan |
| Physiotherapy | Not covered (unless hospital-based or Supplementary) | Partial coverage (10 combined visits/year) | Not covered | Varies by plan |
| Prescription Drugs | Not covered | Not covered | Covers eligible medications (based on income) | Varies by plan |
| Eligibility | All BC residents | Low-income (income-tested) | All BC residents (income-based plan) | Varies by insurer/plan |
How to Manage Your Coverage
Navigating provincial health and financial benefits is key to healthy aging. To manage your coverage effectively:
- Register for MSP: If you are a new resident or have not yet enrolled, you must apply through Health Insurance BC. You will receive a BC Services Card once enrolled.
- Verify Supplementary Eligibility: The application for Supplementary Benefits is combined with MSP and Fair PharmaCare. Annual income verification is automatic through the CRA, so file your taxes every year.
- Explore Other Programs: Consider applying for programs like SAFER and the BC Bus Pass if you meet the income requirements.
- Consider Private Insurance: For coverage of services not included under MSP or Supplementary Benefits (e.g., dental, prescription glasses), many seniors choose to purchase a private health plan.
For more detailed information on specific medical benefits, refer to the official Government of British Columbia website.
