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FACTSHEET Feb FACTSHEET Feb. 15, 2010 Ministry of Health Services FACTS ABOUT PUBLIC HEALTH CARE IN B.C. • B.C.’s Medical Services Plan (MSP) covers all residents of the Province for medically necessary health care, whether provided in a hospital, clinic or doctor’s office. • The Medical Services Plan provides the following medical benefits: o medically required services of a physician, or of a specialist (such as a surgeon, anesthetist or psychiatrist) when referred by a physician; o maternity care by a physician or by a specialist when referred by a physician; o diagnostic x-ray and laboratory services when ordered by a physician, podiatrist, dental surgeon or oral surgeon; o dental and oral surgery when medically required to be performed in a hospital. o A person who is covered by the Medical Services Plan automatically has hospital coverage. • MSP does not cover: o routine physical examinations performed for reasons other than medical necessity; o medical examinations, certificates or tests required for life insurance, a driver’s licence, school, immigration, employment, etc.; o the cost of ambulance/paramedic care; o cosmetic surgery for the alteration of appearance; o restorative or other dental work performed in a dental office; o eyeglasses, hearing aids, and other equipment or appliances; o the services of counselors or psychologists; o routine eye examinations for beneficiaries between the ages of 19 and 64; o chiropractic, physiotherapy, naturopathy, massage therapy and non-surgical podiatry services for a person not receiving premium assistance; o prescription drugs; however, the province does have a prescription drug plan called PharmaCare. • To qualify for MSP, a person must be a resident of British Columbia. • A resident is a person who meets all of the following conditions: o must be a citizen of Canada or be lawfully admitted to Canada for permanent residence; o must make his or her home in B.C.; o must be physically present in B.C. at least 6 months in a calendar year; and o dependents of MSP beneficiaries are eligible for coverage if they are residents of B.C. o Foreign college students may be eligible for coverage if they have study permits for six or more months and reside in B.C.; those with work permits may also be eligible, but only if the permit is valid for six or more months. • A wait period needs to be completed before coverage can begin. The wait period is the same for all new residents or persons returning to B.C.: 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. • MSP beneficiaries pay monthly premiums of $57 per person, $102 for a family of two or $114 for a family of three or more. Low-income families and others who cannot afford to pay for premiums may qualify for premium assistance, from 20 to 100 per cent of the monthly cost. • Non-residents are not covered by MSP. • For Canadian residents from other provinces, B.C. has a reciprocal billing agreement with each province and territory for hospital services. B.C. will bill the home province for any medically necessary services performed in a hospital. o For services provided by a physician outside a hospital, all provinces and territories except Quebec have reciprocal billing with B.C.; physicians are encouraged to bill any medically necessary services provided back to the home province. o For Quebec residents, B.C. does not have reciprocal billing with Quebec for doctor’s services outside a hospital. You will be required to pay the physician. • Before any services are provided to non-residents of Canada, payment is collected up- front at the hospital or by the physician whenever possible. If that’s not possible, such as when very ill patients are admitted through the emergency department, the patient is billed after the visit. If the person is insured privately, it would be his or her responsibility to seek repayment from their insurance company. Signs are posted in ERs across the province, explaining that people without MSP coverage will be charged. • Non-residents are encouraged to buy appropriate travel medical insurance before arriving in B.C. • In 2009/10, B.C.’s budget for the Ministry of Health Services is $14.09 billion; the province’s Medical Services Plan collects about $1.5 billion in premiums from residents each year. -30- Contact: Public Affairs Bureau Ministry of Health Services Media Line 250 952-1887 VCH Community Engagement Advisory Network What is the relationship between GPs and our BC health service structure? GPs: How are they paid? General Practitioners (e.g. family physicians) are paid by the Medical Services Commission, a public agency funded by the BC Government. The Medical Services Commission pays GPs under two categories: All GPs are independent, autonomous practitioners, and are represented by the BC Medical Association (BCMA). The BCMA represents the collective views of the medical profession, and they negotiate the fees to be paid, by the Medical Services Commission, to physicians and surgeons. 1) Approximately 80% of all GPs are paid on a fee-for-service basis by the BC Medical Services Plan (managed by the Medical Services Commission). 2) The remaining 20% of GPs are: o Doctors in rural areas: they receive baseline compensation plus fees-for-service o Doctors at community clinics run by the Health Authorities (paid by contract) o Doctors working in the public health system (paid by salary or contract) Who do GPs report to? Their practice is governed and regulated by the College of Physicians and Surgeons of BC, an independent regulatory body. GP Support and Education: What is the GP Services Committee? Established in 2004, the GPSC is a joint committee between the BC Ministry of Health and the BCMA, created to develop and implement strategies to support improvements in primary healthcare (for example, physician education, resources to support their practice, etc.). The GPSC has developed a Practice Support Program, collaborating with each health authority in BC to develop and conduct training modules for primary healthcare physicians. 1 VCH Community Engagement Advisory Network British Columbia’s Health Authorities Each health authority provides a broad range of health related services and programs. Please visit the appropriate websites below to learn more about the health authority you live in and how you can be involved. Vancouver Coastal Health Authority General: www.vch.ca Get involved: www.vch.ca/get-involved/ News and Events: http://www.vch.ca/about-us/news/news Island Health Authority General: www.viha.ca News and Events: http://www.viha.ca/about_viha/news/ Interior Health Authority General: www.interiorhealth.ca News and Events: https://www.interiorhealth.ca/AboutUs/MediaCentre/Pages/default.aspx Fraser Health Authority General: www.fraserhealth.ca News and Events: www.fraserhealth.ca/about_us/media_centre/ Northern Health Authority General: www.northernhealth.ca/ News and Events: https://www.northernhealth.ca/NewsEvents.aspx 1 VCH Community Engagement Advisory Network Providence Health Care Providence Health Care is a non-profit organization, providing services in partnership with Vancouver Coastal Health and the Provincial Health Services authority. General: www.providencehealthcare.org/ News and Events: http://www.providencehealthcare.org/about-providence/providence-news Provincial Health Services Authority Provides province-wide health care services, including the BC Cancer Agency, BC Centre for Disease Control, BC Children's Hospital, BC Mental Health and Addiction Services, BC Provincial Renal Agency, BC Transplant Society, BC Women's Hospital & Health Centre, and Cardiac Services BC. General: www.phsa.ca News and Events: www.phsa.ca/News/default.htm First Nations Health Authority This new health authority has taken over the administration of federal health programs and services previously delivered by Health Canada's First Nations Inuit Health Branch – Pacific Region, and to work with the province and First Nations to address service gaps through new partnerships, closer collaboration, and health systems innovation. General: http://www.fnha.ca/ News and Events: http://www.fnha.ca/about/news-and-events 2 British Columbia Health Authorities * Plus the First Nations Health Authority = 7 Health Authorities in BC .
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