Eligibility requirements for an adopted child

Authority Health Insurance BC – Medical Services Plan, Ministry of Health
Details

Lori is a B.C. resident and has two adopted children from the United States. She applied for coverage under the Medical Services Plan (MSP) for the two boys in February 2011. The application stated the children had been living in British Columbia for almost two years and included their adoption orders dated September 2010. However, Lori was told by Health Insurance BC (HIBC) that her children were not eligible for MSP until she provided evidence that they could remain in Canada under a visitor visa or evidence that she had applied for their permanent residency. Lori thought it was unfair that her children were being denied MSP coverage despite the fact that she was a resident of the province and that her children had been living in British Columbia for almost two years.

When we first spoke with the Ministry of Health, the ministry confirmed that Lori was required to provide proof of the children’s immigration status before they would process the application. We reviewed the relevant regulations and it appeared that an adopted child of a B.C. resident was “deemed” to be a resident as long as they made their home in British Columbia and were physically present in the province for at least six months of the year.

In the course of our investigation, HIBC approved MSP coverage for Lori’s children retroactive to February 2011, when she had first applied. However, its reasons for doing so seemed inconsistent with the regulations, which raised a concern about the ministry’s and HIBC’s general practice or policies in this area. Therefore, we continued consulting with ministry staff. After several meetings, the ministry agreed that an adopted child who makes their home in British Columbia and is physically present in the province for at least six months in a calendar year should not have to provide proof of citizenship or permanent residency. The ministry also confirmed that this shift in position was drawn to the attention of HIBC staff.

Since HIBC approved MSP coverage for Lori’s children and the ministry revised its practice of processing applications for adopted children to be consistent with the requirements under the regulations, we considered the complaint resolved and closed our file.

Category Health
Type Case Summary
Fiscal Year 2012
Location The Lower Mainland