Denied basic health coverage

Authority Health Insurance BC - MSP, Ministry of Health
Details

Darci’s baby was due soon. An applicant for permanent residency status, she was having trouble getting the Medical Services Plan (MSP) coverage she needed. She and her partner, who was a resident of B.C., faced $20,000 in hospital bills. Concerned, Darci turned to the Office of the Ombudsperson for help. We investigated and found that Canadian citizens and persons with permanent resident status in Canada may be eligible to get health care benefits. In addition, spouses and children of B.C. residents both may be deemed residents for the purposes of health coverage if they have an active application for permanent residency and have paid their application fee. In the past, the ministry would consider an application “active” as soon as it was received by Citizenship and Immigration Canada, and CIC had sent an acknowledgement that the application fee had been paid. While the regulation remained unchanged, the ministry’s interpretation was that confirmation of receipt of the application was now not enough. The ministry wanted the application to first proceed to secondary screening at the federal agency. Due to a long federal backlog of applications, the processing time for applications exceeded 12 months. Noting that this unexplained policy change delayed access to MSP for Darci – and potentially many others – we consulted with the ministry to ensure its process was fair and consistent with the regulation. As a result of our investigation, the ministry agreed to change its policy for all people who have been sponsored to immigrate in the Spouse or Common-law Partner in Canada class. In addition, following proof of payment of the permanent residency status application fee, MSP coverage will now begin the first day of the month following completion of the standard wait period. The ministry also agreed to write to the spouses, like Darci, who were denied coverage, offering retroactive coverage based on a residency status beginning on the application fee payment date. Furthermore, accepting this retroactive coverage would be optional, since it would involve paying MSP premiums for that retroactive time period. 

Category Health
Type Case Summary
Fiscal Year 2017