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BC Medical Services Plan.

BC Medical Services Plan.

Old Jul 23rd 2016, 6:00 am
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Default BC Medical Services Plan.

I lived in BC from 1990 but now spend most of my retirement in Bali. My BC MSP card is still active as I file annual T1's to Canada Revenue...however, I also stated I stay out of BC for more than 6 months at a time.
I recently had a colon tumor removed and chemo-therapy at my own expense (C$25,000+). I'm 79 and find medical insurance mostly unavailable, or the premiums extremely expensive, so I self-insure...i.e. I saved/invested the quoted premiums for the last 5 years and it is more than the cost of my latest medical problem. I couldn't have had better hospital-care/treatment than in Bali.....which most Insurance Co's would not totally cover.

I hadn't thought I could return to Canada for the surgery as I would need to wait 90 days to re-qualify, then there would be a wait.....but I was back in Vancouver last month and friends tell me I can claim some of that expense from BC MSP.
Anybody advise if my friends are correct...I may not claim but would be interested in any details.
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Old Jul 23rd 2016, 2:43 pm
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Default Re: BC Medical Services Plan.

Originally Posted by Davita
I hadn't thought I could return to Canada for the surgery as I would need to wait 90 days to re-qualify, then there would be a wait.....but I was back in Vancouver last month and friends tell me I can claim some of that expense from BC MSP.
Anybody advise if my friends are correct...I may not claim but would be interested in any details.
Thankfully this is incorrect. You have to be a resident at least 5 months in a year, wait the 90 days on taking up residency and be paying MSP premiums.
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Old Jul 24th 2016, 1:39 am
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Default Re: BC Medical Services Plan.

Originally Posted by Aviator
Thankfully this is incorrect. You have to be a resident at least 5 months in a year, wait the 90 days on taking up residency and be paying MSP premiums.
Why do you say thankfully?

I don't understand why a senior citizen in retirement, who lives in a warmer clime, but still files taxes to Revenue Canada have to wait 90 days on return to qualify for MSP....makes no sense.
If that same person becomes sick abroad and pays for his/her own treatment it saves the MSP from that cost.
If a citizen resident crosses the border to the USA for shopping, and has an accident, can he/she not claim some of the health cost to the MSP's?

I can understand a new immigrant (not yet a contributor) having to wait 90 days to prevent abuse of the Health Service....that's different.
I remember, living in UK, when pregnant foreigners would, on purpose, arrive at Dover on the ferry....just to have their child delivered for free under the UK NHS.
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Old Jul 24th 2016, 2:09 am
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Default Re: BC Medical Services Plan.

Originally Posted by Davita
Why do you say thankfully?

I don't understand why a senior citizen in retirement, who lives in a warmer clime, but still files taxes to Revenue Canada have to wait 90 days on return to qualify for MSP....makes no sense.
If that same person becomes sick abroad and pays for his/her own treatment it saves the MSP from that cost.
If a citizen resident crosses the border to the USA for shopping, and has an accident, can he/she not claim some of the health cost to the MSP's?

I can understand a new immigrant (not yet a contributor) having to wait 90 days to prevent abuse of the Health Service....that's different.
I remember, living in UK, when pregnant foreigners would, on purpose, arrive at Dover on the ferry....just to have their child delivered for free under the UK NHS.
Davita,
Just to clarify, are you paying monthly MSP premiums throughout the year? If so then your argument holds water but if not then why do you feel that it is unreasonable to have a 3 month waiting period, filing taxes isn't relevant. By your comments, I'm presuming you are indeed paying your x 12 monthly premiums.

You cite the NHS as an example - having worked for them for donkeys years, I am baffled by the organisation's leniency/ stupidity allowing such actions.

They held a review to assess whether non-resident UK citizens who had lived in the UK and had contributed for 15 years or more should be able to access care. It was initially thought that this was going to be taken up but was subsequently chucked out, perhaps similarly unfair comparing it with your situation. Result, we pay like everyone else who are non resident. I find it astounding that Johnny Foreigner can access GP care for free, now that I do thing is totally wrong.
Just my humble opinion

Last edited by Stinkypup; Jul 24th 2016 at 2:26 am.
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Old Jul 24th 2016, 2:49 am
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Default Re: BC Medical Services Plan.

Originally Posted by Stinkypup
Davita,
Just to clarify, are you paying monthly MSP premiums throughout the year? If so then your argument holds water but if not then why do you feel that it is unreasonable to have a 3 month waiting period, filing taxes isn't relevant. By your comments, I'm presuming you are indeed paying your x 12 monthly premiums.
Thanks Stinky for your response.

I think Revenue Canada must be integrated with the MSP as I'm told my adjusted income is below the threshold for paying a premium. I used to pay premiums when my income was higher. I understood that the Federal Gov't (from taxation) had a cost share with Provincial MSP's.
In Vancouver last month I had to have a blood test. I thought I would need to pay but the walk-in clinic staff said my MSP card is active so "no charge".....welcome to Canada.

We have an apartment in BC which we let someone use, when not there, and pay the maintenance bills and upkeep....and send me any personal mail.

Indeed the UK NHS was initially a bit skewed but I haven't been back to UK in 25+ years. I thought I was under their veterans plan as I served 22 years in the RAF...but not sure and have no plan to visit or bother them.

Last edited by Davita; Jul 24th 2016 at 2:53 am.
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Old Jul 24th 2016, 4:08 am
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Default Re: BC Medical Services Plan.

Originally Posted by Davita
Thanks Stinky for your response.

I think Revenue Canada must be integrated with the MSP as I'm told my adjusted income is below the threshold for paying a premium. I used to pay premiums when my income was higher. I understood that the Federal Gov't (from taxation) had a cost share with Provincial MSP's.
In Vancouver last month I had to have a blood test. I thought I would need to pay but the walk-in clinic staff said my MSP card is active so "no charge".....welcome to Canada.

We have an apartment in BC which we let someone use, when not there, and pay the maintenance bills and upkeep....and send me any personal mail.

Indeed the UK NHS was initially a bit skewed but I haven't been back to UK in 25+ years. I thought I was under their veterans plan as I served 22 years in the RAF...but not sure and have no plan to visit or bother them.
"Integrated" only in the sense that when you file your taxes with Revenue Canada, your tax form also includes taxes paid to BC, and Revenue Canada provides the information to the provinces as to the taxable income level of citizens.

The medical plans are administered by the provinces. There are Health funding transfer payments from Ottawa to the provinces but that is far from enough to provide all the care necessary.

When we first came to Canada, BC provided a detailed itemised account of how much had been paid by the province on your beahlf when you had received hospital treatment.

I remember paying a grand total of $10 in 1969 for 3 days in hospital for an eye operation, the resulting statement told me that the operation, surgeon, anaesthetist, etc etc had cost well over $1,000. I do so wish they had continued with that as it would make people think twice when complaining about costs or not getting treatment free!

I fail to see why someone who has not paid MSP premiums should expect to be able to return to Canada (or the UK) to receive treatment for free ................. at MY cost.


Now, if you were living here, and your income was below the minimum, then that is a different matter. As a matter of fact, MY income is below the minimum rate, but the FAMILY income is not.
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Old Jul 24th 2016, 5:00 am
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Default Re: BC Medical Services Plan.

Originally Posted by scilly
"Integrated" only in the sense that when you file your taxes with Revenue Canada, your tax form also includes taxes paid to BC, and Revenue Canada provides the information to the provinces as to the taxable income level of citizens.

The medical plans are administered by the provinces. There are Health funding transfer payments from Ottawa to the provinces but that is far from enough to provide all the care necessary.

When we first came to Canada, BC provided a detailed itemised account of how much had been paid by the province on your beahlf when you had received hospital treatment.

I remember paying a grand total of $10 in 1969 for 3 days in hospital for an eye operation, the resulting statement told me that the operation, surgeon, anaesthetist, etc etc had cost well over $1,000. I do so wish they had continued with that as it would make people think twice when complaining about costs or not getting treatment free!

I fail to see why someone who has not paid MSP premiums should expect to be able to return to Canada (or the UK) to receive treatment for free ................. at MY cost.


Now, if you were living here, and your income was below the minimum, then that is a different matter. As a matter of fact, MY income is below the minimum rate, but the FAMILY income is not.
Stinky said there was NO relevance between BC MSP and Revenue Canada. My post said the same as you have said...there IS a connection and some funding does source from taxes.

I agree that if someone has declined, or fails to pay MSP premiums, then they shouldn't get treatment.....but I'm exempted this year due to my adjusted income tax, just like everyone else. My difference is I lived 'out of Province' for more than 6 months and paid for my surgery. Surely that means less cost to MSP!!!

My friends told me if anyone on BC MSP has treatment in USA then some of that cost can be refunded, according to a formula...anyone know if this is true? I've searched but cannot find any info.
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Old Jul 24th 2016, 5:49 am
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Default Re: BC Medical Services Plan.

Originally Posted by Davita
Stinky said there was NO relevance between BC MSP and Revenue Canada. My post said the same as you have said...there IS a connection and some funding does source from taxes.

I agree that if someone has declined, or fails to pay MSP premiums, then they shouldn't get treatment.....but I'm exempted this year due to my adjusted income tax, just like everyone else. My difference is I lived 'out of Province' for more than 6 months and paid for my surgery. Surely that means less cost to MSP!!!

My friends told me if anyone on BC MSP has treatment in USA then some of that cost can be refunded, according to a formula...anyone know if this is true? I've searched but cannot find any info.
There is since 2013 leeway for people who take longer times out of BC- for holiday purposes This can be up to 7 months You dont say Davita how long you spend out of the country (it doesn't have just to be out of Province). This might apply - some patients of mine head South to their houses in Arizona. They are as far as I am aware paying premiums due to their financial circumstances.
I have also heard that one might be able to get reimbursed to some degree for expenses incurred out of the Province- there was a case of a Canadian skier who was badly injured in the US and got some reimbursement for her very expensive bills incurred during her treatment South of the border. I cant imagine that this however made much of a dent out of the eventual bills that she racked up. She was non resident there, she was there short-term. This reimbursement may not apply to medical expenses incurred in Bali. I think that they would look very carefully into your residence situation, looking at how long you live in Bali versus BC. I'm no expert though! If you spend more than 7 months out of BC then you would not be eligible for MSP care.
Out of interest, do they take into account your worldwide income rather than Canadian Income when determining if you need to pay MSP premiums?

Last edited by Stinkypup; Jul 24th 2016 at 5:59 am.
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Old Jul 24th 2016, 5:58 am
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Default Re: BC Medical Services Plan.

The connection between Revenue Canada is providing BC with statements as to the taxable income of the taxpayer.

Funding from Ottawa to the provinces is separate from Revenue Canada, it is government determined according to some sort of Transfer Payment Agreement. As I understand it, the Feds have some say in how at least part of the payments are spent, while the province can use other money.


Treatments in the US are "iffy" ............. I think you can only count on getting "some of the cost" refunded IF the BC Health Services have agreed to send you down to the US because a) the waiting list is too long, or b) you manage to persuade them that the treatment is only available in the US, and also manage to persuade them to send you. There are often fund raising events to raise money to send children or adults to the US for treatment that will not be funded by BC

It seems a very ad hoc situation, judged on each individual case

But note that only "some of the cost" is refunded or paid ................ and "some" is often a very miniscule part of the bill.

Don't forget how expensive treatments are in the US

I know of people who ended up with a huge bill because the mother was taken ill in the US, treated in hospital, and then they had to bring her home themselves. I think in the end the hospital bill was about $50,000 for 10 days, and they got back a couple of hundred from the BC government. They had long fights with insurance companies in an attempt to get more of the cost paid.


As I understand it, your BC medical coverage is cancelled if you are out of the country for longer than a certain period of months .............. Snowbirds have to judge exactly how long they are going to be away. And the cutting off seems NOT to depend on whether you are or are not above or below the income level for paying MSP premiums.

So, if you are in Bali for 6 months, your medical coverage would be cancelled because you have not lived in Canada for a full 6 months or more.
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Old Jul 24th 2016, 6:00 am
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Default Re: BC Medical Services Plan.

I note Stinkypup has just said "7 months" out of the country ....... my snowbird friends say 6 months. Maybe they are just playing safe!
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Old Jul 24th 2016, 6:03 am
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Default Re: BC Medical Services Plan.

Originally Posted by scilly
I note Stinkypup has just said "7 months" out of the country ....... my snowbird friends say 6 months. Maybe they are just playing safe!
From the Offical website

Residents

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.; and
must be physically present in B.C. at least six months in a calendar year, or a shorter prescribed period.*
*Note: Effective January 1, 2013, eligible B.C. residents (citizens of Canada or persons who are lawfully admitted to Canada for permanent residence) who are outside B.C. for vacation purposes only, are allowed a total absence of up to seven months in a calendar year.
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Old Jul 24th 2016, 6:46 am
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Default Re: BC Medical Services Plan.

Scilly...you said "Funding from Ottawa to the provinces is separate from Revenue Canada, it is government determined according to some sort of Transfer Payment Agreement."
That's interesting...how does Ottawa get the money to dole out to the Provincial Medical Services?

I think Stinky is correct..... it was extended to 7 months but I did receive a document asking if I was 'Out of Province" for more than 6 months. I replied in the affirmative but added that my wife and I had extended our time due to having an opportunity to house-sit for 10 months. They didn't reply so that's why I checked if my MSP card was current, fully expecting it to be cancelled, and was surprised it's still active.

Thanks to all for the info on re-imbursement.
I had my surgery and hospitalisation and oral chemo-therapy in Bali, which is considerably cheaper than USA or when I had surgery in Vancouver General (VGH) in 1990 ($5,000 for 1 night and fixing a broken bone), before I was eligible for MSP and when I still could claim from insurance.
I agree that any re-imbursement might be negligible but I could have returned to Vancouver and had surgery, treatment and chemo-therapy free or, at least, had some costs paid for by MSP.
I think I've saved other BC MSP premium payers considerable costs....just because I stayed in Bali for a longer vacation.
So buy me a beer...
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Old Jul 24th 2016, 2:58 pm
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Default Re: BC Medical Services Plan.

Originally Posted by Davita
I think Stinky is correct..... it was extended to 7 months but I did receive a document asking if I was 'Out of Province" for more than 6 months. I replied in the affirmative but added that my wife and I had extended our time due to having an opportunity to house-sit for 10 months. They didn't reply so that's why I checked if my MSP card was current, fully expecting it to be cancelled, and was surprised it's still active...
Not an expert but it seems to me that up to 7 months elsewhere is allowed every year if BC is still your home - or centre of interest as the UK calls it - and that the 10 months thing mentioned is okay because it was just a one off or someone turned a blind eye to it.

But I do wonder that maybe you don't return to BC every year and that your centre of interest is actually Bali and that you've just been lucky with the MSP card so far.

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Old Jul 24th 2016, 4:09 pm
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Default Re: BC Medical Services Plan.

If you have medical treatment abroad, and are eligible for coverage in BC, then MSP will reimburse up to the cost of of the equivalent treatment in BC. It is as useful as a chocolate fireguard in the US but for many other countries you could have the whole cost of treatment reimbursed.
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Old Jul 24th 2016, 5:46 pm
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Default Re: BC Medical Services Plan.

Originally Posted by JonboyE
If you have medical treatment abroad, and are eligible for coverage in BC, then MSP will reimburse up to the cost of of the equivalent treatment in BC. It is as useful as a chocolate fireguard in the US but for many other countries you could have the whole cost of treatment reimbursed.
I believe that is what my friends are saying. Does anyone have any references so I can read-up about that?

A 'chocolate fireguard'...that's funny...I'm melting with mirth...

Re: Stinky post # 8
'Out of interest, do they take into account your worldwide income rather than Canadian Income when determining if you need to pay MSP premiums?'

A few years ago I sold our holiday house in Scottsdale, AZ. I paid taxes on that capital gain (CGT) to the IRS then filed an adjusted T1 to Revenue Canada and paid tax to them, less what I'd paid in the States. That put my income higher that year and I had to repay MSP premiums as well as GST rebates I'd received.

Revenue Canada requires filing world-wide income. I include my UK Old Age Pension (OAP) so I reckon that must be income that is assessed for MSP.

Last edited by Davita; Jul 24th 2016 at 5:56 pm.
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